CC2022: Higher Incidence of Radiographic Posttraumatic Osteoarthritis With Transtibial Femoral Tunnel Positioning Compared With Anteromedial Femoral Tunnel Positioning During Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis (January 2022)-CC2022: Higher Incidence of Radiographic Posttraumatic Osteoarthritis With Transtibial Femoral Tunnel Positioning Compared With Anteromedial Femoral Tunnel Positioning During Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis (January 2022)

CC2022: Higher Incidence of Radiographic Posttraumatic Osteoarthritis With Transtibial Femoral Tunnel Positioning Compared With Anteromedial Femoral Tunnel Positioning During Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis (January 2022)

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Pdf Summary

A systematic review and meta-analysis was conducted to evaluate the influence of femoral tunnel positioning during primary anterior cruciate ligament reconstruction (ACLR) on the development of radiographic posttraumatic osteoarthritis (PTOA). The study included 16 studies with a total of 1,546 patients. The mean follow-up across all studies was 10.9 years. The results showed that transtibial (TT) ACLR was associated with higher overall rates of radiographic PTOA compared to the anteromedial (AM) approach. The weighted mean proportion of PTOA after TT ACLR was 49.3%, compared to 25.4% after AM ACLR. Subgroup analysis by follow-up time showed that TT ACLR had significantly higher rates of PTOA compared to AM ACLR at 5-10 year follow-up (53.7% vs 14.2%) and greater than 10-year follow-up (45.6% vs 31.2%). These findings suggest that anatomic placement of the ACL femoral tunnel with the AM approach may reduce the risk of PTOA development compared to the TT approach. The study concluded that TT ACLR was associated with higher rates of radiographic PTOA compared to the AM ACLR approach, and these differences were observed at both midterm and long-term follow-up.

Keywords

systematic review

meta-analysis

femoral tunnel positioning

anterior cruciate ligament reconstruction

radiographic posttraumatic osteoarthritis

transtibial ACLR

anteromedial ACLR

follow-up time

anatomic placement

risk of PTOA development