Transtibial technique versus two incisions in anterior cruciate ligament reconstruction: tunnel positioning, isometricity and functional evaluation

AbstractObjectiveTo compare the transtibial and two-incision techniques for anterior cruciate ligament (ACL) reconstruction using a single band.MethodsA prospective and randomized study was conducted in blocks. Patients underwent ACL reconstruction by means of two techniques: transtibial (group 1: 20 patients) or two incisions (group 2: 20 patients). The radiographic positioning of the tunnel, inclination of the graft, graft isometricity and functional results (IKDC and Lysholm) were evaluated.ResultsThe positioning of the femoral tunnel on the anteroposterior radiograph, expressed as a mean percentage relative to the medial border of the tibial plateau, was 54.6% in group 1 and 60.8% in group 2 (p<0.05). The positioning of the femoral tunnel on the lateral radiograph, expressed as a mean percentage relative to the anterior border of Blumensaat's line, was 68.4% in group 1 and 58% in group 2 (p<0.05). The mean inclination of the graft was 19° in group 1 and 27.2° in group 2 (p<0.05). The mean graft isometricity was 0.96mm in group 1 and 1.33mm in group 2 (p>0.05). Group 2 had better results from the pivot-shift maneuver (p