Translateral and Transtibial Techniques Provide Similar Patient Outcomes in Arthroscopic Anterior Cruciate Ligament Reconstruction.

Abstract

Purpose: To compare the outcomes of the transtibial technique (TT) and the translateral technique (TLL) for anterior cruciate ligament (ACL) reconstruction in an Asian population.

Methods: Patients who underwent either TT or TLL for ACL reconstruction between 2019 and 2021 were identified. Inclusion criteria were skeletal maturity, a magnetic resonance imaging-diagnosed ACL tear, completion of at least 2 of 3 postoperative assessments, and a minimum follow-up of 24 months. Data collected include patient demographics, patient-reported outcome measure scores (Tegner activity scale and Lysholm score), objective clinical outcome scores (KT-1000), and medical records review to identify complications.

Results: The average follow-up time was 15.2 months (range: 6 to 24 months) in TT versus 17.5 months (range: 6 to 24 months) in TLL, P value = .622. Recovery of quadriceps function in a cohort of 134 patients was identified as the only significant difference in postoperative functional outcomes between the TT and TLL groups. At 12 months, the extension range of motion in TLL was statistically better than TT (TT: 1.1 ± 3.4 [-2.2, 4.4] vs TLL: -0.9 ± 2.9 [-3.7, 2.0], P = .005). KT-1000 measurement, Tegner activity scale, and Lysholm score were not statistically significant between the TT and TLL groups at 24 months. The follow-up rate (n [%]) between the TT and TLL groups at 12 months was 59 (78.7%) and 50 (84.7%), respectively, and at 24 months was 55 (77.3%) and 47 (79.7%), respectively.

Conclusions: In this Asian cohort, transtibial and translateral ACL reconstruction showed similar short-term outcomes. Small, transient differences in extension recovery favoring TLL did not persist at 24 months.

Level of evidence: Level III, retrospective comparative study.