Review article - (2021)20, 237 - 249
DOI:
https://doi.org/10.52082/jssm.2021.237
Comparison of Clinical Outcomes between Anteromedial and Transtibial Techniques of Single-Bundle Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-Analysis
Ran Li1, Tao Li1, Qiuping Zhang2, Weili Fu1,, Jian Li1
1Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, China
2Rheumatism Immunology Laboratory, West China Hospital, Sichuan University, China

Weili Fu
✉ Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, No 37 Guo Xue Xiang, Chengdu, Sichuan 610041, P. R. China
Email: foxwin2008@163.com
Received: 05-12-2020 -- Accepted: 04-02-2021
Published (online): 08-03-2021

ABSTRACT

This study compared clinical outcomes obtained after single-bundle anterior cruciate ligament (ACL) reconstruction using the anteromedial (AM) and transtibial (TT) techniques, which comprise the conventional transtibial (cTT) and modified transtibial (mTT) techniques. This study included clinical randomized controlled trials and prospective and retrospective controlled trials with AM and TT techniques from the PubMed and Embase databases and the Cochrane Library. All databases were searched from January 2010 to July 2020. Two independent evaluators verified the quality of the included studies using the Cochrane Collaboration’s risk of bias tool and the Newcastle-Ottawa Scale (NOS). Outcome measures analysed included the Lachman test, pivot-shift test, side-to-side difference (SSD), Lysholm score, Tegner activity scale, International Knee Documentation Committee (IKDC) grade and score. Ten randomized controlled trials (RCTs) and 16 prospective and retrospective controlled trials were included with a total of 2202 patients. There were 1180 patients and 1022 patients in the AM and TT groups, respectively. Compared to the cTT group, superior postoperative results were observed in the AM group based on the negative rate of the Lachman test and the pivot-shift test, IKDC grade and score, Lysholm score, Tegner activity scale and SSD (p < 0.05). However, there was no significant difference between the AM and mTT groups (p > 0.05). Compared to the conventional TT technique, the AM technique exhibited superior clinical outcomes. Nevertheless, the modified TT and AM techniques had comparable results. With neither of the techniques (mTT or AM) producing significantly superior outcomes, surgeons can choose either of them depending on their preferences.

Key words: Anterior cruciate ligament reconstruction, anteromedial, transtibial, modified transtibial, meta-analysis

Key Points
  • This meta-analysis was conducted based on the latest studies about the cTT, mTT and AM techniques.
  • Compared to the cTT technique, the AM technique showed superior clinical outcomes.
  • The mTT and AM techniques had comparable clinical outcomes.
  • Surgeons can choose the one between the mTT and AM techniques, depending on their preferences.








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