A COMPARISON BETWEEN OUTSIDE-IN AND TRANSTIBIAL TECHNIQUES FOR THE POSITIONING OF THE FEMORAL TUNNELS IN THE DOUBLE BUNDLE ACL RECONSTRUCTION TECHNIQUE, USING MRI EVALUATION

Abstract

Thirty patients with chronic lesions of the ACL underwent reconstruction of the ACL with double bundle technique. A wire at 65° was used for AM tibial tunnel and a prototype was used for the PL. For femoral tunnels, a transtibial technique was applied in fifteen patients and the outside-in technique was used in fifteen more. All patients had an MRI after three months. The tunnels position was studied with Amis’ circle method, as a proportion of the circle’s height and width. We compared the proportion of the anatomical data on fourteen cadaveric knees. In the transtibial group the AM tunnel was at 56% of the circle’s height and at 65%of the depth (mean); the PL was at 40% of the circle’s height and 54% of the depth. In the out-side group the AM tunnel was 48%of the circle’s height and at 66% of the depth; the PL one was at 32%of the circle’s height and at 61%of the depth. In corpses the AM insertion was at 50% of the circle’s height and 69% of the depth (mean). In conclusion the outside-in technique allows better anatomical positioning.