TY - JOUR
T1 - Comparison of femoral tunnel length and obliquity between transtibial, anteromedial portal, and outside-in surgical techniques in single-bundle anterior cruciate ligament reconstruction
T2 - A meta-analysis
AU - Lee, Dae Hee
AU - Kim, Hyun Jung
AU - Ahn, Hyeong Sik
AU - Bin, Seong Il
N1 - Publisher Copyright:
© 2016 Arthroscopy Association of North America.
PY - 2016
Y1 - 2016
N2 - Purpose It is unclear whether femoral tunnel length and obliquity differ after transtibial and independent femoral drilling techniques of anterior cruciate ligament (ACL) reconstruction. This meta-analysis therefore compared femoral tunnel length and obliquity in patients who underwent ACL reconstruction by the transtibial, anteromedial (AM) portal, and outside-in (OI) techniques. Methods In accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, all studies comparing femoral tunnel length and obliquity with various measurement tools - from direct measurement to imaging methods such as plain radiography, computed tomography, or magnetic resonance imaging - in patients who underwent reconstruction by the transtibial or independent femoral drilling (AM portal or OI) techniques were included. Results Fourteen studies were included in the meta-analysis. The femoral tunnel length was 7.8 to 11.0 mm longer (P <.05) and coronal obliquity was 7.5° to 29.1° more vertical (P <.05) with the transtibial technique than with the AM portal or OI technique. Femoral tunnel and graft obliquity in the sagittal plane, however, did not differ significantly (P >.05). Conclusions ACL reconstruction using the AM portal and OI femoral drilling techniques resulted in a shorter length and greater coronal obliquity of the femoral tunnel than did the transtibial technique. However, these 3 femoral drilling techniques resulted in similar obliquities of the femoral tunnel and graft in the sagittal plane. Level of Evidence Level III, meta-analysis.
AB - Purpose It is unclear whether femoral tunnel length and obliquity differ after transtibial and independent femoral drilling techniques of anterior cruciate ligament (ACL) reconstruction. This meta-analysis therefore compared femoral tunnel length and obliquity in patients who underwent ACL reconstruction by the transtibial, anteromedial (AM) portal, and outside-in (OI) techniques. Methods In accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, all studies comparing femoral tunnel length and obliquity with various measurement tools - from direct measurement to imaging methods such as plain radiography, computed tomography, or magnetic resonance imaging - in patients who underwent reconstruction by the transtibial or independent femoral drilling (AM portal or OI) techniques were included. Results Fourteen studies were included in the meta-analysis. The femoral tunnel length was 7.8 to 11.0 mm longer (P <.05) and coronal obliquity was 7.5° to 29.1° more vertical (P <.05) with the transtibial technique than with the AM portal or OI technique. Femoral tunnel and graft obliquity in the sagittal plane, however, did not differ significantly (P >.05). Conclusions ACL reconstruction using the AM portal and OI femoral drilling techniques resulted in a shorter length and greater coronal obliquity of the femoral tunnel than did the transtibial technique. However, these 3 femoral drilling techniques resulted in similar obliquities of the femoral tunnel and graft in the sagittal plane. Level of Evidence Level III, meta-analysis.
UR - http://www.scopus.com/inward/record.url?scp=84961894396&partnerID=8YFLogxK
U2 - 10.1016/j.arthro.2015.07.026
DO - 10.1016/j.arthro.2015.07.026
M3 - Article
C2 - 26422705
AN - SCOPUS:84961894396
SN - 0749-8063
VL - 32
SP - 142
EP - 150
JO - Arthroscopy - Journal of Arthroscopic and Related Surgery
JF - Arthroscopy - Journal of Arthroscopic and Related Surgery
IS - 1
ER -