ملخص الدراسة

5 randomized controlled trials including 557 patients undergoing primary hamstring tendon anterior cruciate ligament (ACL) reconstruction were included in this systematic review and meta-analysis comparing anteromedial (AM) portal antegrade femoral tunnel drilling vs retrograde drilling techniques. Pooled outcomes of interest included International Knee Documentation Committee (IKDC) scores, Lysholm scores, Tegner scores, visual analogue scale (VAS) pain scores, revision ACL reconstruction, reoperations, infections, arthrofibrosis, and overall complications. No significant differences were observed between techniques for patient-reported outcomes, revision surgery, reoperations, infections, arthrofibrosis, or overall complication rates. Both drilling methods produced comparable clinical outcomes and safety profiles. These findings suggest that femoral tunnel drilling technique can be selected according to surgeon preference and individual patient factors without compromising outcomes.