Evidence map›Paper›PMID 28801704›Full record

Trial reportKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2018

No clinical differences between anteromedial portal and transtibial technique for femoral tunnel positioning in anterior cruciate ligament reconstruction: a prospective randomized, controlled trial.

Peter MacDonald, Chris Kim, Sheila McRae, Jeff Leiter, Ryan Khan, Daniel Whelan

Abstract readMulticenter StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 4 pooled it
4.0field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

16 citing papers in PubMed, 4 syntheses or guidelines pooled it, 35 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. [Progress of different methods for femoral tunnel positioning in anterior cruciate ligament reconstruction].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2021
    Pooled it
  4. Pooled it
  5. Trial
  6. Article
  7. Article
  8. Article
  9. Review
  10. Review
  11. ACL Reconstruction Graft Angle and Outcomes: Transtibial vs Anteromedial Reconstruction.HSS journal : the musculoskeletal journal of Hospital for Special Surgery · 2020
    Article
  12. Article
  13. Article
  14. Article
  15. Article
  16. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

Peter MacDonaldDepartment of Surgery, Pan Am Clinic, University of Manitoba, Orthopaedics 75 Poseidon Bay, Winnipeg, MB, R3M 3E4, Canada. pmacdonald@panamclinic.com.
Chris KimDepartment of Surgery, Pan Am Clinic, University of Manitoba, Orthopaedics 75 Poseidon Bay, Winnipeg, MB, R3M 3E4, Canada.
Sheila McRaeDepartment of Surgery, Pan Am Clinic, University of Manitoba, Orthopaedics 75 Poseidon Bay, Winnipeg, MB, R3M 3E4, Canada.
Jeff LeiterDepartment of Surgery, Pan Am Clinic, University of Manitoba, Orthopaedics 75 Poseidon Bay, Winnipeg, MB, R3M 3E4, Canada.
Ryan KhanSt. Michael's Hospital, St. Michael's Orthpaedic Associates, 55 Queen St E., Suite 800, Toronto, ON, M5C 1R6, Canada.
Daniel WhelanSt. Michael's Hospital, St. Michael's Orthpaedic Associates, 55 Queen St E., Suite 800, Toronto, ON, M5C 1R6, Canada.
Pan Am Clinic · CASt. Michael's Hospital · CAUniversity of Manitoba · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe anteromedial (AMP) portal technique was introduced to position the femoral tunnel in anterior cruciate ligament (ACL) reconstruction to more closely replicate the original ACL footprint compared to the transtibial (TT) approach. Few randomized trials have evaluated differences in these techniques with respect to clinical outcomes. The purpose of this study was to determine if there are any differences in clinical outcome between the AMP and TT approaches.

methodsThis is a single-blinded, prospective, randomized controlled trial. Participants were randomized to undergo ACL reconstruction using the AMP or TT approach. The primary outcome measure was the ACL quality of life (ACL-QOL), and secondary outcomes were the IKDC knee assessment, side-to-side difference in anterior-posterior knee laxity (KT-1000) and tunnel orientation (X-ray findings) at preoperative, 3, 6, 12, and 24 months postoperative. Statistical comparisons were performed using a series of t tests for independent groups with equal variance.

resultsNinety-six participants were consented and randomized between 2007 and 2011 with eight excluded postrandomization. Mean (SD) preoperative ACL-QOL was 33 (13) for TT and 36 (17) for AMP and improved significantly (p < 0.001) in both groups to 79 (18) and 78 (18) at 24 months postoperative, respectively. The preoperative median IKDC grade for both groups was C and improved similarly in both groups at 24 months (n.s.). There was no side-to-side difference in knee laxity based on KT-1000 measurements with a mean (SD) 1 (3) mm between affected and unaffected limbs in the TT group compared to 1 (3) mm for the AMP group. A significant difference was found in femoral tunnel orientation with the AMP group at 43° (7) and the TT group 58° (8) in the coronal plane (p < 0.001).

conclusionNo differences in clinical outcome were found when comparing AMP to TT in primary ACL reconstruction using a STG graft. This prospective randomized controlled trial suggests surgeons can use either method without significantly compromising clinical outcome. LEVEL OF EVIDENCE: I.

Indexed as

Quality of LifeAdultAnterior Cruciate LigamentAnterior Cruciate Ligament InjuriesAnterior Cruciate Ligament ReconstructionFemaleFemurHumansMaleProspective StudiesRadiographySingle-Blind MethodTendonsAnterior cruciate ligamentAnteromedialGracilisReconstructionSemitendinosusTibial tunnel independentTrans-tibial

Identifiers

PMID28801704
OpenAlexW2743694977

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.