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Year : 2015  |  Volume : 15  |  Issue : 2  |  Page : 181-186

Radiographic (magnetic resonance) evaluation of the anteromedial versus the transtibial technique in anterior cruciate ligament reconstruction

Department of Surgery, Division of Orthopedic, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia

Correspondence Address:
Mohammed Al Sobeai
King Saud bin Abdulaziz University for Health Sciences, Riyadh
Saudi Arabia
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1319-6308.156368

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Purpose: Making the femoral tunnel through the anteromedial (AM) portal is believed to allow an unconstrained position compared with the traditional transtibial (TT) tunnel. Our aim was to compare the AM and TT portals during anterior cruciate ligament (ACL) reconstruction using magnetic resonance imaging (MRI) to identify the three-dimensional (3D) position of the ACL and compare it to the normal ACL. Materials and Methods: The literature was reviewed to identify the angles used for comparison. A case-control study was conducted with AM, TT and control groups. MRI was used to measure the sagittal ACL angle (angle A), the Blumensaat angle (angle B), and the coronal ACL angle (angle C) in the three groups. Results: The sum of squares and mean squares of the angles were used. A comparison of the AM and control groups (A vs. C) showed a P value of 0.417, whereas the P value for the control and TT groups (C vs. T) was 0.001. The P values for the two comparisons with angle C were significant (P = 0.0007 and < 0.0001). The P values for the third angle (angle B) were not significant (P = 0.047 and 0.086, respectively). Conclusion: The 3D position of the ACL for the AM group was closer to that of the control group compared to that of the TT group. Thus, the AM technique was superior to the TT technique in terms of restoring normal anatomy. So, reconstruction of ACL using the AM technique is expected to give better functional result than the TT technique.

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