Comparison of the Efficacy of Two Femoral Tunnel Techniques in All-Inside Technique of the Anterior Cruciate Ligament Reconstruction

Zhang Jun; Zhu Weiwei; Xu Fuguo; Zhao Yilang; Wang Tao

Abstract：Objective To compare the differences in postoperative clinical efficacy between the outside-in technique and the anteromedial portal technique in arthroscopic all-inside technique for creating femoral tunnels of the anterior cruciate ligament(ACL)reconstruction.Methods A retrospective analysis was conducted on 60 patients with ACL rupture treated at the Department of Sports Medicine,Xuzhou Central Hospital,between February 2020 and June 2022.Patients were divided into two groups:The observation group(n=30,treated with the outside-in technique)and the control group(n=30,treated with the anteromedial portal technique).Demographics included 20 males and 10 females in the observation group[age range:24～37 years,mean age:(29.30±4.00)years]and 17 males and 13 females in the control group[age range:23～40 years,mean age:(29.70±4.21)years].Clinical outcomes were evaluated using the Lysholm knee scores and knee society scores(KSS)at baseline,6 months,and 12 months postoperatively.Knee joint laxity was assessed preoperatively and at the final follow-up.During the follow-up period,the incidence of wound infections,tendon loosening,and postoperative revisions were recorded for both groups.Results All patients completed a follow-up period ranging from 12 to 18 months,with a mean follow-up duration of(15.37±1.61)months in the observation group and(14.97±1.56)months in the control group.At 12 months postoperatively,the knee joint anterior drawer test,Lachman test,and axial shift test results were comparable between the observation group and the control group,demonstrating no statistically significant difference(P＞0.05).The Lysholm knee scores and KSS at 6 and 12 months postoperatively were similar in both groups,with no statistically significant difference observed(P＞0.05).Throughout the follow-up period,neither group reported any cases of wound infection,tendon loosening,or the need for postoperative revision.Conclusion Both the anteromedial portal technique and the outside-in technique,when employed in arthroscopic all-inside reconstruction of the anterior cruciate ligament,effectively achieve anatomical positioning of the femoral tunnel.Following surgery,patients in both groups experienced satisfactory recovery of knee joint function,with comparable short-term therapeutic outcomes.This suggests that both techniques are viable options for ACL reconstruction,offering comparable efficacy and outcomes in the short-term.