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Indian Journal of Orthopaedics Surgery


A comparative study of the clinical and functional outcome of anterior cruciate ligament reconstruction using transportal and transtibial approach for femoral tunnel drilling


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Author Details: Apoorva Vijaysinh Dodia, Aparna V. Dodia, Purvi A. Dodia

Volume : 3

Issue : 2

Online ISSN : 2395-1362

Print ISSN : 2395-1354

Article First Page : 143

Article End Page : 146


Abstract

 

Background: Traditionally there are two ways to drill a femoral tunnel – Transtibial method where the drilling is done through the already made tibial tunnel and Transportal method where the drilling is done through anteromedial portal or accessory anteromedial portal. Both the methods have their own set of advantages and disadvantages.
Aims: Aim of this study is to compare the functional and clinical outcomes of arthroscopic ACL reconsturction using transportal versus transtibial approaches for femoral tunnel drilling.
Materials and Methods: All patients operated with arthroscopic ACL reconstruction were screened using the inclusion and exclusion criteria, informed consent was taken and the willing patients were included. Patients were selected for either study group (transportal and transtibial groups) both prospectively and retrospectively from data dating back to 2010. 87 patients were included in the transportal group (group I) and 75 patients in the transtibial group (group II). Protocol was approved by Institutional review board. They were then evaluated using 5 different evaluation systems i.e. IKDC, Lysholm, Lower Extremity Activity Score (LEAS), Tegner and pain VAS at 3 months, 6 months and 1 year post surgery.
Results and Conclusions:
In our series, Statistical analysis shows that:

·          There was significant difference in functional outcome on comparing the IKDC knee score of Group I and Group II at 1 year.

·          There was significant difference in functional outcome on comparing the Lysholm knee score of Group I and Group II at 1 year.

·          There was no significant difference in functional outcome on comparing the LEAS score of Group I and Group II at 1 year.

·          There was significant difference in functional outcome on comparing the Tegner's score of Group I and Group II at 1 year.

·          There was significant difference in functional outcome on comparing the Pain on VAS of Group I and Group II at 1 year.

·          There was significant difference in the Physical Component Survey but not in the Mental Component Survey on comparing all 10 criteria of the SF-36 score of Group I and Group II at 1 year.

·          There was no significant difference in functional outcome on comparing the average knee ROM of Group I and Group II at 1 year.

·          The Percentage of cases who had a Lachman's test positive 1 year post­operatively was higher in Group II than Group I.

Keywords: Arthroscopic ACL reconstruction, Transportal femoral drilling, Transtibial femoral drilling, IKDC knee score, Lysholm knee score, LEAS score, Tegner’s score, SF-36 score

Doi No:-10.18231