Table 3.
Summary of Femoral Tunnel Techniques RCTs With Significant Findings
| RCT | Level of Evidence | Subgroup | Interventions | Outcome Measures | Results |
|---|---|---|---|---|---|
| Takeda et al., 201327 | II | TP vs TT | Anteromedial vs Transtibial portals double-bundle hamstrings (n = 50) | Volume-rendering CT, 3D-CT tunnel placements on 7th postoperative day. | With AM technique, femoral tunnels were placed significantly deeper, lower, and closer to the femoral footprint and the overall femoral tunnel length was significantly shorter. |
| Venosa et al., 201728 | I | TP vs TT | Anteromedial vs Transtibial portals hamstrings (n = 52) | Femoral tunnel positioning 3D-CT | AM portal technique provided more anatomical graft placement than TT techniques. |
| Mirzatolooei, 201229 |
II | TP vs TT | Transportal TransFix femoral fixation vs Transtibial using hamstrings at minimum 18 months’ FU (n = 168/223) | IKDC, Lysholm, Tegner scores and rolimeter, tunnel positioning | Better reported outcomes for TP group: Laxity (mean difference between normal / affected side): TT 2.2 ± 1.13 vs TP 1.73 ± 0.85 mm (P = .002). Mean Lysholm score 81.41 TP vs 78.32 TT (P = .037). More anatomic tunnel placement with TP |
| Kim et al., 201330 | I | TP vs OI | Transportal vs Outside-in double bundle (n = 80) | CT analysis of the femoral tunnel position | TP technique had significantly more ellipsoidal AM femoral tunnel aperture than the OI technique. |
| Nakamura et al., 202031 | I | TP vs TT vs OI | Transportal vs Transtibial vs Outside-in techniques double-bundle (n = 86/98) | Femoral and tibial tunnel angles and positions 3D-CT | Femoral tunnel positions created by the TT technique were significantly higher, with larger variance, than the TP and OI technique. |
3D, 3-dimensional; AM, anteromedial; CT, computed tomography; FU, follow-up; IKDC, International Knee Documentation Committee; OI, outside-in; RCT, randomized controlled trial; TP, transportal; TT, transtibial.