Functional outcome of transtibial VS transportal drilling techniques in anterior cruciate ligament reconstruction

Abstract

Background: Anterior Cruciate ligament injuries are one of the most common injuries of the knee. The choice of the optimal surgical method in ACL reconstruction is still unclear. A frequent cause for failure after ACL reconstruction has been the incorrect placement of bone tunnels, especially on the femoral side. The most commonly employed trans-tibial technique has been reported not to provide anatomical placement of femoral tunnel and result in rotational instability. Cadaveric and radiographic studies have confirmed that drilling the femoral tunnel through anteromedial portal allows a more anatomical placement of the tunnel and higher rotational stability. However clinical results of trans-tibial and anteromedial portal techniques are still comparable. Objective: To study the functional outcome in transtibial vs transportal drilling techniques in ACL reconstruction. Materials and Methods: This is a prospective follow up study of functional outcome in 40 patients who underwent ACL reconstruction by either transtibial or transportal technique. Patients were followed up for at least 24 months and assessed using Lysholm and IKDC scale. Statistical Analysis of the data was done by Mann-Whitney test and chi square test. Results: In the present study the Trans-portal group of patients showed a marginally better functional outcome with respect to the Lysholm and IKDC scores; however the statistical significance was lacking. Conclusion: There isn’t enough clinical evidence to warrant giving up on transtibial technique which is time tested and simpler.