Two Portal vs Three Portal Technique Using Accessory Anteromedial Portal for Femoral Tunnel Placement in Arthroscopic Acl Reconstruction

Purpose The anterior cruciate ligament (ACL) arthroscopic reconstruction is a top ranked orthopedic surgery conducted very commonly worldwide. When utilizing the standard two-portal technique for endoscopic ACL reconstruction, the most frequent surgical mistake is the incorrect placement of tunnels. In an anatomic ACL reconstruction, ensuring the accurate positioning of both tunnels is crucial, and this necessitates clear visualization. In our current research, we contrasted two methods for positioning the femoral tunnel, specically the two- portal and three-portal techniques, with the latter incorporating an extra accessory anteromedial portal. O Material and methods ur study involved 31 patients split into two groups: one with 17 patients using the 2-portal technique and the other with 14 using the 3-portal approach. We assessed the tunnel's position through post-operative CT scans, employing Quadrant and Mochizuki's methods. The subjects had an average age of 29.90 ± 8.49 yrs, comprising 23 males and 8 females. A majority, 19 (61.29%), suffered from right ACL tears, while the remaining 12 (38.71%) had left ACL tears. Outcome measures such as the femoral tunnel center point (A1/(A1+A2)) and the ratios (A/T) a Results nd (B/H) have demonstrated no important differences between the two techniques employed. It suggests that both methods for femoral tunnel placement are comparably effective. Conclusion A key advantage of the anteromedial technique is its facilitation of more precise identication of the anatomical location for tunnel placement. This approach provides surgeons with greater ease during ACL reconstruction, aiding in the creation of nearly accurate femoral tunnels and contributing to improved surgical outcomes.