CC2023: Transtibial Versus Anteromedial Portal Technique for Femoral Tunnel Drilling in Primary Single-Bundle Anterior Cruciate Ligament Reconstruction: A Meta-analysis of Level 1 and 2 Evidence of Clinical, Revision, and Radiological Outcomes (January 2023)-Transtibial Versus Anteromedial Portal Technique for Femoral Tunnel Drilling in Primary Single-Bundle Anterior Cruciate Ligament Reconstruction: A Meta-analysis of Level 1 and 2 Evidence of Clinical, Revision, and Radiological Outcomes

Transtibial Versus Anteromedial Portal Technique for Femoral Tunnel Drilling in Primary Single-Bundle Anterior Cruciate Ligament Reconstruction: A Meta-analysis of Level 1 and 2 Evidence of Clinical, Revision, and Radiological Outcomes

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This meta-analysis compared the transtibial (TT) and anteromedial portal (AMP) techniques for femoral tunnel drilling in primary single-bundle anterior cruciate ligament (ACL) reconstruction. The study included 18 clinical studies involving 53,888 patients. The results showed that the AMP technique led to better knee stability, as evidenced by a lower side-to-side difference in anterior translation of the tibia, a lower incidence of positive pivot shift, and a higher postoperative Lysholm score compared to the TT technique. However, there were no statistically significant differences between the two techniques in terms of subjective International Knee Documentation Committee scores, activity level, and incidence of revision ACL reconstruction. The AMP technique was found to create a more anatomically positioned femoral tunnel, with a shorter and more oblique tunnel compared to the TT technique. The incidence of revision ACL reconstruction did not differ between the two techniques. Overall, the findings suggest that the AMP technique may offer better knee stability and improved clinical outcomes compared to the TT technique, but more research is needed to fully evaluate the long-term effects and clinical significance of the differences between the two techniques.

Keywords

meta-analysis

transtibial technique

anteromedial portal technique

femoral tunnel drilling

knee stability

anterior translation

pivot shift

Lysholm score

ACL reconstruction

anatomically positioned tunnel