DOS 2017

DOS Kongressen 2017 ·

139

Better failure rates with recent compared to early pri-

mary anterior cruciate ligament reconstruction using

anteromedial portal for drilling of the femoral tunnel.

Niclas Højgaard Eysturoy , Torsten Grønbech Nielsen, Martin Carøe Lind

Division of SportsTrauma, Department of Orthopaedic Surgery., Aarhus Univer-

sity Hospital, Aarhus.

Background:

Registry studies have suggested increased revision rates and in-

ferior clinical outcomes when using the newer anteromedial (AM) technique for

femoral drill hole placement compared to the more established transtibial (TT)

technique in primary anterior cruciate ligament reconstruction (ALC-R).

Purpose / Aim of Study:

The aim of this study is to compare the techniques

from two different time-periods, namely the period when the AM-technique

was initiated and a more recent period when it has been established as a com-

mon technique.

Materials and Methods:

Respectively 8.436 and 8.862 primary ACL- R were

registered in the Danish Knee Ligament Reconstruction (DKRR) between Janu-

ary 2007 to December 2010 and January 2012 to December 2015. Relative

risk (RR) for revision ACL-R, positive pivot- shift, increased instability (KT-1000

> 2mm) and patient-reported outcome was used to compare the outcome of

the two periods.

Findings / Results:

The AM-technique went from being used in 23% in 2007-

10 to 84% in 2012-15. The relative risk (RR) for revision surgery in the AM

(2007-10) cohort compared to TT (2007-10) cohort was 1.55 (P < 0.00).

Comparing AM (2012-15) to TT (2012-15), no difference was found. In the

2007-10 period, the one-year postoperative RR for positive pivot-test was

1.28 (P<0.00), and for instability was 1.45 (P<0.00), both in favour for the

TT- technique. There was no significant difference in the period from 2012-15

Conclusions:

We found an increased RR of revision ACL- R, increased rotational

and sagittal instability when using the AM technique in the period from 2007-

10 compared to the TT technique. However, there was no significant difference

between the techniques in the period from 2012-2015. This could indicate

that the results found in the period 2007-10 may have been caused by a learn-

ing curve when introducing a new and more complex procedure (AM)

No conflicts of interest reported

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