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

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

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)383-390
Number of pages8
JournalArchives of Orthopaedic and Trauma Surgery
Volume140
Issue number3
DOIs
Publication statusPublished - 1 Mar 2020

Bibliographical note

Publisher Copyright:
© 2020, Springer-Verlag GmbH Germany, part of Springer Nature.

Keywords

  • Anterior cruciate ligament reconstruction
  • Femoral tunnel geometry
  • Flexible reamer system
  • Posterior wall breakage
  • Transportal technique

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