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Table 2 Summary of findings table of indirect outcomes

From: Transtibial versus independent femoral tunnel drilling techniques for anterior cruciate ligament reconstruction: evaluation of femoral aperture positioning

Outcome

Illustrative comparative risks

No of participants (studies)

Assumed risk

Corresponding risk (95% CI)

Aperture coronal plane position as % of scaling dimension

a. Perpendicular to BL

Quadrant method

   

On CT

On radiograph

Heming method on tunnel radiograph

Sommer method on tunnel radiograph

24%

16.3%

61.7°

0%, 17%, and 83% in Zone D, A, and B, respectively

11.3% lower position (8% lower: 14.6 lower)

4.45% lower position (1.9% lower to 7% lower)

5.8° lower (7.75° lower to 3.9° lower)

17%, 48%, and 34% in Zone D, A, and B, respectively

1070 (16 studiesa)

102 (2 studiesb)

105 (1 study)

105 (1 study)

b. Along AP axis

Anatomic coordinate axis method on CT

   

Clock face method

On specimen

On MRI

Heming method on axial CT

56.2%

25.5°

327°

63.3°

13.6% more posterior (3.4% more posterior to 22.9% more posterior)

4.50° more anterior (3.15° more posterior to 12.15° more anterior)

19.15° more posterior (24.1° more posterior to 14.2° more posterior)

10.6° more posterior

359 (4 studiesc)

20 (1 study)

126 (3 studies)

20 (1 study)

c. Mediolateral position%

NE

NEd

92 (2 studies)

Aperture coronal plane position as distance from fixed anatomic landmark

On specimen

Distance of aperture center to ANT along AP axis

19 mm posterior

0.6 mm more anterior (0.8 mm more posterior to 2 mm more anterior)

10 (1 study)

On CT

   

Distance of aperture center to IAS

Distance of aperture to IAS

11.8 mm

NE

2.4 mm closer (3.6 mm closer to 1.8 mm closer)

NEe

20 (1 study)

40 (2 studies)

On MRI

   

Distance of aperture center to O-t-T along AP axis

1.4 mm posterior

7 mm more posterior (6.65 mm more posterior to 7.35 mm more posterior)

61 (1 study)

Aperture sagittal plane position as % of scaling dimension

a. Along BL

Quadrant method

   

On CT

On radiograph

On MRI

Harner method on radiograph

Aglietti method

On radiograph

On specimen

Aperture screw head position by quadrant method on radiograph

30.9%

32.2%

15.2%

26.6%

NE

52.7%

25%

3% deeper (6.2% deeper to 0.3% shallower)

2.4% deeper (9.5% deeper to 4.7% shallower)

2.9% deeper (5.9% deeper to 0.1% shallower)

12.5% shallower (9.9% shallower:15% shallower)

NEf

8% shallower (4.2% shallower: 11.8% shallower)

5.7% shallower (2.7% shallower:8.7% shallower)

1070 (16 studiesa)

102 (2 studiesb)

87 (2 studies)

92 (2 studies)

80 (2 studies)

12 (1 study)

30 (1 study)

b. Along PD axis

   

Anatomic coordinate axis method on CT

Heming method on coronal CT

37.9%

74.67°

0.6% more distal (0.9% more proximal to 2.25% more distal)

7° more distal (9° more distal to 5° more distal)

359 (4 studiesc)

100 (1 study)

Aperture sagittal plane position as distance from fixed anatomic landmark

On specimen

   

Distance of aperture center to ANT along PD axis

Distance of aperture posterior edge to PAS

Distance of aperture center to PAS

26.3 mm proximal

2.32 mm

6.1 mm

5.2 mm more distal (9.5 mm more distal to 0.9 mm more distal)

0.04 mm further (0.3 mm closer to 0.3 mm further)

0.85 mm closer (1 mm closer to 0.7 mm closer)

10 (1 study)

20 (1 study)

20 (1 study)

On CT

   

Distance of aperture center to PAS

Distance of aperture posterior edge to PAS

Distance of aperture anterior edge to AAS

10.8 mm

3.36 mm

9.9 mm

3.9 mm closer (4.6 mm closer to 3.2 mm closer)

0.86 mm closer (NS)

4.9 mm closer (6.3 mm closer to 3.5 mm closer)

20 (1 study)

20 (1studiy)

20 (1 study)

On MRI

   

Distance of aperture center to O-t-T along PD axis

8.6 mm distal

0.4 mm more distal (0.3 mm more proximal to 1.1 mm more distal)

61 (1 study)

  1. Harner method: aperture position % from whole BL; Aglietti method: aperture anterior edge position; NE: not estimable; ANT: anterior notch tip; IAS: inferior articular surface; PAS: posterior articular surface; O-t-T: over-the-top point; NS: nonsignificant
  2. aOther 2 studies [31, 66] whose results could not be pooled, measured the same outcome and showed inconsistent results
  3. bA third study [23] whose results could not be pooled, measured the same outcome, and demonstrated a consistent result
  4. cA fifth study [27] whose results could not be pooled, measured the same outcome, and demonstrated a consistent result
  5. dQualitative synthesis: The results were consistent. Both studies [28, 46] showed that TI technique placed F aperture at significantly more lateral position
  6. eQualitative synthesis: The results were inconsistent. Tompkins 2013 found nonsignificant difference and Larson found TI technique placed aperture significantly closer with mean difference of 6 mm
  7. fQualitative synthesis: The results were consistent. Both studies [13, 56] showed that there was nonsignificant difference between both techniques in position along BL