Riccardo Maria Lanzetti1, Domenico Lupariello2, Angelo De Carli1, Edoardo Monaco1, Matteo Guzzini1, Mattia Fabbri1, Antonio Vadalà1, Andrea Ferretti1. 1. Orthopaedic Unit and "Kirk Kilgour" Sports Injury Centre, S. Andrea Hospital, University of Rome "La Sapienza", Via di Grottarossa 1035, 00189, Rome, RM, Italy. 2. Orthopaedic Unit and "Kirk Kilgour" Sports Injury Centre, S. Andrea Hospital, University of Rome "La Sapienza", Via di Grottarossa 1035, 00189, Rome, RM, Italy. domenico.lupariello@gmail.com.
Abstract
BACKGROUND: There are different techniques for drilling the femoral tunnel in the anterior cruciate ligament reconstruction (ACLR), but their influence in the bone tunnel enlargement in unknown. The purpose of this study was to compare two different surgical techniques for evaluating femoral tunnel enlargement in ACLR. The hypothesis was that tunnel placement using the outside-in technique leads to less tunnel enlargement compared to the transtibial technique. METHODS: Forty-four patients treated for ACLR between March 2013 and March 2014 were prospectively enrolled in this study. According to the surgical technique, subjects were assigned to Group A (Out-in) or Group B (Transtibial). All patients underwent CT examination in order to evaluate the femoral tunnel enlargement at four different levels. Moreover, all patients were evaluated with the Lachman test and pivot shift test, and the KT1000 arthrometer was used to measure the anterior laxity of the knee. A subjective evaluation was performed using the 2000 International Knee Documentation Committee Subjective Knee score, Lysholm knee score and Tegner activity scale. All patients were assessed after 24 months of follow-up. RESULTS: At the final follow-up, there were statistically significant differences (p < 0.05) in femoral tunnel enlargement between the two groups at all four femoral levels in favor of the out-in group. No statistical significant differences were found in the objective and subjective clinical outcomes between the two groups (p > 0.05). CONCLUSIONS: In ACLR with a suspension system, the outside-in technique leads to less enlargement of the femoral tunnel lower than the transtibial technique.
BACKGROUND: There are different techniques for drilling the femoral tunnel in the anterior cruciate ligament reconstruction (ACLR), but their influence in the bone tunnel enlargement in unknown. The purpose of this study was to compare two different surgical techniques for evaluating femoral tunnel enlargement in ACLR. The hypothesis was that tunnel placement using the outside-in technique leads to less tunnel enlargement compared to the transtibial technique. METHODS: Forty-four patients treated for ACLR between March 2013 and March 2014 were prospectively enrolled in this study. According to the surgical technique, subjects were assigned to Group A (Out-in) or Group B (Transtibial). All patients underwent CT examination in order to evaluate the femoral tunnel enlargement at four different levels. Moreover, all patients were evaluated with the Lachman test and pivot shift test, and the KT1000 arthrometer was used to measure the anterior laxity of the knee. A subjective evaluation was performed using the 2000 International Knee Documentation Committee Subjective Knee score, Lysholm knee score and Tegner activity scale. All patients were assessed after 24 months of follow-up. RESULTS: At the final follow-up, there were statistically significant differences (p < 0.05) in femoral tunnel enlargement between the two groups at all four femoral levels in favor of the out-in group. No statistical significant differences were found in the objective and subjective clinical outcomes between the two groups (p > 0.05). CONCLUSIONS: In ACLR with a suspension system, the outside-in technique leads to less enlargement of the femoral tunnel lower than the transtibial technique.
Authors: C Benjamin Ma; Kimberly Francis; Jeffrey Towers; Jay Irrgang; Freddie H Fu; Christopher H Harner Journal: Arthroscopy Date: 2004-02 Impact factor: 4.772
Authors: Tone Gifstad; Olav A Foss; Lars Engebretsen; Martin Lind; Magnus Forssblad; Grethe Albrektsen; Jon Olav Drogset Journal: Am J Sports Med Date: 2014-09-08 Impact factor: 6.202