{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T07:06:59Z","timestamp":1778569619066,"version":"3.51.4"},"reference-count":57,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2009,11,10]],"date-time":"2009-11-10T00:00:00Z","timestamp":1257811200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2010,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The transtibial (TT) drilling of the femoral tunnel in the bone\u2010patellar tendon\u2010bone (BPTB) anterior cruciate ligament (ACL) reconstruction was found to place the tunnel non\u2010anatomically. The use of the anteromedial portal (AMP) for the femoral drilling would provide the surgeon with more freedom to anatomically place the tunnel in the real femoral ACL footprint. The purpose of this study was to compare the clinical outcomes of BPTB ACL reconstruction using the AMP or the TT technique for the femoral tunnel drilling. A Medline search was not able to identify any study directly comparing the clinical outcomes of the AMP and the TT techniques. The literature search identified experimental and quasi\u2010experimental studies published from 1966 to March 2009 where at least one group underwent arthroscopic autologous BPTB ACL reconstructions using either the AMP or the TT technique for the femoral tunnel drilling. Overall IKDC, Lysholm score, activity level, range of motion, single\u2010leg hoop test, Lachman test, Pivot shift sign test, KT\u20101000 arthrometer measurements, and radiographic assessments were indirectly compared between the two groups (AMP versus TT). Twenty\u2010one studies, involving a total of 859 patients (257\u00a0in the AMP and 602\u00a0in the TT group), were included in this analysis. The AMP group demonstrated significantly earlier return to run and significantly greater range of motion, Lachman test values, and KT\u20101000 arthrometer measurements in the 1\u20132\u2010year follow\u2010up, although no differences were found for both the 3\u20135 and the 6\u201310\u2010year follow\u2010ups for any of these parameters. In contrast, the TT group demonstrated significantly higher activity level for the 3\u20135 and 6\u201310\u2010year follow\u2010up. The use of the AMP elicited greater knee stability and range of motion values, and earlier return to run compared to the TT technique. These results may indicate a potential benefit of the AMP over the TT technique. However, as the benefits of the AMP were not obtained in the mid and long\u2010term follow\u2010ups, overall there is no definitive evidence at this point to conclude that one technique is superior to the other. Randomized controlled trials directly comparing the use of both techniques with long\u2010term follow\u2010ups will help clarify which one, if any, provides best clinical outcomes.<\/jats:p>","DOI":"10.1007\/s00167-009-0964-0","type":"journal-article","created":{"date-parts":[[2009,11,9]],"date-time":"2009-11-09T12:12:54Z","timestamp":1257768774000},"page":"1013-1037","source":"Crossref","is-referenced-by-count":90,"title":["The transtibial versus the anteromedial portal technique in the arthroscopic bone\u2010patellar tendon\u2010bone anterior cruciate ligament reconstruction"],"prefix":"10.1002","volume":"18","author":[{"given":"Eduard","family":"Alentorn\u2010Geli","sequence":"first","affiliation":[{"name":"Artroscopia G.C. 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