Clinical trial NCT02795247: Comparison of 3 Techniques for Recreation of Anterior Cruciate Ligament Anatomic Footprint
Official title: Three Dimensional Computed Tomography Comparison of the Transtibial, Modified Transtibial and Anteromedial Portal Technique for Recreation of the Anterior Cruciate Ligament Anatomic Footprint
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Anterior Cruciate Ligament Reconstruction
Lead sponsor: OrthoCarolina Research Institute, Inc.
Sponsor class: OTHER
First posted: 2016-06-10
Enrollment: 30
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: The purpose of this study is to compare the tomographic results of patients who underwent single-bundle anterior cruciate ligament reconstruction at the investigator's institution using the transtibial, accessory medial portal technique and the modified transtibial technique to determine which technique best recreates the anterior cruciate ligament anatomic footprint.


Eligibility criteria: Inclusion Criteria:

* Patients presenting for single bundle ACL reconstruction, with or without associated partial meniscectomy or meniscal repair.
* Skeletally mature patients
* Patients who are able and willing to receive post-operative CT imaging of the affected knee

Exclusion Criteria:

* Previous ACL reconstruction in the studied knee
* Previous ACL injury or reconstruction in the contralateral kneeConcomitant non-ACL ligament reconstruction or osteotomy

Primary outcomes:
measure: 3D reconstructed CT imaging
timeFrame: 6 weeks Post-Operatively
Secondary outcomes:
measure: International Knee Documentation Committee (IKDC) Subjective Knee Evaluation
timeFrame: 6 weeks post-operative
measure: Knee injury and Osteoarthritis Outcome Score (KOOS)
timeFrame: 6 weeks post-operative
measure: International Knee Documentation Committee (IKDC) Subjective Knee Evaluation
timeFrame: 6 months post-operative
measure: Knee injury and Osteoarthritis Outcome Score (KOOS)
timeFrame: 6 months post-operative
measure: International Knee Documentation Committee (IKDC) Subjective Knee Evaluation
timeFrame: 1 year post-operative
measure: Knee injury and Osteoarthritis Outcome Score (KOOS)
timeFrame: 1 year post-operative
measure: International Knee Documentation Committee (IKDC) Subjective Knee Evaluation
timeFrame: 2 year post-operative
measure: Knee injury and Osteoarthritis Outcome Score (KOOS)
timeFrame: 2 year post-operative
measure: Knee Laxity
timeFrame: 6 month post-operatively
Other outcomes:
Locations:
city: Charlotte
country: United States
facility: OrthoCarolina Sports Center
state: North Carolina
Study officials:
affiliation: OrthoCarolina Research Institute, Inc.
name: Dana P Piasecki, MD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Robin BN, Jani SS, Marvil SC, Reid JB, Schillhammer CK, Lubowitz JH. Advantages and Disadvantages of Transtibial, Anteromedial Portal, and Outside-In Femoral Tunnel Drilling in Single-Bundle Anterior Cruciate Ligament Reconstruction: A Systematic Review. Arthroscopy. 2015 Jul;31(7):1412-7. doi: 10.1016/j.arthro.2015.01.018. Epub 2015 Mar 5.
citation: Youm YS, Cho SD, Eo J, Lee KJ, Jung KH, Cha JR. 3D CT analysis of femoral and tibial tunnel positions after modified transtibial single bundle ACL reconstruction with varus and internal rotation of the tibia. Knee. 2013 Aug;20(4):272-6. doi: 10.1016/j.knee.2012.10.024. Epub 2012 Nov 26.
citation: Lee MC, Seong SC, Lee S, Chang CB, Park YK, Jo H, Kim CH. Vertical femoral tunnel placement results in rotational knee laxity after anterior cruciate ligament reconstruction. Arthroscopy. 2007 Jul;23(7):771-8. doi: 10.1016/j.arthro.2007.04.016.
citation: Alentorn-Geli E, Lajara F, Samitier G, Cugat R. The transtibial versus the anteromedial portal technique in the arthroscopic bone-patellar tendon-bone anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. 2010 Aug;18(8):1013-37. doi: 10.1007/s00167-009-0964-0. Epub 2009 Nov 10.
citation: Takeda Y, Iwame T, Takasago T, Kondo K, Goto T, Fujii K, Naruse A. Comparison of tunnel orientation between transtibial and anteromedial portal techniques for anatomic double-bundle anterior cruciate ligament reconstruction using 3-dimensional computed tomography. Arthroscopy. 2013 Feb;29(2):195-204. doi: 10.1016/j.arthro.2012.08.020. Epub 2012 Dec 24.
citation: de Abreu-e-Silva GM, de Oliveira MH, Maranhao GS, Deligne Lde M, Pfeilsticker RM, Novais EN, Nunes TA, de Andrade MA. Three-dimensional computed tomography evaluation of anterior cruciate ligament footprint for anatomic single-bundle reconstruction. Knee Surg Sports Traumatol Arthrosc. 2015 Mar;23(3):770-6. doi: 10.1007/s00167-013-2703-9. Epub 2013 Oct 22.
citation: Larson AI, Bullock DP, Pevny T. Comparison of 4 femoral tunnel drilling techniques in anterior cruciate ligament reconstruction. Arthroscopy. 2012 Jul;28(7):972-9. doi: 10.1016/j.arthro.2011.12.015. Epub 2012 Mar 10.
citation: Osaki K, Okazaki K, Matsubara H, Kuwashima U, Murakami K, Iwamoto Y. Asymmetry in Femoral Tunnel Socket Length During Anterior Cruciate Ligament Reconstruction With Transportal, Outside-In, and Modified Transtibial Techniques. Arthroscopy. 2015 Dec;31(12):2365-70. doi: 10.1016/j.arthro.2015.06.026. Epub 2015 Aug 24.
citation: Bernard M, Hertel P, Hornung H, Cierpinski T. Femoral insertion of the ACL. Radiographic quadrant method. Am J Knee Surg. 1997 Winter;10(1):14-21; discussion 21-2.
citation: Forsythe B, Kopf S, Wong AK, Martins CA, Anderst W, Tashman S, Fu FH. The location of femoral and tibial tunnels in anatomic double-bundle anterior cruciate ligament reconstruction analyzed by three-dimensional computed tomography models. J Bone Joint Surg Am. 2010 Jun;92(6):1418-26. doi: 10.2106/JBJS.I.00654.
citation: Sohn OJ, Lee DC, Park KH, Ahn HS. Comparison of the Modified Transtibial Technique, Anteromedial Portal Technique and Outside-in Technique in ACL Reconstruction. Knee Surg Relat Res. 2014 Dec;26(4):241-8. doi: 10.5792/ksrr.2014.26.4.241. Epub 2014 Dec 2.
citation: Trofa DP, Saltzman BM, Corpus KT, Connor PM, Fleischli JE, Piasecki DP. A Hybrid Transtibial Technique Combines the Advantages of Anteromedial Portal and Transtibial Approaches: A Prospective Randomized Controlled Trial. Am J Sports Med. 2020 Nov;48(13):3200-3207. doi: 10.1177/0363546520956645. Epub 2020 Oct 5.