To compare the 2 approaches, the researchers evaluated 10 cadaveric knees that were randomized for ACL reconstruction using either a transtibial or anteromedial portal technique. This identification is very important, so place the femoral tunnel as far posteriorly as desired. Hamstring anterior cruciate ligament (ACL) reconstruction or bone patellar bone graft fixation? 0000082528 00000 n Reconstruction techniques for the anterior cruciate ligament (ACL) have evolved considerably over the past 3 decades. Drill a 2.5-mm guidewire through the LFC with the knee in 120 degrees of flexion; the drill exits from the skin at the lateral side of the femur ( Fig. 0000031244 00000 n 4,5,9,11,19,27,34,36 While a transtibial (TT) technique remains the most common femoral tunnel … 2010; 18 :1013–37. 0000033510 00000 n Fluoroscopic control in lateral projection. 0000003738 00000 n Resect the ligamentum mucosum and, if needed, pieces of infrapatellar fat for better visualization. Drilling a guidewire from the anteromedial portal through the lateral femoral condyle. This procedure is usually done arthroscopically and involves making tunnels in the femur and tibia, allowing passage of the graft material to reconstruct the ACL. 2014;42(12):2941-7. Burnout Might Really Be Depression; How Do Doctors Cope? 0000094017 00000 n To compare the 2 approaches, the researchers evaluated 10 cadaveric knees that were randomized for ACL reconstruction using either a transtibial or anteromedial portal technique. 0000002446 00000 n 0000001796 00000 n Found inside – Page 75Dargel J, Schmidt-Wiethoff R, Fischer S, Mader K, Koebke J, Schneider T. Femoral bone tunnel placement using the transtibial tunnel or the anteromedial portal in ACL reconstruction: a radiographic evaluation. Knee Surg Sports Traumatol ... Mean Lysholm score was 78.32±10.7 in the transtibial group and ... Anterior cruciate ligament reconstruction using either the transtibial or transportal TransFix ... U-guide is inserted through the anteromedial portal. The maximal achievable coronal obliquity, however, was significantly better with an anteromedial portal compared with transtibial drilling. Transtibial vs. Far Anteromedial Portal vs. Outside-In Technique for Femoral Tunnel Drilling in ACL Reconstruction: Why Do You Prefer the Technique? The posterior margin of the notch must be clearly identified to ensure an over-the-top position. Among the many factors that determine knee anterior cruciate ligament (ACL) surgical reconstruction outcome is the position of the ACL femoral tunnel or socket,1, 2 and various techniques for ACL femoral socket creation exist, including 4 primary techniques: endoscopic transtibial (TT) technique, anteromedial portal (AMP) technique, outside-in (OI) technique, and outside-in retrograde … The HTT technique avoids hyperflexion and maintains femoral tunnel orientation and length, similar to the TT technique, but simultaneously achieves anatomic graft positioning. In double-bundle ACL reconstruction, it is easier to choose the two entry points. There was a statistically significant difference in translation between the anteromedial portal ACL reconstruction and the ACL-deficient condition ( P < .05). Transtibial versus anteromedial portal reaming in anterior cruciate ligament reconstruction: an anatomic and biomechanical evaluation of surgical technique. 0000009361 00000 n Transtibial vs. Anteromedial Portal Techniques in Anterior Cruciate Ligament Reconstruction: Prospective and Randomized Series Luiz Gabriel B. Guglielmetti, MD, PhD, BRAZIL Paper Presentation 2019 Congress rating (2) "The anteromedial approach offers the advantage of reliably reproducing the anatomy of the native ligament.". 17. Purpose: Although anatomical and independent drilling techniques, such as transportal (TP) technique, have become more popular in anterior cruciate ligament (ACL) reconstruction, the TP technique has not been shown to yield superior clinical or functional outcomes compared to the transtibial (TT) technique. Bedi A, Musahl V, Steuber V, Kendoff D, Choi D, Allen AA, et al. The study includes clinical randomized controlled trials comparing the clinical outcomes of ACL reconstruction using the autologous … Clinical Comparisons Between the Transtibial Technique and the Far Anteromedial Portal Technique for Posterolateral Femoral Tunnel Drilling in Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction Atsuo Nakamae, M.D., Mitsuo Ochi, M.D., Nobuo Adachi, M.D., Masataka Deie, M.D., and Tomoyuki Nakasa, M.D. 0000069306 00000 n trailer … 42.6 ). Transtibial versus anterome- operative technique and pre- reconstruction: a prospective demonstrated superior clinical dial portal reaming in anterior liminary results. 0000106599 00000 n Found inside – Page 850Bedi A, Musahl V, Steuber V, et al. Transtibial Versus Anteromedial Portal Reaming in Anterior Cruciate Ligament Reconstruction: An Anatomic and Biomechanical Evaluation of Surgical Technique. Arthroscopy. 2010. 5. The femoral and tibial tunnels are drilled separately. 0000024190 00000 n Found inside – Page 16... (2009) Epidemiology of anterior cruciate ligament reconstruction: trends, readmissions, and subsequent knee surgery. ... Lajara F, Samitier G et al (2010) The transtibial versus the anteromedial portal technique in the arthroscopic ... Knee Surg Sports Traumatol Arthrosc. Modified transtibial versus anteromedial portal technique in anatomic single-bundle anterior cruciate ligament reconstruction: comparison of femoral tunnel position and clinical results. Found inside – Page 1426Scientists discuss in 'Anteromedial portal versus transtibial drilling techniques in ACL reconstruction: a blinded cross-sectional study at two- to five-year follow-up' new findings in orthopedics. According to recent research from ... The review showed wide variability in the outcome measures utilised with no consensus on the ideal outcome instrument or combination of instruments to report the outcome of ACLR. Found insideBedi A, Musahl V, Steuber V, et al: Transtibial versus anteromedial portal reaming in anterior cruciate ligament reconstruction: An anatomic and biomechanical evaluation of surgical technique. Arthroscopy 2011;27(3):380-390. 18. Am J Sports Med. Overdrill the K wire if its position is correct; if not, replace the K wire and repeat the fluoroscopy ( Fig. The center of the anterior cruciate ligament insertion is located in the distal corner of the most superoposterior quadrant, Example of different K wire positions in true lateral projection, Click to share on Twitter (Opens in new window), Click to share on Facebook (Opens in new window), Click to share on Google+ (Opens in new window), on The Anteromedial Portal for Anterior Cruciate Ligament Reconstruction, Three-Portal Technique for Anatomic Single-Bundle Anterior Cruciate Ligament Reconstruction, Arthrex TightRope Fixation of a Soft Tissue Graft, Posterior Mini-Incision Hamstring Harvest Approach for Anterior Cruciate Ligament Reconstruction, Transtibial Tunnel Drilling of the Femoral Tunnel for Anatomic Single-Bundle Anterior Cruciate Ligament Reconstruction, The Use of CO 2Instead of Fluid in Arthroscopic Anterior Cruciate Ligament Reconstruction, Description of the Direct Femoral Attachment of the Anterior Cruciate Ligament: Implication for Femoral Tunnel Placement in Reconstruction, Anterior Cruciate Ligament Reconstruction with the Use of Femoral INTRAFIX: Rationale, Procedure, and Pearls for a Novel Anterior Cruciate Ligament Fixation Technique to Achieve Anatomical Single-Tunnel Reconstruction, Computer-Assisted Navigation for Anterior Cruciate Ligament Reconstruction, The Anterior Cruciate Ligament: Reconstruction and Basic Science. Found inside – Page 62Transtibial versus anteromedial portal reaming in anterior cruciate ligament reconstruction: an anatomic and biomechanical evaluation of surgical technique. Arthroscopy. 2011;27(3):380–90. Woo SL, Kanamori A, Zeminski J, Yagi M, ... 20 Handy ICD-10 Codes for Thanksgiving and the Holidays, Young Doc to Aaron Rodgers: Be a 'Team' Player on COVID Vaccine, Freeman Tribunal: Claims Testosterone for Athlete 'Offensive', Brachial Plexus Injury in Sports Medicine, Cervical Spine Acute Bony Injuries in Sports Medicine, Black Young Adults: Remember This When Facing Discrimination. It has been suggested that better results might be expected by doing it anteromedially. The Hybrid Transtibial ACL Reconstruction Technique. Orthop J … ((h��LNTL�`a����^�����o�]Eeπ�ς/�տ��/� +���K�^��iŪ��7���c��CG���ӳ�%l�X����#7n��ܸuc�Ʒ6��a#�qx+2l���F��q8}c88l�a+8_����|a8_�����a��&߄�o�Ǜ��f�o3η���p�����AAj�hqP�PJ Benefits and drawbacks for each of these techniques exist. Found inside – Page 2294For single-bundle ACL reconstruction, the center of the femoral tunnel should be placed 1.7 mm proximal to the bifurcate ... Numerous studies comparing transtibial versus anteromedial portal technique have not found any substantial ... Found inside – Page 308Femoral bone tunnel placement using the transtibial tunnel or the anteromedial portal in ACL reconstruction: a radiographic evaluation. Knee Surg Sports Traumatol Arthrosc. 2009;17(3):220-227. 3. Gavriilidis I, Motsis EK, Pakos EE, ... 0000114008 00000 n The aim of the study is to compare the risk of revision of single-bundle hamstring anterior cruciate ligament (ACL) reconstruction between the anteromedial, transtibial and outside-in techniques. 0000057713 00000 n The transtibial versus the anteromedial portal technique in the arthroscopic bone-patellar tendon-bone anterior cruciate ligament reconstruction. Recent studies have raised concerns that the more commonly used transtibial technique falls short in its ability to reproduce the native anatomy of the ligament, thereby increasing the risk for complications, said coauthor Asheesh Bedi, MD, orthopaedic surgeon and fellow in sports medicine and shoulder surgery at the Hospital for Special Surgery in New York City. Under fluoroscopic control in strictly lateral projection, superimpose both femoral condyles on the monitor ( Fig. Slowly flex the knee to 120 degrees, and check for good visualization. Purpose: Several studies have suggested that drilling the femoral tunnel through an anteromedial arthroscopic portal during anterior cruciate ligament reconstruction allows more anatomic placement of the graft. 0000026183 00000 n Ischemic Stroke May Hint at Underlying Cancer, Topol: US Betrays Healthcare Workers in Coronavirus Disaster, The 6 Dietary Tips Patients Need to Hear From Their Clinicians. 2010; 18: 1013-37. Cite this: Anteromedial Portal Drilling Offers Advantages Over Transtibial Approach for ACL Reconstruction - Medscape - Jul 17, 2009. Found insideWang H, Fleischli JE, Zheng N. Transtibial versus anteromedial portal technique in singlebundle anterior cruciate ligament reconstruction: outcomes of knee joint kinematics during walking. Am J Sports Med. 2013;41(8):1847–1856. 0000005874 00000 n 17. The atlas integrates the key morphological features of ossification in the bones of the hand and wrist and provides idealized, sex- and age-specific images of skeletal development New to this revised second edition is a description and user ... Bla on productions www.blazonproductions.com poster exhibit designed by LLC SPORTS MEDICINE CENTER A number of studies suggest improved biomechanical and clinical results when ACL grafts are placed anatomically. 0000114317 00000 n Youm Y.S., Cho S.D., Lee S.H., Youn C.H. A femoral bone tunnel in ACL reconstruction can be constructed from the outside in or from the inside out. For the anteromedial group, the mean interval (±SD) was 11.5±6.2 months. �BBP%� "U�AA��jqP�3�JB��@�"5���zq�c1���YD�'n� ���-~9�y�� ��5 K$�A��ᗠ5.��8xq���%9K�K*�X����:����p�{��I�g�hZ���Υ���_Z��D��O|�d���O�Z�����y���{�g�5�gj����7��|v`�[�f��Z>����>w������U>g|~��b�x���W/xq�ş)Rʃ���BH!GBnQ���%ӟ�?͆rhɴ[/+_�����Vĭ���W�����W��:������+�V~�j٪��̫&V��/�>�z�ï�f{��k?�9�F�Ƶ�g��Z���x� ���������������?g����soR�Ծ������e�?��[�3a���a�a����ڴssS��'6�%�ׇ����S!bmDI�%�-bz˺-�-�-w���b[n�ߚ���վ�۷��E�$���zlw%�hg��Ie�%ye4�I�-��)�RS�֍�;�|O���q{�LO~>��J�y��00�{�2F��'�-0�B6�T"X ��� ���d�2��X;� &!�0���L&��0�ĕ�/��c�x)z. Anterior cruciate ligament graft positioning, tensioning and twisting. 0000003288 00000 n 2019 Congress Am J Sports Med. xref Clinical Comparisons Between the Transtibial Technique and the Far Anteromedial Portal Technique for Posterolateral Femoral Tunnel Drilling in Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction Atsuo Nakamae, M.D., Mitsuo Ochi, M.D., Nobuo Adachi, M.D., Masataka Deie, M.D., and Tomoyuki Nakasa, M.D. Purpose: Making the femoral tunnel through the anteromedial (AM) portal is believed to allow an unconstrained position compared with the traditional transtibial (TT) tunnel. The advantages of this technique are as follows: It allows for easy manipulation of the instruments to drill the tunnel in any position at the medial side of the LFC without considering the placement of the tibial tunnel. The drilling can be performed with the knee flexed to 120 degrees. 0000003400 00000 n Anterior cruciate ligament (ACL) reconstruction is a common procedure performed by orthopaedic surgeons, particularly in association with sports-related injuries. A transtibial single-bundle technique can accomplish a highly anatomic reconstruction Piasecki et al, AJSM, 2011 We describe the hybrid transtibial ACL reconstruction technique which combines the advantages of the traditional ... transtibial technique and the anteromedial portal technique. Transtibial™ ACL Reconstruction. 2001http://www.medscape.com/slideshow/holiday-icd-10-codes-6014567. The transtibial (TT) technique has been shown to be less capable of this than an anteromedial (AM) portal approach but is more familiar to surgeons and less technically challenging. The drill exits from the skin at the lateral side of the femur. Please use this form to submit your questions or comments on how to make this article more useful to clinicians. This book provides the reader with the best available evidence on the most pressing issues relating to reconstruction of the anterior cruciate ligament (ACL) with the goal of supporting surgical reconstruction of the ACL and improving ... Mean translation was 6.1 ± 3.6 mm and 5.2 ± 2.0 mm after transtibial (n = 5) and anteromedial portal (n = 5) ACL reconstruction, respectively ( Fig 5 ). 0000032169 00000 n Found inside – Page 982001;9(4):194–9. Hantes ME, Zachos VC, Liantsis A, Venouziou A, Karantanas AH, Malizos KN. Differences in graft orientation using the transtibial and anteromedial portal technique in anterior cruciate ligament reconstruction: a magnetic ... 0000114216 00000 n Bedi A, Musahl V, Steuber V, et nosus tendon with endobuttons: ble-bundle hamstrings ACL bundle ACL reconstruction al. Modified transtibial (mTT) and anteromedial portal (AMP) techniques aim at the anatomical placement of femoral tunnel. American Orthopaedic Society for Sports Medicine (AOSSM) 35th Annual Meeting. There is no risk of enlarging the tibial tunnel posteriorly, which can lead to poor fit and stabilization of the graft in the tunnel. There are two primary surgical techniques to reconstruct the anterior cruciate ligament (ACL), transtibial (TT) technique and anteromedial portal (AMP) technique. Both American and international perspectives on the treatment of ACL injuries are included to provide the most comprehensive review on the market today. Inside this richly illustrated text, Drs. 0000029673 00000 n A hybrid transtibial (HTT) technique using medial portal guidance of a transtibial guide wire without knee hyperflexion may offer anatomic tunnel placement while maintaining the relative ease of a TT technique. Background: In anterior cruciate ligament (ACL) reconstruction, the transtibial (TT) technique often creates a nonanatomically placed femoral tunnel, which is a frequent cause of surgical failure and postsurgical knee instability. Examinations included anterior drawer, Lachman, maximal internal rotation at 30 degrees, manual pivot-shift, and instrumented pivot-shift. Are Sleep Disorders in Athletes a Sign of CTE? Click the topic below to receive emails when new articles are available. Measure the position of the end of the K wire using the quadrant method ( Fig. 0000002411 00000 n Improper tunnel placement is the cause of failure for ACL reconstruction 70% of the time. "This can have profound implications for the biology and mechanical properties of the reconstruction, as well as potentially compromising bone stock in the setting of a revision procedure," Dr. Bedi said. This book is aimed at providing an overview of arthroscopic joint surgery involving major joints in the body. Kim MK, Lee BC, Park JH. hygtSW���꒢���V� 0000032701 00000 n 2011; 23:213–219. Transtibial versus anteromedial portal reaming in anterior cruciate ligament reconstruction: an anatomic and biomechanical evaluation of surgical technique. ... Cadaveric Analysis Comparing Anteromedial Portal Versus Outside-In Technique. The transtibial drilling of the femoral tunnel has been very much popularized because of its simplicity and good visualization. Yourn YS, Cho SD, Lee SH, Youn CH. This cohort study was based on data from a single surgeon’s registry. Found inside – Page 52Transtibial versus anteromedial portal drilling for yet to be fully determined who most benefits anterior cruciate ligament reconstruction: a cadaveric from an anterolateral augmentation. However, study of femoral tunnel length and ... 0000002950 00000 n [Color figure can be viewed in … Transtibial versus anteromedial portal reaming in anterior cruciate ligament reconstruction: An anatomic and biomechanical evaluation of surgical technique. Am J Sports Med 2014; 42(12): 2941-7. Found inside – Page 427Aglietti P, Buzzi R, D'Andria S, Zaccherotti G: Long-term study of anterior cruciate ligament reconstruction for chronic ... et al: Transtibial versus anteromedial portal of the femoral tunnel in ACL reconstruction: a cadaveric study. This article outlines the surgical technique for an anteromedial portal ACL reconstruction with a tibialis anterior allograft fixed with the Mitek Femoral and Tibial Intrafix sheath and screw system (DePuy Synthes, Raynham, MA). 0000111467 00000 n ACL reconstruction involves replacing the torn ACL with tissue taken from the patient (autograft) or taken from a tissue donor (allograft). Transtibial Versus Anteromedial Portal ACL Reconstruction Can A Hybrid Approach Achieve The Best Of Both? Found inside – Page 8038. Bedi A, Musahl V, Steuber V, et al. Transtibial versus anteromedial portal reaming in anterior cruciate ligament reconstruction: an anatomic and biomechanical evaluation of surgical technique. Arthroscopy. 2011;27(3):380–390. 39. Dr. Ellman, most recently with the Steadman Clinic in Vail, is a fellowship trained, board-certified orthopedic surgeon specializing in hip, knee and shoulder injuries. Found inside(2010 SEP 13) Hospital for Special Surgery, New York City: Transtibial Versus Anteromedial Portal Drilling for Anterior Cruciate Ligament Reconstruction: A Cadaveric Study of Femoral Tunnel Length and Obliquity In this recently ... Found insideDifferences in graft orientation using the transtibial and anteromedial portal technique in anterior cruciate ligament reconstruction: a magnetic resonance imaging study. Knee Surg Sports Traumatol Arthrosc. 2009;17(8):880–886. 41. Found insideHamstring Tendon Autograft for Anterior Cruciate Ligament Reconstruction А Transtibial Tunnel Technique Versus Anteromedial Portal Technique Hamstring ACL reconstruction can be performed by the transtibial tunnelor anteromedial portal ... The AMP method additionally secures the graft in a more horizontal orientation, providing better rotational control and … "The improved ability to recreate native anatomy and restore stability of the knee for competitive athlete has been a very compelling argument for us," he said. [Europe PMC free article] [Google Scholar] Jennings JK, Leas DP, Fleischli JE, D’Alessandro DF, Peindl RD, Piasecki DP: Transtibial vs. Anteromedial Portal ACL Reconstruction: Is Hybrid Approach the Best? Computer-assisted navigation technology was used to assess knee stability. h�b```b``_���� �� Ȁ ��@Q��D.�w$� *�00�}����E&:�F�ppSy^Wֺ#A>G�b��N�|��>���I9-��h(��jXZZGG�0�K�N�h@r�00}�@l Qf�c`� v�c�`� �;��V�(8p�0(�d It is not necessary to perform an additional fluoroscopic tunnel view because the quadrant method determines the position of the end of the K wire in the anteroposterior direction as well ( Fig. Currently, there is no consensus which surgical technique elicits the best clinical and functional outcomes. Keywords Transtibial Low anteromedial Tunnel position ACL reconstruction Introduction Anatomic anterior cruciate ligament (ACL) graft posi-tioning is considered a key factor for proper postoperative "We found that the tibial tunnel is inadvertently re-reamed when preparing the 'best possible' femoral socket with the transtibial technique, resulting in as much as 40% enlargement of the tibial tunnel on the day of surgery.". 0000093963 00000 n Transtibial vs. Anteromedial Reaming of Femoral Tunnel Tibial and femoral tunnels can be positioned in a highly anatomic manner using a transtibial technique but require careful choice of the tibial starting position. 42.2 ). Modified transtibial versus anteromedial portal technique in anatomic single-bundle anterior cruciate ligament reconstruction: comparison of femoral tunnel position and clinical results. Modified transtibial versus anteromedial portal technique in anatomic single-bundle anterior cruciate ligament reconstruction: comparison of femoral tunnel position and clinical results. The aim of the study is to compare the risk of revision of single-bundle hamstring anterior cruciate ligament (ACL) reconstruction between the anteromedial, transtibial and outside-in techniques. This results in a more reproducible, anatomic ACL reconstruction. Controversies abound in anterior cruciate ligament (ACL) reconstruction. Found inside – Page 234Transtibial versus anteromedial portal reaming in anterior cruciate ligament reconstruction: an anatomic and biomechanical evaluation of surgical technique. Arthroscopy. 2011;27: 380–90. Cain EL, Clancy WG. Anatomic endoscopic anterior ... Improved Knee Stability With Anteromedial Approach. This cohort study was based on data from a single surgeon’s registry. 0000006821 00000 n Hybrid Transtibial Femoral Preparation for Transphyseal Anterior Cruciate Ligament Reconstruction: A Radiographic Comparison With the Transtibial and Anteromedial Portal Techniques D. Landry Jarvis, MD , Danica D. Vance, MD , Emily K. Reinke, PhD , and Jonathan C. Riboh, MD Knee Surg Sports Traumatol Arthrosc. However, there is evidence that drilling the femoral tunnel through the tibial tunnel can result in a nonanatomical placement of the graft in the femur. Please enter a Recipient Address and/or check the Send me a copy checkbox. This injury is biomechanically comparable to a total meniscectomy, leading to compromised hoop stresses resulting in decreased tibiofemoral contact area and increased contact pressures in the involved compartment. 0000028812 00000 n Found inside – Page 14A potential advantage to this technique was highlighted by a study comparing femoral tunnel size following transtibial and anteromedial portal drilling techniques. Chhabra et al40 found greater femoral tunnel expansion in the ... 0000032469 00000 n posteroinferior on the wall of the lateral femoral condyle than the more traditional transtibial approach. Trochleoplasty. Bedi A, Musahl V, Steuber V, Kendoff D, Choi D, Allen AA, et al. 0000114112 00000 n When doing it inside out, the approach can be via the anteromedial (AM) portal or through the tibial bone tunnel. You will receive email when new content is published. "One concern with the anteromedial portal technique is the potential to overconstrain or overtighten the joint, and many feel that it is better to be on the looser side than the too-tight side because of the risk of being excessively tight, resulting in arthritic change within the joint," Dr. Black noted. Introduction. 0000114547 00000 n 0000114653 00000 n ACL reconstruction involves replacing the torn ACL with tissue taken from the patient (autograft) or taken from a tissue donor (allograft). 0000009295 00000 n Anteromedial drilling successfully restored the Lachman and anterior drawer to the intact ACL, and the technique constrained translation with the manual pivot-shift and instrumented pivot-shift to improve the native ACL (P < .05). 0000079230 00000 n 0000114459 00000 n 0000022869 00000 n You are being redirected to Medscape Education. 38. Analysis of variance and Tukey's test were used to perform statistical analyses, and P < .05 was defined as significant. [ Links ] 11. 0000000016 00000 n Found inside – Page 149Transtibial versus anteromedial portal drilling for anterior cruciate ligament reconstruction: a cadaveric study of femoral tunnel length and obliquity. Arthroscopy 2010;26:342–50. Markolf KL, Jackson SR, McAllister DR. Controversy existed in the literature with regard to the outcome of these techniques. 0000004972 00000 n 0000004075 00000 n Purpose: Our aim was to evaluate tunnel-graft angle, tunnel length and position and change in graft length between transtibial (30 patients) and anteromedial (30 patients) portal techniques using 3D knee models after anterior cruciate ligament (ACL) reconstruction. Is a Hybrid Approach the Best? Level of evidence Case series, Level IV. A total of 103 patients who received ACL reconstruction using trans-portal (50 patients) and outside-in techniques (53 patients) were included in the study. Thus the anteromedial portal has become more and more attractive, and a large number of orthopaedic surgeons prefer this portal. "But I don't think individuals should necessarily abandon the transtibial technique if it has worked well for them for many years.". The Anterior Cruciate Ligament: Reconstruction and Basic Science, 2nd Edition, by Dr. Chadwick Prodromos, provides the expert guidance you need to effectively select the right procedure and equipment, prevent complications, and improve ... Transtibial versus anteromedial portal reaming in anterior cruciate ligament reconstruction: An anatomic and biomechanical evaluation of surgical technique. Found inside – Page 197Youm YS, Cho SD, Lee SH, Youn CH (2014) Modified transtibial versus anteromedial portal technique in anatomic single-bundle anterior cruciate ligament reconstruction: comparison of femoral tunnel position and clinical results. You've successfully added to your alerts. Bla on productions www.blazonproductions.com poster exhibit designed by LLC SPORTS MEDICINE CENTER A number of studies suggest improved biomechanical and clinical results when ACL grafts are placed anatomically.
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