Arthroscopic Anterior Cruciate Ligament Reconstruction: A Comparative Clinical Outcome between Transtibial and Anteromedial Portal Techniques in Femoral Tunnelling

Introduction: ACL reconstruction has evolved as gold standard for ACL injuries. However, anatomic reconstruction of ACL is of utmost importance to have best outcomes. Newly reconstructed ACL should control the anterior translation as well as internal rotation, for which appropriate anatomical femoral tunnel placement is of absolute necessity. There are two methods of securing femoral tunnel. Anteromedial portal technique and transtibial technique. The study aims to compare the outcomes using both these methods. Materials and Methods: Patients with clinically diagnosed and radiologically diagnosed ACL tears are recruited in the study and divided into two groups, viz, transtibial group (TT group) and Anteromedial portal group (AMP group). After surgery, the outcomes are compared clinically and subjective scores are compared. Results: The mean age of the participants is 31.5years. There is male preponderance in both the groups and right side is more commonly affected. IKDC scores are better in the AMP group compared to TT group. However, Lysholm scores are better in the later. Clinical outcome with respect to pivot shift test is better in AMP group compared to TT group. Conclusion: AMP technique provides more anatomical femoral tunnel placement compared to TT technique with respect to clinical outcomes. But care should be taken about posterior femoral cortex blow out.