Introduction
Materials and methods
Use of an acc. medial portal | Visualization of the femoral ACL insertion site | Visualization of the tibial ACL insertion site | Lateral intercondylar ridge identified | Bifurcate ridge identified | Placing the femoral tunnel(s) in the femoral ACL insertion site | Placing the tibial tunnel(s) in the tibial ACL insertion site | Transportal drilling of the femoral ACL tunnel(s) | |
---|---|---|---|---|---|---|---|---|
Group | ||||||||
TP-reference | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes |
TP-anatomic | Yes | Yes | Yes | |||||
TT-anatomic | Yes | Yes | No | |||||
TT-partial anatomic | No | Yes | No | |||||
TT-non-anatomic | No | No | No | |||||
All landmarks | Yes | Yes | Yes | Yes | ||||
No landmarks | No | No | No | No | ||||
TP drilling | Yes | |||||||
TT-drilling | No |
Statistical analysis
Results
Cohort (n = 17,682) | ||
---|---|---|
% |
N
| |
Patient sex | ||
Male | 56.6 | 10,013 |
Female | 43.4 | 7669 |
Age at index ACL reconstruction | ||
13–15 years | 7.4 | 1300 |
16–20 years | 28.7 | 5075 |
21–25 years | 20.7 | 3667 |
26–30 years | 14.2 | 2513 |
31–35 years | 10.0 | 1777 |
36–49 years | 18.9 | 3350 |
Concomitant MCL injury at index surgery | ||
Yes | 2.4 | 425 |
No | 97.6 | 17,257 |
Concomitant LCL injury at index surgery | ||
Yes | 0.6 | 100 |
No | 99.4 | 17,582 |
Meniscus injury present (medial and/or lateral) at index surgery | ||
Yes | 43.8 | 7743 |
No | 56.2 | 9939 |
Cartilage injury present at index surgery | ||
Yes | 26.0 | 4598 |
No | 74.0 | 13,084 |
Meniscus and/or cartilage injury at index surgery | ||
Yes | 54.8 | 9685 |
No | 45.2 | 7997 |
Revision cohort (n = 552) | |||||
---|---|---|---|---|---|
% |
N
| Hazard rate | 95% CI |
P value | |
Patient sex | |||||
Malea
| 53.6 | 296 | 1.128 | 0.954–1.333 | n.s. |
Female | 46.4 | 256 | |||
Age at index ACL reconstruction | |||||
13–15 years | 13.4 | 74 | 5.259 | 3.532–7.833 | <0.001 |
16–20 years | 45.7 | 252 | 4.675 | 3.297–6.628 | <0.001 |
21–25 years | 21.2 | 117 | 3.131 | 2.155–4.548 | <0.001 |
26–30 years | 7.8 | 43 | 1.590 | 1.021–2.476 | 0.040 |
31–35 years | 5.4 | 30 | 1.527 | 0.941–2.479 | n.s. |
36–49 yearsa
| 6.5 | 36 | |||
Meniscus injury present (medial and/or lateral) at index surgery | |||||
Yes | 43.1 | 238 | 0.994 | 0.840–1.176 | n.s. |
Noa
| 56.9 | 314 | |||
Cartilage injury present at index surgery | |||||
Yes | 21.2 | 117 | 0.720 | 0.587–0.883 | 0.002 |
Noa
| 78.8 | 435 |
Patient sex
Patient age
Meniscus injury and cartilage injury
Surgical technique
HR | ADJUSTED HRa
| ||||||||
---|---|---|---|---|---|---|---|---|---|
Group | HR | 95% CI |
P value | HR | 95% CI |
P value | |||
Comparison group | No. of eventsb
| Reference group | No. of eventsb
| ||||||
TT-non-anatomic (n = 1296) |
n = 40 | TP-reference (n = 6685) |
n = 162 | 0.704 | 0.497–0.998 | 0.049 | 0.694 | 0.490–0.984 | 0.041 |
TT-anatomic (n = 2159) |
n = 77 | 0.942 | 0.717–1.239 | n.s. | 0.944 | 0.718–1.241 | n.s. | ||
TT-partial anatomic (n = 1516) |
n = 48 | 0.723 | 0.522–1.001 | n.s. | 0.759 | 0.548–1.051 | n.s. | ||
TP-anatomic (n = 4036) |
n = 146 | 1.285 | 1.027–1.607 | 0.028 | 1.310 | 1.047–1.640 | 0.018 | ||
All landmarks (n = 9398) |
n = 252 | No landmarks (n = 831) |
n = 27 | 1.387 | 0.928–2.072 | n.s. | 1.392 | 0.931–2.081 | n.s. |
TP drilling (n = 12,440) |
n = 380 | TT-drilling (n = 5110) |
n = 167 | 1.390 | 1.157–1.670 | <0.001 | 1.399 | 1.163–1.682 | <0.001 |