Comparison of anatomic femoral tunnel and transtibial tunnel technique in arthroscopic anterior cruciate ligament reconstruction

Comparison of Anatomic Femoral Tunnel and Transtibial Tunnel Technique in Arthroscopic Anterior Cruciate Ligament Reconstruction We performed anterior cruciate ligament reconstruction using autogenous hamstring tendons arthroscopically in 40 patients with transtibial tunnel technique and 43 patients with anatomic femoral tunnel technique between January 1, 2013 and November 15, 2016 in Atatürk University Medical Faculty Orthopedics and Traumatology Clinic. Lachman and pivot shift tests were evaluated in physical evaluation preoperatively. Radiologically, X-ray and MRI were asked. We assessed the patients using Tegner, Lysholm and IKDC functional scoring systems preoperatively and postoperatively. 95.2% (n : 79) male and 4.8% (n = 4) female patients were included in the study. The mean age of the patients was 30.4. Fifty (59.5%) patients were affected by right knee and 33 (40.5%) by left knee. We observed our patients for an average of 18.9 months. Tegner, Lysholm and IKDC scores were similar in both patients with anatomic femoral tunnel technique and patients with transtibial tunnel technique. When compared with preoperative stage, patients with anatomic femoral tunnel technique showed significant improvement compared to transtibial tunnel technique in anterior drawer and Lachman test. There was no significant difference in pivot shift test between both techniques. The anatomic femoral tunnel technique showed significant anterior-posterior and rotational stabilization increase compared to the preoperative rotation. As a result, the duration of rehabilitation of patients with AMP technique was short and turnover times to sports were decreased. It is possible to say that anatomic femoral tunnel (anteromedial portal) technique is superior to patient satisfaction and the rate of return to preoperative activity level despite the possibility of technical difficulty and revision risk. Keywords: Anterior Cruciate Ligament, Anatomic Femoral Tunnel, Transtibial Tunnel, Artroskopic Repair, Hamstring