Comparing Transtibial and Anteromedial Drilling Techniques for Single-bundle Anterior Cruciate Ligament Reconstruction

Erhan Sukura, *, Yunus Emre Akmanb, Ahmet Senelc, Ethem Ayhan Unkard, Huseyin Nevzat Topcua, and Yusuf Ozturkmenc
a Sakarya Education and Research Hospital, 54100, Sakarya, Turkey
b Metin Sabanci Baltalimani Bone and Diseases Training and Research Hospital, 34470, Istanbul, Turkey
c Istanbul Education and Research Hospital, 34100, Istanbul, Turkey
d Kartal Yavuz Selim State Hospital, 34050, Istanbul, Turkey

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© Sukur et al.; Licensee Bentham Open

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution-Non-Commercial 4.0 International Public License (CC BY-NC 4.0) (, which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Sakarya Education and Research Hospital, 54100, Sakarya, Turkey; Tel: +905322632090; Fax: +902642759192; E-mail:



Among the many factors that determine the outcome following anterior cruciate ligament (ACL) reconstruction, the position of the femoral tunnel is known to be critically important and is still the subject of extensive research.


We aimed to retrospectively compare the outcomes of arthroscopic ACL reconstruction using transtibial (TT) or anteromedial (AMP) drilling techniques for femoral tunnel placement.


ACL reconstruction was performed using the TT technique in 49 patients and the AMP technique in 56 patients. Lachman and pivot-shift tests, the Lysholm Knee Scale, International Knee Documentation Committee (IKDC) score, Tegner activity scale and visual analog scale (VAS) were used for the clinical and functional evaluation of patients. Time to return to normal life and time to jogging were assessed in addition to the radiological evaluation of femoral tunnel placement.


In terms of the Lysholm, IKDC, Tegner score, and stability tests, no significant differences were found between the two groups (p > 0.05). Statistical analysis revealed reduced time to return to normal life and jogging in the AMP group (p < 0.05). The VAS score was also significantly reduced in the AMP group (p < 0.05). The position of the femoral tunnel was anatomically appropriate in 51 patients in the AMP group and 5 patients in the TT group.


The AMP technique is superior to the TT technique in creating anatomical femoral tunnel placement during single-bundle ACL reconstruction and provides faster recovery in terms of return to normal life and jogging at short-term follow-up.

Keywords: Anterior cruciate ligament, Anteromedial portal, Drilling, Femoral tunnel, Graft, Transtibial technique.