Comparison of clinical results of anteromedial and transtibial femoral tunnel drilling techniques in knee reconstruction surgery

ISRCTN ISRCTN16407730
DOI https://doi.org/10.1186/ISRCTN16407730
Secondary identifying numbers 9750/44
Submission date
31/12/2019
Registration date
09/01/2020
Last edited
05/06/2020
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Musculoskeletal Diseases
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Background and study aims
Anterior cruciate ligament (ACL) reconstruction is a type of knee surgery to replace the ACL – one of the main ligaments in the knee. The ACL connects the thigh bone to the shin bone, and along with other ligaments in the knee, keeps the knee stable. A number of methods can be used to reconstruct an anterior cruciate ligament (ACL). The most common method is to use a tendon from elsewhere in the body to replace the ACL. The surgeon needs to drill a tunnel in the bone to pass the new tissue through.
The aim of this study is to compare two different drilling techniques in terms of the long term outcome on knee function.

Who can participate?
Patients who underwent knee reconstructive surgery at Orton Hospital in Helsinki Finland between May 1990 and December 2011

What does the study involve?
Retrospective data is gathered from patient records regarding the clinical outcomes of two different surgical techniques for knee reconstruction (anteromedial drilling and transtibial drilling).

What are the possible benefits and risks of participating?
None

Where is the study run from?
Hospital Orton, Invalid Foundation, Helsinki, Finland.

When is the study starting and how long is it expected to run for?
January 2006 to December 2013

Who is funding the study?
Orton research-grants by the Ministry of Social Affairs and Health, Finland.

Who is the main contact?
Dr Leena Metso
leena.metso@fimnet.fi

Contact information

Dr Leena Metso
Scientific

Työpajankatu 14 A
Helsinki
00580
Finland

ORCiD logoORCID ID 0000-0003-2875-6478
Phone +358 406700094
Email leena.metso@fimnet.fi

Study information

Study designRetrospective case control study
Primary study designObservational
Secondary study designCase-control study
Study setting(s)Hospital
Study typeTreatment
Participant information sheet Not available in web format, please use contact details to request a participant information sheet.
Scientific titleA retrospective comparison of clinical results of anteromedial and transtibial femoral tunnel drilling in ACL reconstruction
Study objectivesIs there a clinical difference in results between anteromedial and transtibial femoral drilling in the reconstruction of anterior cruciate ligament?
Ethics approval(s)Approved 11/11/2015, The Hospital District of Helsinki and Uusimaa Operative Ethics Committee (Tynnyrintekijänkatu 1 C, Helsinki, Finland; +358 (0)50 428 7838; keskuskirjaamo@hus.fi), ref: 364/13/03/02/2015. TMK02 §219
Health condition(s) or problem(s) studiedAnterior cruciate ligament rupture
InterventionIs there a clinical difference between anteromedial and transtibial tunnel drilling results in anterior cruciate ligament reconstruction at two year follow up. For this study we chose retrospectively 300 consecutive patients admitted to Orton Hospital, Helsinki Finland. They had been divided into two groups of 150 patients. The evaluation methods were clinical examination, knee scores (Lysholm, Tegner, IKDC) and instrumented laxity measurements (KT-2000™).

ACL ruptures were treated with an operation. 150 patients with anteromedial (AM) drilling and 150 with transtibial (TT) drilling. In the AM group the reconstructions were performed using semitendinosus graft with Tape Locking Screw (TLS™) technique or Retrobutton™ femoral and BioScrew™ tibial fixation with a semitendinosus-gracilis graft. In the TT group the fixation method used was Rigidfix™ femoral and Intrafix tibial fixation.

Patients were allocated consecutively in a single-centre hospital Orton in Helsinki Finland between May 1990 and December 2011. Clinical controls were at 1 and 2 years postoperatively. This is a retrospective study.
Intervention typeProcedure/Surgery
Primary outcome measureRecovery of knee function measured at one and two years post-operatively using:
1. Clinical examination
2. Knee scores (Lysholm, Tegner, IKDC)
3. Instrumented laxity measurements (KT-2000™)
Secondary outcome measuresPatient satisfaction measured using inteview at one and two years post-operatively
Overall study start date01/01/2006
Completion date31/12/2013

Eligibility

Participant type(s)Patient
Age groupMixed
SexBoth
Target number of participantsTotal number of patients recruited was 300. Revision ACL reconstruction was performed in 18 patients in the anteromedial group and in 17 in the transtibial group. These patients were excluded from the final evaluation leaving 132 patients in the anteromedial group and 133 patients in the transtibial group.
Total final enrolment265
Key inclusion criteria1. Male and female gender, no data of the percentage is collected
2. No limitations, mean age of the patients was 34 years (12-64 years)
3. ACL reconstruction performed with meniscal and collateral surgery done if needed
Key exclusion criteria1. PCL reconstruction done at the same time or previously
2. Revision ACL surgery (exclusion from the final data analysis)
Date of first enrolment15/05/1990
Date of final enrolment31/12/2011

Locations

Countries of recruitment

  • Finland

Study participating centre

Hospital Orton, Invalid Foundation
Tenholantie 10
Helsinki
00280
Finland

Sponsor information

Invalidisäätiö
Hospital/treatment centre

ORTON Orthopaedic Hospital, Invalid Foundation
Tenholantie 10
Helsinki
00280
Finland

Phone +358947481
Email leena.ristolainen@orton.fi
Website https://www.orton.fi
ROR logo "ROR" https://ror.org/020vv3w23

Funders

Funder type

Government

This work was supported by Orton research-grants by the Ministry of Social Affairs and Health, Finland.

No information available

Results and Publications

Intention to publish date16/01/2020
Individual participant data (IPD) Intention to shareYes
IPD sharing plan summaryAvailable on request
Publication and dissemination planThis article will be sent for evaluation in an orthopaedic journal in January 2020.
IPD sharing planThe datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request. Data is available from Arsi Harilainen, arsi.harilainen@orton.fi, type of data: BMDP statistics, data available at any time for 10 years. Access considered upon request. Raw data can be provided. Sharing the data with the third party has not been discussed with participants. Data is anonymised and there are no legal restrictions.

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article results 03/06/2020 05/06/2020 Yes No

Editorial Notes

05/06/2020: Publication reference added.
09/01/2020: Trial’s existence confirmed by The Hospital District of Helsinki and Uusimaa Operative Ethics Committee