Comparison of Clinical Results, Second-Look Arthroscopic Findings, and MRI Findings Between the Transportal and Outside-In Techniques for Double-Bundle Anatomic Anterior Cruciate Ligament Reconstruction: A Prospective, Randomized Controlled Trial With a Minimum 2-Year Follow-up

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128 patients scheduled for double-bundle anterior cruciate ligament (ACL) reconstruction were randomized to independent tunnel drilling using either the outside-in (OI) or transportal (TP) technique. Follow-up over 24 months was conducted for clinical measures, including functional scores and knee laxity. Follow-up over an average of 17.7 months was performed during second-look arthroscopy, which included grading of graft continuity, graft tension, and synovialization. Follow-up over an average of 5.8 months was performed on MRI, and included grading of graft continuity, femoral tunnel healing, and signal/noise quotient of the grafts. Results for all measures demonstrated no statistically significant differences between groups, with the exception of the functional test of IKDC objective score which favoured the OI technique.