Introduction Purpose of this study was to evaluate the outcome of anterior cruciate ligament (ACL) reconstruction surgery in medial tibia tunnel entrance in patients with ruptured ligament.

Materials and Methods This cohort study was performed in patients admitted to Sina academic hospital in Tehran from April 2009 to April 2010. ACL reconstruction was done by arthroscopic surgery and the patients knee function was assessed six months later. International Knee Documentation Committee (IKDC) questionnaire and arthrometer (model KT-1000) were used to measure patients knee activity level and functional testing before and after the procedure. Final knee score was given to the patient based on the lowest score in each section and include four groups: A, B, C and D.

Results 107 patients with mean age 29.61±5.15 years (21–38 years) participated in this study. 84 patients (78.5%) were male. Most common cause ACL rupture was due to sport injuries (54.20%), followed by road traffic accidents (19.62%), daily activities (16.82%) and work activities (9.3%). The mean femoral channel length done in this operation was 44.75±3.41 mm. The mean of range of motion (ROM) of knee after surgery was 143.21±5.37° (133–150°), and showed a significant difference between males and females (p=0.000). The functional test was performed by an arthrometer. Displacement differences between normal and operated knee was calculated six months after surgery. It showed significant difference between both genders (p=0.03).

Conclusion Transtibial graft position is closer to the anatomical position. This method is a simple procedure of transtibial graft surgery and has a good outcome.