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Archives of Orthopaedic and Trauma Surgery

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01-03-2020 | Computed Tomography | Arthroscopy and Sports Medicine

A two-portal technique using a flexible reamer system is a safe and effective method for transportal anterior cruciate ligament reconstruction

Authors: Kyoung Ho Yoon, Jae Ho Kim, Yoo Beom Kwon, Eung Ju Kim, Sang Hyeon Lee, Sang-Gyun Kim

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 3/2020

Abstract

Introduction

A flexible reamer system (FRS) for transportal anterior cruciate ligament reconstruction (ACLR) has been developed to overcome the technical challenges of a rigid reamer system. The purpose of this study was to investigate the safety and effectiveness of the two-portal technique using an FRS by evaluating femoral tunnel geometry.

Methods

This study included 30 patients (mean age 30 ± 12.1) who underwent transportal single-bundle ACLR. Operations were performed with the two-portal technique using an FRS. Three-dimensional computed tomography was performed for all patients 2 days after the operation. The femoral tunnel position, femoral graft bending angle, femoral tunnel length, and posterior wall breakage were evaluated. These radiologic outcomes were compared to previous literature-reported outcomes.

Results

The mean distances (measured as a percentage) from the posterior wall and the intercondylar notch roof to the femoral tunnel center were 29.6 ± 5.5% and 20.1 ± 6.7%, respectively. The femoral graft bending angle (108.4° ± 6.9°) was similar to that associated with the traditional transportal technique using a rigid reamer system, but it was less acute than that associated with the three-portal technique using an FRS. The femoral tunnel length (32.8 ± 4.5 mm) was also similar to the results of the traditional transportal technique using a rigid reamer system, but it was shorter than that of three-portal technique using an FRS. The prevalence of posterior wall breakage was as low as the reported outcomes of the outside-in technique (2 cases, 6.6%).

Conclusions

The two-portal technique for transportal ACLR using an FRS can achieve comparable femoral graft bending angle and femoral tunnel length compared with the conventional three-portal technique using the rigid reamer system and had a low risk of posterior wall breakage. Therefore, the two-portal technique using the FRS can be considered a safe and effective method for transportal ACLR.

Level of evidence

Retrospective case series; level of evidence, 4

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Title: A two-portal technique using a flexible reamer system is a safe and effective method for transportal anterior cruciate ligament reconstruction
Authors: Kyoung Ho Yoon
Jae Ho Kim
Yoo Beom Kwon
Eung Ju Kim
Sang Hyeon Lee
Sang-Gyun Kim
Publication date: 01-03-2020
Publisher: Springer Berlin Heidelberg
Keywords: Computed Tomography
Computed Tomography
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 3/2020
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-020-03343-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

A two-portal technique using a flexible reamer system is a safe and effective method for transportal anterior cruciate ligament reconstruction

Abstract

Introduction

Methods

Results

Conclusions

Level of evidence

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

Level of evidence

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