Farmedial versus anteromedial portal drilling of the femoral tunnel in ACL reconstruction: a computed tomography analysis

36 patients scheduled for arthroscopic anterior cruciate ligament (ACL) reconstruction were randomized to either a farmedial portal (FAM) or anteromedial (AM) portal technique to be used during the procedure. The purpose of this study was to compare femoral tunnel position, femoral tunnel angle, femoral tunnel length and then incidence of posterior wall blow-out between the two techniques in single-bundle ACL reconstruction with hamstring tendon autograft. The operated knees were evaluated with 0.5 mm fine computed tomography (CT) scans of 3-D CT between days 3 and 5 postoperatively. Results demonstrated that average tunnel length was significantly longer with the FAM technique compared to the AM technique, and that tunnels created using the FAM technique were placed more significantly more anterior than those created with the AM technique. Tunnel angle did not appear to significantly differ between techniques, and one patient from each group experienced posterior wall blow-out. As clinical outcome measures were not analyzed in the current study, future work is needed to determine if the current findings impact clinical outcome.