Anterior Cruciate Ligament Reconstruction With Femoral Tunnel Anteromedial Portal Antegrade Drilling Versus Retrograde Drilling Techniques Using Hamstring Graft Has No Difference in Clinical Outcomes or Complications: A Systematic Review and Meta-analysis
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OrthoEvidence Journal (OE Journal) - ACE Report
Epub Ahead of Print
Am J Sports Med. 2026 01-Feb;():. 10.1177/03635465251360229Study Summary
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.
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