Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Mar 7;7(1):11.
doi: 10.1186/s40634-020-00225-x.

Anteromedial positioning of the femoral tunnel in anterior cruciate ligament reconstruction is the best option to avoid revision: a single surgeon registry

Ricardo de Paula Leite Cury  1 , Artur Mistieri Simabukuro  1 , Victor de Marques Oliveira  1 , Diego Escudeiro  2 , Pedro Baches Jorge  1 , Fabrício Roberto Severino  1 , Luiz Gabriel Betoni Guglielmetti  1
Affiliations

Anteromedial positioning of the femoral tunnel in anterior cruciate ligament reconstruction is the best option to avoid revision: a single surgeon registry

Ricardo de Paula Leite Cury et al. J Exp Orthop. .

Erratum in

Abstract

Purpose: The aim of the study is to compare the risk of revision of single-bundle hamstring anterior cruciate ligament (ACL) reconstruction between the anteromedial, transtibial and outside-in techniques.

Methods: This cohort study was based on data from a single surgeon's registry. Patients who underwent primary single-bundle ACL reconstruction with hamstring tendon using the anteromedial portal, transtibial and outside-in technique, operated between 1 November 2003 to 31 December 2016, were eligible for inclusion. A minimum follow-up of 2 years was used, and the end-point of the study was revision surgery.

Results: The total number of registered surgeries identified was 665; 109 were excluded, and 556 was the final sample. The overall revision rate was 8.7%. The transtibial technique presented 14/154 [9.9%] of revisions, the transportal 11/96 [11.4%] and the outside-in 22/306 [7.2%]. Separating the outside-in group into central outside-in and anteromedial (AM) outside-in, 18/219 [8.2%] was found for the central outside-in and 4/87 [4.5%] for the AM outside-in technique. Statistical evaluation of the first comparison (transtibial vs. transportal vs. outside-in) obtained p = (n.s.) The second comparison (transtibial vs. central transportal vs. central outside-in vs. AM outside-in, p = (n.s). Placement was also evaluated: high anteromedial placement (transtibial) vs. central (transportal and central outside-in technique) vs. AM placement (AM outside-in). The high AM placement presented 14/154 [9.9%] of revision, the central placement 29/315 [9.2%] and the AM placement 4/87 [4.5%], p = (n.s.) The AM placement was also compared with the other placements (high and central AM), p = (n.s.) CONCLUSION: Based on the registry of a single surgeon during 14 years of ACL reconstruction, the placement of the femoral tunnel in the high anteromedial region was associated with a rupture rate of 9.9%, central placement with 9.2% and anteromedial placement with 4.5%.

Keywords: Anterior cruciate ligament; Anterior cruciate ligament injuries; Anterior cruciate ligament surgery; Knee injuries.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
Flow diagram of the study
See this image and copyright information in PMC

References

    1. Desai N, Andernord D, Sundemo A-GE, Musahl V, Fu FH, Forssblad M, Samuelsson K. Revision surgery in anterior cruciate ligament reconstruction: a cohort study of 17,682 patients from the Swedish National Knee Ligament Register. Knee Surg Sports Traumatol Arthrosc. 2017;25(5):1542–1554. doi: 10.1007/s00167-016-4399-0. - DOI - PMC - PubMed
    1. Alentorn-Geli E, Samitier G, Alvarez P, Steinbacher G, Cugat R (2010) Anteromedial portal versus transtibial drilling techniques in ACL reconstruction: a blinded cross-sectional study at two- to five-year follow-up. Int Orthop 34(5):747–754 - PMC - PubMed
    1. Forsythe B, Lansdown D, Zuke WA, Verma NN, Cole BJ, Bach BR, Jr, Inoue N. Dynamic 3-dimensional mapping of isometric anterior cruciate ligament attachment sites on the tibia and femur: is anatomic also isometric? Arthroscopy. 2018;34(8):2466–2475. doi: 10.1016/j.arthro.2018.03.033. - DOI - PubMed
    1. Emond CE, Woelber EB, Kurd SK, Ciccotti MG, Cohen SB. A comparison of the results of anterior cruciate ligament reconstruction using bioabsorbable versus metal interference screws: a meta-analysis. J Bone Joint Surg Am. 2011;93(6):572–580. doi: 10.2106/JBJS.J.00269. - DOI - PubMed
    1. Clatworthy M, Sauer S, Roberts T. Transportal central femoral tunnel placement has a significantly higher revision rate than transtibial AM femoral tunnel placement in hamstring ACL reconstruction. Knee Surgery, Sports Traumatol Arthrosc. 2019;27(1):124–129. doi: 10.1007/s00167-018-5036-x. - DOI - PubMed

LinkOut - more resources