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Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy 2/2019

10.10.2018 | KNEE

Femoral tunnel widening is similar between anteromedial portal and transtibial techniques following single-bundle anterior cruciate ligament reconstruction: a systematic review and meta-analysis

verfasst von: Ho Jong Ra, Haluk Celik, Hyun-Jun Kim, Dae-Hee Lee

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 2/2019

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Abstract

Purpose

In anterior cruciate ligament (ACL) reconstruction, there is concern regarding the potential risk of femoral tunnel widening in the anteromedial portal (AMP) technique due to the acute graft-bending angle at the aperture and the more elliptical aperture shape of the femoral tunnel compared to the transtibial (TT) techniques. Therefore, the aim of the current systematic review and meta-analysis was to compare the femoral tunnel widening between the AMP and TT techniques in patients who underwent ACL reconstruction.

Methods

It should be included the studies that reported on femoral tunnel widening in patients who underwent single-bundle ACL reconstruction, using soft-tissue tendon graft, with AMP and/or TT techniques. Two reviewers independently recorded data from each study, including the sample size and magnitude of tunnel widening after ACL reconstruction.

Results

Twenty-one studies were finally included in this meta-analysis. The pooled changes of absolute millimeters of tunnel widening from the immediate postoperative status to the last follow-up did not differ significantly between the AMP and TT techniques at both the aperture [3.31 mm, 95% confidence interval (CI) 1.7–5.0. mm versus 2.9 mm, 95% CI 2.4–3.4 mm, P = n.s.] and the midportion (3.5 mm, 95% CI 0.8–6.3 mm versus 3.0 mm, 95% CI 2.2–3.9 mm, P = n.s.) of the femoral tunnel. No significant difference was observed between the two techniques in the relative percentage of femoral tunnel widening (AMP; 28.8%, 95% CI 14.8–42.9% vs. TT; 29.7%, 95% CI 15.6–43.7%, P = n.s.).

Conclusion

No significant difference in femoral tunnel widening was observed between the AMP and TT techniques, both in absolute millimeter and relative percentage, in patients who underwent single-bundle ACL reconstruction. This finding could alleviate the potential concerns associated with femoral tunnels being wider for the AMP than for the TT technique.

Level of evidence

III.
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Metadaten
Titel
Femoral tunnel widening is similar between anteromedial portal and transtibial techniques following single-bundle anterior cruciate ligament reconstruction: a systematic review and meta-analysis
verfasst von
Ho Jong Ra
Haluk Celik
Hyun-Jun Kim
Dae-Hee Lee
Publikationsdatum
10.10.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 2/2019
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-018-5204-z

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