A Comparative Study of the Results of the Anatomic Medial Portal and All-inside Arthroscopic ACL Reconstruction.

INTRODUCTION Many techniques of graft placement in Arthroscopic Anterior Cruciate Ligament (ACL) reconstruction is available now-a-days, like trans-tibial, anatomical accessory medial portal and anatomical all-inside technique. AIM To compare the improvement in clinical status of patients treated by anatomic accessory medial portal and all-inside arthroscopic ACL reconstruction technique pre-operatively post-operatively using International Knee Documentation Comittee (IKDC) Subjective Knee Scores, Lysholm Knee Score, Knee Society Score, Lachman test, Visual Analog Score (VAS) in both the groups. MATERIALS AND METHODS After informed consent from patients and clearance from Ethical Committee, we included patients aged 18 to 50 years with ACL injury and clinical laxity admitted in Department of Orthopaedics, King George Medical University, Lucknow. We included 100 patients in the study, which were divided into two groups, Group1 comprised of patients treated by Anatomic accessory medial portal technique and group 2 comprised of patients treated by All-Inside technique. Then the patients were followed up post-operatively at 6 weeks, 12 weeks and 6 months, clinically for functional status using Lysholm Knee Score, IKDC Subjective Knee Score, Knee Society Score and VAS score. Grading of laxity was evaluated by Lachman test at pre-operative stage and 6 months follow-up. After collection of the data, analysis was carried out on SPSS software version 16.0 (Chicago, inc. USA) and the statistical test that was used was 2-Way Analysis of Variance (ANOVA). RESULTS IKDC Subjective Knee Score, Lysholm Knee Score, Knee Society Score, Lachman Test and VAS Score was better in group 2 treated by All-inside technique as compared to group1 and the difference was significant (p<0.005). CONCLUSION All- Inside arthroscopic ACL reconstruction technique (group2) is a better technique than arthroscopic Anatomic accessory medial portal technique (group1).

[1]  R. Mather,et al.  Anterior Cruciate Ligament (ACL) Reconstruction , 2014 .

[2]  J. Dugas,et al.  Evaluation and Comparison of Femoral Tunnel Placement During Anterior Cruciate Ligament Reconstruction Using 3-Dimensional Computed Tomography , 2014, Orthopaedic journal of sports medicine.

[3]  A. M. Kiapour,et al.  Basic science of anterior cruciate ligament injury and repair , 2014, Bone & joint research.

[4]  S. Yoshiya,et al.  Comparison of transportal inside-out and outside-in femoral drilling techniques in anatomic ACL reconstruction , 2014 .

[5]  J. O. Smith,et al.  Anatomic all-inside anterior cruciate ligament reconstruction using the translateral technique. , 2013, Arthroscopy techniques.

[6]  Charles H. Brown,et al.  Medial portal technique for single-bundle anatomical Anterior Cruciate Ligament (ACL) reconstruction , 2013, International Orthopaedics.

[7]  M. Lykissas,et al.  All-epiphyseal anterior cruciate ligament reconstruction in skeletally immature patients: a surgical technique using a split tibial tunnel. , 2012, Arthroscopy techniques.

[8]  Ya Liu,et al.  Comparison of two methods of femoral tunnel preparation in single-bundle anterior cruciate ligament reconstruction: a prospective randomized study. , 2012, Acta cirurgica brasileira.

[9]  S. Bisicchia,et al.  Drilling the femoral tunnel during ACL reconstruction: transtibial versus anteromedial portal techniques. , 2012, Orthopedics.

[10]  A. Wilson,et al.  TransLateral ACL reconstruction: a technique for anatomic anterior cruciate ligament reconstruction , 2012, Knee Surgery, Sports Traumatology, Arthroscopy.

[11]  F. Smith,et al.  Single bundle anterior cruciate reconstruction does not restore normal knee kinematics at six months: an upright MRI study. , 2011, The Journal of bone and joint surgery. British volume.

[12]  G. Baltaci,et al.  Effects of additional gracilis tendon harvest on muscle torque, motor coordination, and knee laxity in ACL reconstruction , 2011, Knee Surgery, Sports Traumatology, Arthroscopy.

[13]  A. Amis,et al.  Biomechanical Comparison of Anatomic Double-Bundle, Anatomic Single-Bundle, and Nonanatomic Single-Bundle Anterior Cruciate Ligament Reconstructions , 2011, The American journal of sports medicine.

[14]  Freddie H Fu,et al.  Anatomic double-bundle anterior cruciate ligament reconstruction , 2010, Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association.

[15]  V. Denaro,et al.  Long-term health outcomes of youth sports injuries , 2009, British Journal of Sports Medicine.

[16]  Anthony Festa,et al.  Independent Drilling Outperforms Conventional Transtibial Drilling in Anterior Cruciate Ligament Reconstruction , 2009, The American journal of sports medicine.

[17]  James H. Lubowitz,et al.  Anteromedial portal technique for the anterior cruciate ligament femoral socket: pitfalls and solutions. , 2009, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[18]  W. Garrett,et al.  Reconstruction Technique Affects Femoral Tunnel Placement in ACL Reconstruction , 2008, Clinical orthopaedics and related research.

[19]  S. Lee,et al.  Anterior Cruciate Ligament Reconstruction , 2008, Clinical orthopaedics and related research.

[20]  D. Albrecht [Cruciate ligament reconstruction]. , 2007, Zeitschrift fur Orthopadie und Unfallchirurgie.

[21]  Freddie H. Fu,et al.  Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction , 2013 .

[22]  Freddie H. Fu,et al.  Biomechanical Analysis of an Anatomic Anterior Cruciate Ligament Reconstruction , 2002, The American journal of sports medicine.

[23]  Date of Acceptance , 2022 .