Transtibial Versus Anteromedial Femoral Tunnel Technique in ACL Reconstruction

Prospective Randomized Clinical Study Comparing Anteromedial Portal Versus Transtibial Technique for Femoral Tunnel Positioning in Anterior Cruciate Ligament Reconstruction With Hamstring Autograft

The anteromedial (AM) portal technique was introduced to position the femoral tunnel in anterior cruciate ligament (ACL) reconstruction to more closely replicate the original footprint compared to the transtibial (TT) approach.1-5 Few randomized trials have evaluated differences in these techniques with respect to clinical outcomes. The purpose of this study was to determine if there are any differences in clinical outcome between the AM and TT approaches.

The anteromedial (AM) portal technique was introduced to position the femoral tunnel in anterior cruciate ligament (ACL) reconstruction to more closely replicate the original footprint compared to the transtibial (TT) approach.1-5 Few randomized trials have evaluated differences in these techniques with respect to clinical outcomes. The purpose of this study was to determine if there are any differences in clinical outcome between the AM and TT approaches.

Inclusion Criteria:

• sustained a complete ACL tear and had no other ligament injuries requiring surgical intervention

Exclusion Criteria:

• concomitant collateral ligament tears
• significant chondromalacia (based on diagnostic imaging)
• previous lower limb surgery
• significant injury to either lower limb requiring surgery
• history of arthritis
• were unable to comply with rehabilitation protocols or study follow-ups
• were pregnant females or had other medical conditions which precluded participation.