In–out versus out–in technique for ACL reconstruction: a prospective clinical and radiological comparison

Journal of Orthopaedics and Traumatology

Andrea Ferretti¹  Edoardo Monaco¹  Mattia Fabbri¹  Andrea Redler¹  Jacopo Conteduca¹  Giuseppe Argento¹  Raffaele Iorio¹ 

[1] Orthopaedic Department and “Kirk Kilgour” Sports Injury Center, Sant’ Andrea Hospital, “La Sapienza”, University of Rome;

关键词: ACL;    Femoral tunnel;    Transtibial;    Out–in technique;   

DOI  :  10.1007/s10195-017-0458-7

来源: DOAJ

【 摘 要 】

Abstract Background Several studies have recently shown better restoration of normal knee kinematics and improvement of rotator knee stability after reconstruction with higher femoral tunnel obliquity. The aim of this study is to evaluate tunnel obliquity, length, and posterior wall blowout in single-bundle anterior cruciate ligament (ACL) reconstruction, comparing the transtibial (TT) technique and the out–in (OI) technique. Materials and methods Forty consecutive patients operated on for ACL reconstruction with hamstrings were randomly divided into two groups: group A underwent a TT technique, while group B underwent an OI technique. At mean follow-up of 10 months, clinical results and obliquity, length, and posterior wall blowout of femoral tunnels in sagittal and coronal planes using computed tomography (CT) scan were assessed. Results In sagittal plane, femoral tunnel obliquity was 38.6 ± 10.2° in group A and 36.6 ± 11.8° in group B (p = 0.63). In coronal plane, femoral tunnel obliquity was 57.8 ± 5.8° in group A and 35.8 ± 8.2° in group B (p = 0.009). Mean tunnel length was 40.3 ± 1.2 mm in group A and 32.9 ± 2.3 mm in group B (p = 0.01). No cases of posterior wall compromise were observed in any patient of either group. Clinical results were not significantly different between the two groups. Conclusions The OI technique provides greater obliquity of the femoral tunnel in coronal plane, along with satisfactory length of the tunnel and lack of posterior wall compromise. Level of evidence II, prospective study.

【 授权许可】

Unknown