title: Farmedial versus anteromedial portal drilling of the femoral tunnel in ACL reconstruction: a computed tomography analysis.
abstract: BACKGROUND
  The success of ACL reconstruction is predicated on a variety of factors. Tunnel placement plays one of the most significant roles in achieving knee kinematics and function. The purposes of this study were to compare femoral tunnel position, angle, length and posterior wall blow-out after ACL reconstruction with hamstring tendons autograft through either a farmedial portal or an anteromedial portal technique.
  
  
  METHODS
  We evaluated 36 patients who underwent ACL reconstruction between January 2014 and July 2014 in our institute, in a prospective, randomised cohort study. All the surgical procedures were performed by a sports fellowship-trained orthopaedic surgeon with experience in both portal reaming. The operated knees were evaluated with 0.5 mm fine CT scans of 3-D CT between days 3 and 5 postoperatively.
  
  
  RESULTS
  According to the 3-D CT measurements, the mean femoral tunnel length was significantly longer (p < 0.05) in the FAM group compared with the AM group. The femoral bone tunnel length averaged 34.2 ± 3.6 mm versus 36.6 ± 3.0 mm (p = 0.042) in AM and the FAM groups, respectively. The femoral tunnel position, as evaluated with use of the quadrant method, was more anterior in the FAM transportal technique group, and the difference between the two groups was significant (p < 0.05).
  
  
  CONCLUSIONS
  FAM tranportal drilling of the femoral tunnel creates longer and anterior femoral tunnels with regard to the AM portal drilling techniques. Additional studies with clinical outcomes are required for the clinical relevance of these techniques and to show which one is superior.
  
  
  METHODS
  Level I, prospective randomised comparative cohort study.
authors.affiliation: Orthopaedic and Traumatology Department, Faculty of Medicine, Sakarya University, Sakarya, Turkey, drmehmeterdem@gmail.com.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Erdem
authors.forename: Deniz
authors.initials: D
authors.lastname: Gulabi
authors.forename: Kiyasettin
authors.initials: K
authors.lastname: Asil
authors.forename: Ahmet Can
authors.initials: AC
authors.lastname: Erdem
mesh_terms: D000293:Adolescent; D000328:Adult; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007718:Knee Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D011446:Prospective Studies; D013710:Tendons / Q000637:transplantation*; D013977:Tibia / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D055815:Young Adult