A 3DCT scan based assessment of femoral tunnel placement in arthroscopic ACL reconstruction by modified transtibial and anteromedial portal technique and its relation with the functional outcome: A retrospective comparative study

BackgroundThe purpose of the study was to evaluate the accuracy of placement of femoral tunnels in an anatomical position with Modified Transtibial (TT) and Anteromedial portal (AMP) techniques during single bundle arthroscopic ACL reconstruction and the effect of the tunnel placement on functional outcome in young soldiers.Materials and methodsA total of 92 patients operated for ACL tear between 01 Aug, 2012 and 31 Aug, 2014 were selected for the study of which 49 belonged to the TT and 43 belonged to the AMP group. They were subjected to a single 3DCT scan of knee to assess the femoral tunnel midpoint by quadrant method as described by Bernard and Hertel. These patients were also assessed subjectively for the functional outcomes using Lysholm, Tegner and IKDC scores.ResultsNo statistical difference was noted in the femoral tunnel position or in the functional scores (Lysholm, Tegner and IKDC scores) between the groups. Our results showed that 61.22% of patients in TT group and 62.79% patients of AMP group could go back to the preinjury level of activity based on Tegner scores which is consistent with results in contemporary literature.ConclusionBoth the modified TT and AMP techniques are capable of placing the femoral tunnel in a near anatomic position and also of producing comparable clinical results. With none of the techniques producing significantly superior results, it is up to the surgeon to choose from one of the techniques to produce consistent results.