This small randomised series looks at the functonal and clinical scores as well as the MRI tunnel positions for two commonly performed soft-tissue ACL reconstructive techniques. The authors conclude that anatomically placed tunnels (through the anteromedial portal technique AMP)do indeed lead to more anatomically placed ACL grafts than transtibial femoral tunnel placement (TT). Both techniques appear to be equally effective in correcting the pivot shift, with the AMP reconstructions better correcting AP laxity (Lachman).

However the authors found no difference in the function scores between the techniques.   

These are not novel claims. There have been previous studies of this subject and meta-analyses, which have demonstrated clinical differences between these techniques.

For example, the AMP technique has demonstrated significantly earlier return to run and significantly greater range of motion, Lachman test values, and KT-1000 arthrometer measurements in the 1-2-year follow-up, although no differences were found for both the 3-5 and the 6-10-year follow-ups for any of these parameters. 

Knee Surg Sports Traumatol Arthrosc. 2010 Aug;18(8):1013-37. doi: 10.1007/s00167-009-0964-0. Epub 2009 Nov 10.
The transtibial versus the anteromedial portal technique in the arthroscopic bone-patellar tendon-bone anterior cruciate ligament reconstruction. Alentorn-Geli E1, Lajara F, Samitier G, Cugat R.

or

a blinded cross-sectional study which found that the AMP technique significantly improved the anterior-posterior and rotational knee stability, IKDC scores, and recovery time from surgery compared to the TT technique.

Int Orthop. 2010 Jun;34(5):747-54. doi: 10.1007/s00264-010-1000-1. Epub 2010 Apr 20.
Anteromedial portal versus transtibial drilling techniques in ACL reconstruction: a blinded cross-sectional study at two- to five-year follow-up. Alentorn-Geli E1, Samitier G, Alvarez P, Steinbacher G, Cugat R.

Nevertheless this paper does add to the subject, and confirms that "anatomical" reconstructions are more "anatomical"!

The claims are properly placed in the context of previous literature, however the "introduction" or "discussion" section could elaborate further on the actual clinical findings of other papers, specifically quoting the the clinical differences and/or lack of differences found by the larger clinical studies; rather than just summarising this as the authors have done in the introduction seciton "Comparative prospective studies comparing the results of TT and AMP technique have shown varied results with no definite advantage of either of them", which is not altogether correct. 

The results support the claims

N/A

The Methodology is valid

A longer term follow-up of this cohort of patients would be helpful, for instance at 5 and 10 years post-surgery, looking at the functional and clinical outcomes, failure rates etc..... 

The is an interesting paper. It is not a landmark paper. It does however add to the subject and merits publication. 

Nil

Anterior cruciate ligament reconstruction with the ligament augmentation and reconstruction system: a systematic review. Newman SD, Atkinson HD, Willis-Owen CA. Int Orthop. 2013 Feb;37(2):321-6. doi: 10.1007/s00264-012-1654-y. Epub 2012 Sep 14. Review.

.