~ 70 ~ National Journal of Clinical Orthopaedics 2019; 3(1): 70-74 ISSN (P): 2521-3466 ISSN (E): 2521-3474 © Clinical Orthopaedics www.orthoresearchjournal.com 2019; 3(1): 70-74 Received: 11-11-2018 Accepted: 15-12-2018 Vikas Trivedi Professor, Department of Orthopaedics, Era’s Lucknow Medical College, Lucknow, Uttar Pradesh, India Shakeel Qidwai Professor and Head, Department of Orthopaedics, Era’s Lucknow Medical College, Lucknow, Uttar Pradesh, India Karn Singh Chauhan Junior Resident, Department of Orthopaedics, Era’s Lucknow Medical College, Lucknow, Uttar Pradesh, India Amit Nandan Mishra Professor, Department of Orthopaedics, Era’s Lucknow Medical College, Lucknow, Uttar Pradesh, India Sudhir Shyam Kushwaha Assistant Professor, Department of Orthopaedics, Era’s Lucknow Medical College, Lucknow, Uttar Pradesh, India Afroz Khan Assistant Professor, Department of Orthopaedics, Era’s Lucknow Medical College, Lucknow, Uttar Pradesh, India Vipin Kumar Assistant Professor, Department of Orthopaedics, Era’s Lucknow Medical College, Lucknow, Uttar Pradesh, India Correspondence Karn Singh Chauhan Junior Resident, Department of Orthopaedics, Era’s Lucknow Medical College, Lucknow, Uttar Pradesh, India Outcome analysis of arthroscopic single bundle anterior cruciate ligament reconstruction through an accessory antero medial portal technique Vikas Trivedi, Shakeel Qidwai, Karn Singh Chauhan, Amit Nandan Mishra, Sudhir Shyam Kushwaha, Afroz Khan and Vipin Kumar DOI: https://doi.org/10.33545/orthor.2019.v3.i1b.15 Abstract Introduction: Anterior Cruciate Ligament (ACL) injuries are quite common among young sportspersons and those leading an active life, thereby stressing on the need to provide a rehabilitation that provides full functionality and can cut-back the duration of hospital stay in order to enable these persons to contribute actively to the society. As far as the incidence of ACL injuries in general population is concerned, it is one of the most common ligament injuries in sports traumatology. Materials and Methods: This is a comparative prospective study comprising of two groups each having 30 patients with complete ACL tear. In one group Accessory Antero medial portal technique was used and in the other group antero medial portal technique was used. The follow period was 1 year. Patients were assessed clinically and by lysholm knee score. Result: On the basis of this study it was found that patients in short term there is no significant difference between two techniques. However, in mid-term (6 months and 12 months) functional results are better in AAM as compared to AM. Femoral tunnel angles are smaller in AAM as compared to AM. Conclusion: For single bundle ACL reconstruction Accessory antero medial portal technique is a better procedure. Keywords: Anterior cruciate ligament, accessory antero medial portal technique Introduction Anterior Cruciate Ligament (ACL) injuries are quite common among young sportspersons and those leading an active life [1] , thereby stressing on the need to provide a rehabilitation that provides full functionality and can cut-back the duration of hospital stay in order to enable these persons to contribute actively to the society. More than 3% of athletes in a 4-year of sporting activity sustain a rupture of the ACL and the risk is higher in females [2] . The decision to undertake a surgical procedure for rehabilitation is dependent on the patient’s degree of symptoms and requirements in terms of activity level and participation in activities requiring pivoting motions [3] . ACL reconstruction is a surgical tissue graft replacement of ACL in the deficient knee to restore its function after ACL injury [4] . ACL reconstruction has traditionally been performed using two arthroscopic portals: the anterolateral (AL) and the anteromedial (AM) portal. In the two-portal technique, the AL portal is used as the arthroscopic viewing portal and the ACL femoral tunnel is drilled through the AM portal. Drilling the ACL femoral tunnel through the AM portal can also result in a shorter femoral tunnel length, limiting the amount of ACL graft that can be inserted into the ACL femoral tunnel when a cortical suspensory femoral fixation device is used. This approach requires an exact appreciation of the intra-articular bony anatomy, particularly on the medial face of the lateral femoral condyle to define tunnel placement [5] . This can be difficult to establish using traditional lateral portal arthroscopic viewing, where the femoral intercondylar and bifurcate ridges are not readily identified. Furthermore, use of the clock-face reference can lead to a high or anterior placement of the graft leading to graft failures [6] . The additional medial portal allows the ACL femoral attachment site to be viewed through the AM portal, while working instrumentation is inserted into the notch through the AAM portal.