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Transportal Anatomic Anterior Reconstruction Results in Better Stability Than Conventional Transtibial Anterior Cruciate Reconstruction: A Brazilian Clinical Study


Guilherme Moreira Abreu E Silva, MD PhD
BRAZIL

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Transportal Anatomic Anterior Reconstruction Results in Better Stability Than Conventional Transtibial Anterior Cruciate Reconstruction: A Brazilian Clinical Study

Guilherme Moreira Abreu E Silva, MD PhD, BRAZIL Marco Antonio Percope De Andrade, MD, PhD, BRAZIL

Minas Gerais Federal University, Belo Horizonte, Minas Gerais , BRAZIL

2013 Congress   Paper Abstract   2013 Congress   Not yet rated

 

Anatomic Location

Knee

Anatomic Structure

Ligaments

Diagnosis / Condition

Instability

Diagnosis Method

CT-Scan

Sports Medicine

Basic Science Practice Management

Treatment / Technique

Single Bundle

Ligaments

ACL

Summary: AMP technique reestablished better articular stability function than TT technique. Less extension deficit was more related with transtibial group.

Background

The traditional transtibial (TT) technique, usually leads to excellent and good results in more than 90% of patients. However, in the last years, biomechanics and anatomic studies had brought into question its ability to restore knee’s homeostasis. The anatomic reconstruction concept was developed, as well the transportal (AMP) approach for femoral tunnel creation, placing the graft in a more anatomic position.

Purpose

The objective of this study is to evaluate clinical results in patients with anterior cruciate ligament reconstruction with transtibial or transportal technique, in the last five years.

Methods

Seventy one knees undergone to anterior cruciate reconstruction (thirty by the TT technique and forty one by the AMP technique) were followed-up in the last years, in terms of functional scores (subjective IKDC form and Lysholm score), stability – (quantitative pivot-shift, anterior drawer test, Lachman test), KT-1000-MEDmetrics® arthrometer and global articular function (extension and flexion deficit, thigh circumference and monopodalic hop test performance.

Results

AMP technique showed better results in terms of stability tests than TT technique (TT versus AMP: positive pivot-shift: 60% vrs 14,6%, p = 0,00; positive anterior drawer test: 53,3% vrs 17,1%, p=0,002; positive Lachman test: 20% vrs 2,4%, p = 0,037; KT-1000 arthrometer side-to-side difference 2 mm vrs 0,5 mm, p =0,002). Extension deficit was higher in transtibial group (2,5 degrees versus 0,98 degrees, p = 0,013).

Conclusions

In this series, AMP technique reestablished better articular stability function than TT technique. Less extension deficit was more related with transtibial group.
Keywords: ACL, cruciate, reconstruction, single bundle.