Clinical outcomes of ACL reconstruction with tibialis anterior allograft using an anteromedial portal approach

Background The purpose of the current study was to evaluate the clinical and functional outcomes of ACL reconstruction with tibialis anterior allograft using the anatomic anteromedial portal approach and aperture sheath and screw fixation. Methods We evaluated primary ACL reconstructions with tibialis anterior allograft using an anatomic anteromedial portal approach performed at our institution between January 2011 and February 2014. Patients with a minimum of two years of follow-up were contacted and brought back for a complete physical examination of the knee. A KT-1000 arthrometer was used to measure anterior tibial translation in both knees. Clinical outcome scores were generated using validated outcome measures. Results Forty-five patients with a mean age of 43.9 years were available for complete follow-up at a mean of 30.8 months. Of the 45 patients who came in for follow-up, two were found to have a clinical failure/ruptured graft (4.4%). Significant improvements were noted to be present compared to baseline values for all assessed clinical outcome measurements. KT-1000 arthrometer measures demonstrated a mean (± standard deviation) of 0.26 ± 1.11 mm side to side difference compared to the contralateral side with maximum manual stress applied. Conclusions Our data demonstrating significant improvements in clinical outcome assessments coupled with excellent KT-1000 arthrometer values and a low rate of clinical failure supports the use of tibialis anterior allografts with an anteromedial portal surgical approach in ACL reconstruction. This improvement in results may be related to more accurate anatomic tunnel placement via AMP drilling and improved graft fixation methods.