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In ACL reconstruction, the placement and obliquity of tibial and femoral tunnels affect the orientation of graft in coronal and sagittal planes hence important for its function. Commonly used conventional transtibial technique (TT) had the disadvantage of more vertical tunnel. In the modified transtibial technique (mTT) the entry for the tibial tunnel is shifted slightly superomedially, and the leg is adducted and internally rotated. Aim: To compare the functional outcome of Arthroscopic ACL reconstruction using Bone –Patellar tendon – Bone graft with two different techniques (mTT vs. TP) of femoral tunnel placement. Methods: It was a prospective study of two groups (30 each) in which group 1 underwent Arthroscopic ACL reconstruction using PTB graft using the modified transtibial technique (mTT) for making the femoral tunnel and group 2 using transportal technique(TP). The outcome was assessed in terms of knee function (Lysholm knee scoring), clinical testing and radiological assessment (X-ray and CT) of tunnel orientation. Short-term and mid-term functional results were analyzed. Results: The short-term results have shown that the transportal technique(TP) had given slightly better functional outcome with the more anatomical femoral tunnel as compared to the modified transtibial technique(mTT)but statistically not significant. But midterm results have shown that there is no much difference in the knee function, and there was no statistically significant difference (p-value < 0.05) noted between the two groups. The transportal technique (TP) group had better rotary stability, but the femoral tunnel length was more in mTT group. Conclusion: At short-term and midterm follow up, no statistically significant difference(p-value < 0.05) was noted between the two groups (mTT vs. TP) in terms of knee function, rehabilitation, and patient’s satisfaction. Long-term results should be compared.

international journal of orthopaedics sciences

Comparison of functional outcome of ACL reconstruction using modified transtibial technique (MTT) and transportal technique (TP) for making the femoral tunnel in a randomised prospective study