Effect of anteromedial portal location on femoral tunnel inclination, length, and location in hamstring autograft-based single-bundle anterior cruciate ligament reconstruction: a prospective study
Abstract Background Portal positioning in arthroscopic anterior cruciate ligament reconstruction is critical in facilitating the drilling of the femoral tunnel. However, the traditional approach has limitations. A modified inferior anteromedial portal was developed. Therefore, this study aims to com...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-11-01
|
| Series: | Knee Surgery & Related Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s43019-023-00202-5 |
| _version_ | 1797414828286935040 |
|---|---|
| author | Abdulaziz Z. Alomar Baraa Baltow Ismail AlMogbil |
| author_facet | Abdulaziz Z. Alomar Baraa Baltow Ismail AlMogbil |
| author_sort | Abdulaziz Z. Alomar |
| collection | DOAJ |
| description | Abstract Background Portal positioning in arthroscopic anterior cruciate ligament reconstruction is critical in facilitating the drilling of the femoral tunnel. However, the traditional approach has limitations. A modified inferior anteromedial portal was developed. Therefore, this study aims to compare the modified and conventional far anteromedial portals for femoral tunnel drilling, assessing factors such as tunnel length, inclination, iatrogenic chondral injury risk, and blowout. Material and methods Patients scheduled for hamstring autograft-based anatomical single-bundle arthroscopic anterior cruciate ligament reconstruction were divided into two groups: modified and far anteromedial groups. Primary outcomes include differences in femoral tunnel length intraoperatively, tunnel inclination on anteroposterior radiographs, and exit location on lateral radiographs. Secondary outcomes encompass tunnel-related complications and reconstruction failures. To identify potential risk factors for shorter tunnel lengths and posterior exits, regression analysis was conducted. Results Tunnel parameters of 234 patients were analyzed. In the modified portal group, femoral tunnel length and inclination were significantly higher, with tunnels exhibiting a more anterior exit position (p < 0.05). A higher body mass index exerted a negative influence on tunnel length and inclination. However, obese patients in the modified portal group had longer tunnels, increased inclination, and a lower risk of posterior exit. Only a few tunnel-related complications were observed in the far anteromedial group. Conclusion The modified portal allowed better control of tunnel length and inclination, ensuring a nonposterior femoral tunnel exit, making it beneficial for obese patients. |
| first_indexed | 2024-03-09T05:39:38Z |
| format | Article |
| id | doaj.art-ecba4ea069c84463bffc32d28632ec1b |
| institution | Directory Open Access Journal |
| issn | 2234-2451 |
| language | English |
| last_indexed | 2024-03-09T05:39:38Z |
| publishDate | 2023-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Knee Surgery & Related Research |
| spelling | doaj.art-ecba4ea069c84463bffc32d28632ec1b2023-12-03T12:26:47ZengBMCKnee Surgery & Related Research2234-24512023-11-0135111410.1186/s43019-023-00202-5Effect of anteromedial portal location on femoral tunnel inclination, length, and location in hamstring autograft-based single-bundle anterior cruciate ligament reconstruction: a prospective studyAbdulaziz Z. Alomar0Baraa Baltow1Ismail AlMogbil2Department of Orthopaedic Surgery, College of Medicine, King Saud UniversityDepartment of Orthopaedic surgery, AlHada Armed Forces Hospital, Ministry of defenseDepartment of Surgery, Unaizah College of Medicine and Medical Sciences, Qassim UniversityAbstract Background Portal positioning in arthroscopic anterior cruciate ligament reconstruction is critical in facilitating the drilling of the femoral tunnel. However, the traditional approach has limitations. A modified inferior anteromedial portal was developed. Therefore, this study aims to compare the modified and conventional far anteromedial portals for femoral tunnel drilling, assessing factors such as tunnel length, inclination, iatrogenic chondral injury risk, and blowout. Material and methods Patients scheduled for hamstring autograft-based anatomical single-bundle arthroscopic anterior cruciate ligament reconstruction were divided into two groups: modified and far anteromedial groups. Primary outcomes include differences in femoral tunnel length intraoperatively, tunnel inclination on anteroposterior radiographs, and exit location on lateral radiographs. Secondary outcomes encompass tunnel-related complications and reconstruction failures. To identify potential risk factors for shorter tunnel lengths and posterior exits, regression analysis was conducted. Results Tunnel parameters of 234 patients were analyzed. In the modified portal group, femoral tunnel length and inclination were significantly higher, with tunnels exhibiting a more anterior exit position (p < 0.05). A higher body mass index exerted a negative influence on tunnel length and inclination. However, obese patients in the modified portal group had longer tunnels, increased inclination, and a lower risk of posterior exit. Only a few tunnel-related complications were observed in the far anteromedial group. Conclusion The modified portal allowed better control of tunnel length and inclination, ensuring a nonposterior femoral tunnel exit, making it beneficial for obese patients.https://doi.org/10.1186/s43019-023-00202-5Anterior cruciate ligament reconstructionAnteromedial portalFar anteromedial portalFemoral tunnelTunnel inclinationTunnel length |
| spellingShingle | Abdulaziz Z. Alomar Baraa Baltow Ismail AlMogbil Effect of anteromedial portal location on femoral tunnel inclination, length, and location in hamstring autograft-based single-bundle anterior cruciate ligament reconstruction: a prospective study Knee Surgery & Related Research Anterior cruciate ligament reconstruction Anteromedial portal Far anteromedial portal Femoral tunnel Tunnel inclination Tunnel length |
| title | Effect of anteromedial portal location on femoral tunnel inclination, length, and location in hamstring autograft-based single-bundle anterior cruciate ligament reconstruction: a prospective study |
| title_full | Effect of anteromedial portal location on femoral tunnel inclination, length, and location in hamstring autograft-based single-bundle anterior cruciate ligament reconstruction: a prospective study |
| title_fullStr | Effect of anteromedial portal location on femoral tunnel inclination, length, and location in hamstring autograft-based single-bundle anterior cruciate ligament reconstruction: a prospective study |
| title_full_unstemmed | Effect of anteromedial portal location on femoral tunnel inclination, length, and location in hamstring autograft-based single-bundle anterior cruciate ligament reconstruction: a prospective study |
| title_short | Effect of anteromedial portal location on femoral tunnel inclination, length, and location in hamstring autograft-based single-bundle anterior cruciate ligament reconstruction: a prospective study |
| title_sort | effect of anteromedial portal location on femoral tunnel inclination length and location in hamstring autograft based single bundle anterior cruciate ligament reconstruction a prospective study |
| topic | Anterior cruciate ligament reconstruction Anteromedial portal Far anteromedial portal Femoral tunnel Tunnel inclination Tunnel length |
| url | https://doi.org/10.1186/s43019-023-00202-5 |
| work_keys_str_mv | AT abdulazizzalomar effectofanteromedialportallocationonfemoraltunnelinclinationlengthandlocationinhamstringautograftbasedsinglebundleanteriorcruciateligamentreconstructionaprospectivestudy AT baraabaltow effectofanteromedialportallocationonfemoraltunnelinclinationlengthandlocationinhamstringautograftbasedsinglebundleanteriorcruciateligamentreconstructionaprospectivestudy AT ismailalmogbil effectofanteromedialportallocationonfemoraltunnelinclinationlengthandlocationinhamstringautograftbasedsinglebundleanteriorcruciateligamentreconstructionaprospectivestudy |