Research progress on preparation of lateral femoral tunnel and graft fixation in anterior cruciate ligament reconstruction

Table 1 Advantages and disadvantages of anterior cruciate ligament reconstruction techniques

Technique	Advantages	Disadvantages
Transtibial	Less surgical trauma; few complications[17]	Poor rotational stability of the knee joint; cartilage degeneration occurred earlier after surgery[14]
Anteromedial	The femoral tunnel was accurately positioned; better rotational stability[18,19]	The femoral tunnel is short; breaking the femoral cortex; a risk of injury to the common peroneal nerve[24,25]
Outside-in	Larger tendon-bone interface contact area[22]	Add auxiliary incision
Over-the-top	Reduce femoral inlet graft wear	Need to practice the technique[32,33]

Table 2 Advantages and disadvantages of femoral graft fixation

Technique	Advantages	Disadvantages
Aperture fixation	High fixation strength[67]	Meta obstructing postoperative evaluation; the degradation rate of absorbable materials is not completely controllable[63-66]
Cortical suspension fixation	Adjustable length is easy to use	The probability of complications such as bungee jumping effect and wiper effect increased; bone tunnel enlargement[68,69]
Transverse nail fixation	More tendon-bone contact area; uniform resistance distribution[9,71]	Risk of nail breakage