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Comparison of Clinical Results, Second-Look Arthroscopic Findings, and MRI Findings Between the Transportal and Outside-In Techniques for Double-Bundle Anatomic Anterior Cruciate Ligament Reconstruction: A Prospective, Randomized Controlled Trial With a Minimum 2-Year Follow-up
- Source :
-
American Journal of Sports Medicine . Mar2018, Vol. 46 Issue 3, p544-556. 13p. - Publication Year :
- 2018
-
Abstract
- Background: Although image analysis has shown that the outside-in (OI) technique is associated with different femoral tunnel geometry than the transportal (TP) technique in anatomic anterior cruciate ligament (ACL) reconstruction, it is not known whether clinical results differ between the 2 techniques. Purpose: To compare clinical results, second-look arthroscopic findings, and magnetic resonance imaging (MRI) findings between the TP and OI techniques in anatomic double-bundle (DB) ACL reconstruction. Study Design: Randomized controlled trial; Level of evidence, 2. Methods: From November 2010 to March 2013, 128 patients were enrolled in this study and were randomly assigned to either the TP group (64 patients) or the OI group (64 patients), and DB ACL reconstructions were performed. At the minimum 2-year follow-up (34.9 ± 10.9 months), 111 patients (86.7%) were evaluated with multiple clinical scores and stability tests (KT-2000 arthrometer, Lachman test, and pivot-shift test). Ninety-three knees were evaluated for graft continuity, graft tension, and synovialization by use of second-look arthroscopy. Seventy-eight knees were evaluated on MRI for graft continuity, femoral graft tunnel healing, and graft signal/noise quotient (SNQ). The primary outcome was KT-2000 arthrometer results. Results were compared between the TP and OI groups. Results: No significant differences were found between the 2 groups in terms of KT-2000 arthrometer results, which was the primary outcome, and other clinical results, with the exception of the postoperative functional test of International Knee Documentation Committee (IKDC) objective score. The ratio of grade A and B on the postoperative functional test of IKDC objective score was significantly larger for the OI group (51/58) than the TP group (36/53) (P = .005). The second-look arthroscopic findings were not significantly different between the 2 groups in either bundle (P > .05). In addition, MRI findings did not differ significantly between the 2 groups (P > .05). Conclusion: With the exception of the functional test of IKDC objective score, we found that clinical results, second-look arthroscopic findings, and MRI findings did not differ significantly between the OI and TP techniques for anatomic ACL reconstruction, although femoral tunnel geometries differed significantly between the 2 techniques. [ABSTRACT FROM AUTHOR]
- Subjects :
- *ANTERIOR cruciate ligament surgery
*ARTHROSCOPY
*CHI-squared test
*CLINICAL trials
*CONFIDENCE intervals
*FISHER exact test
*RANGE of motion of joints
*LONGITUDINAL method
*MAGNETIC resonance imaging
*PROBABILITY theory
*RESEARCH funding
*STATISTICAL sampling
*STATISTICS
*T-test (Statistics)
*STATISTICAL power analysis
*DATA analysis
*RANDOMIZED controlled trials
*TREATMENT effectiveness
*PRE-tests & post-tests
*INTER-observer reliability
*DATA analysis software
*FUNCTIONAL assessment
*DESCRIPTIVE statistics
*MANN Whitney U Test
*INTRACLASS correlation
RESEARCH evaluation
Subjects
Details
- Language :
- English
- ISSN :
- 03635465
- Volume :
- 46
- Issue :
- 3
- Database :
- Academic Search Index
- Journal :
- American Journal of Sports Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 128291633
- Full Text :
- https://doi.org/10.1177/0363546517744535