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Published on: April 30, 2014
Influence of two different techniques of anterior cruciate ligament reconstruction on tunnel morphology and
Vijaykumar Digge1, Arpan Samanta1, Pankaj Kumar Sharma2
1All India Institute of Medical Sciences, New Delhi, India.
Objective:
The purpose of this study was to compare the all-inside (Group A) and conventional (Group B) anterior cruciate ligament reconstruction (ACLR) methods in terms of tunnel or socket morphology and functional outcomes.
Design:
Retrospective cohort study.
Methods:
Tunnel morphology was evaluated using a computed tomography scan and compared with intra-operative tibial and femoral drilling diameter at a mean follow-up of 29 months following ACLR between these groups. Clinical outcomes were studied using the 2000 IKDC subjective knee score, Lysholm score, and Knee Laxity Tester.
Results:
The study compared the tunnel morphology of all-inside (Group A; 20 subjects) and conventional (Group B; 43 subjects) ACLR methods in 63 patients. The results showed no significant differences in functional outcomes between the two groups. However, the femoral tunnel shrunk in Group A by 1.32% and 6.9% at articular (F1) and mid-portion (F2), respectively, compared to Group B at the same locations. The tibial tunnel widened in Group A by 1.91% and 11.07% at articular (T1) and mid-portion (T2) respectively, compared to Group B at the same locations. The statistical analysis showed a significant difference in the tunnel diameter change between the two groups at F2 (P = 0.02), T1 (P = 0.008), and T2 (P = 0.04).
Conclusion:
This study found that patients who underwent all-inside ACLR (Group A) had similar functional outcomes to those who underwent conventional ACLR (Group B). However, "tunnel diameter changes were overall more favourable in the all-inside group, particularly on the femoral side".
