A drilling technique that improves the outcome of surgery to reconstruct the anterior cruciate ligament (ACL) has been identified by surgeons from Hospital for Special Surgery in New York. The news will be presented during the annual meeting of the American Orthopedic Society for Sports Medicine, June 9-12, in Keystone. Colo.
"We found that the anatomy was better reproduced with the anteromedial portal drilling technique compared to the transtibial technique," said Asheesh Bedi, M.D., a fellow in sports medicine and shoulder surgery at Hospital for Special Surgery who was involved with the study.
In recent years, an improved understanding of the anatomy of the ACL has allowed surgeons to refine techniques to reconstruct the ACL. Investigators at Hospital for Special Surgery (HSS) set out to compare the outcomes of surgeries using two common techniques. "The goal in repairing the ACL is to recreate the normal anatomy, and there are a variety of different techniques to prepare tunnels for ACL reconstruction that have evolved over time," said Dr. Bedi. "The focus of the study was to compare two very common techniques in terms of their ability to reproduce the native ligament anatomy and restore the stability of the knee after reconstruction in a cadaveric model."
"This study clearly demonstrates that restoring the anatomy of the ACL and the stability of the knee is far superior when the femoral socket is reamed through the anteromedial portal rather than the tibial tunnel, as has been traditionally done by most surgeons," said David W. Altchek, M.D., attending orthopedic surgeon and co-chief of the Sports Medicine and Shoulder Service at HSS. "HSS is an international leader in this innovative solution toward further improving patient outcomes in ACL surgery."
According to Dr. Bedi, the work has translated into modified techniques in the operating room at HSS, where more than 800 ACL surgeries are performed each year. Tears of the ACL are quite common, with between 70,000 and 80,000 reported each year in the United States.