The Effect of Remnant Preservation on Tibial Tunnel Enlargement in Anterior Cruciate Ligament Reconstruction with Polyethylene Terephthalate Artificial Ligament in a Large Animal Model

J Knee Surg DOI: 10.1055/s-0038-1675599An enlarged bone tunnel may affect the graft–bone integration and pose a problem for revision anterior cruciate ligament (ACL) surgery. The purpose of this study was to evaluate the effect of remnant preservation on tibial tunnel enlargement in ACL reconstruction with polyethylene terephthalate (PET) artificial ligament. Twenty-four skeletally mature male beagles underwent ACL reconstruction with PET artificial ligament for both knees. One knee was reconstructed with remnant preservation using sleeve technique (remnant group), while the contralateral was reconstructed without remnant preservation (control group). The animals were sacrificed at 1 day, 6 weeks, and 12 weeks after surgery for further evaluation including macroscopic observation, microcomputed tomography (micro-CT), histological assessment, and biomechanical testing. The remnant group had better synovial coverage than the control group at 6 and 12 weeks after surgery. The micro-CT analysis showed the tibial tunnel area (TTA) of the remnant group was significantly smaller and the bone volume/total volume fraction (BV/TV) value was higher than those of the control group at 6 and 12 weeks. Moreover, TTA and BV/TV at each time point were divided into three groups according to the different grade of synovial coverage. Significant association was observed between the synovial coverage degree and the TTA and BV/TV values. The histological assessment revealed that the interfac...
Source: Journal of Knee Surgery - Category: Orthopaedics Authors: Tags: Original Article Source Type: research

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AbstractBackgroundAnterior cruciate ligament (ACL) return-to-sport (RTS) test batteries are popular and are employed to test athletes ’ sport performance and help ensure a safe return to sport.ObjectiveTo perform a systematic review and meta-analysis to determine: (1) the proportion of patients who passed RTS test batteries after ACL reconstruction, (2) whether passing RTS test batteries increased rates of return to play, and (3) whether passing RTS test batteries reduced subsequent rates of knee and ACL injury.MethodsFive databases (PubMed, MEDLINE, Embase, CINAHL, and SPORTDiscus) were searched to identify relevant...
Source: Sports Medicine - Category: Sports Medicine Source Type: research
ConclusionThe rates of LARS ACL construct failure (33.3%) in this cohort are high and based on these results the LARS should not be considered as a graft option for primary ACL reconstruction.Level of evidenceIII, cohort study.
Source: Knee Surgery, Sports Traumatology, Arthroscopy - Category: Orthopaedics Source Type: research
We compared autografts and allograft using partial and complete transphyseal anterior cruciate ligament (ACL) reconstruction techniques among skeletally immature individuals.
Source: Journal of Orthopaedic Surgery and Research - Category: Orthopaedics Authors: Tags: Research article Source Type: research
ConclusionsMeniscal transplantation is clinically effective in treating patients with symptomatic meniscal deficiency. Where indicated, the addition of osteotomy or ACL reconstruction achieves results similar to patients undergoing simple meniscal transplantation in stable and normally aligned knees. Survivorship is lower in patients with full-thickness chondral loss and future treatments should, therefore, be directed at improving success in this at-risk group. The results support encouragement for earlier referral of symptomatic patients to a specialist meniscal reconstruction centre before a significant chondral damage ...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - Category: Orthopaedics Source Type: research
Anterior cruciate ligament reconstruction with the semitendinosus-gracilis graft leads to increased external tibial rotation. Our findings suggest that clinicians should make an effort to prevent increased external tibial rotation during the rehabilitation process in patients with semitendinosus-gracilis graft.
Source: Clinical Biomechanics - Category: Orthopaedics Authors: Source Type: research
ConclusionThis article reviews the regulations on graft tissue within the United States, factors affecting the biomechanics of allograft tissue, differences in allograft tissue choices, and the use of allograft for anterior cruciate ligament reconstruction and multiligamentous knee injury reconstruction.Level of evidenceV
Source: Knee Surgery, Sports Traumatology, Arthroscopy - Category: Orthopaedics Source Type: research
AbstractPurposeTo compare the “all-inside technique” for anterior cruciate ligament (ACL) reconstruction using a short, quadrupled semitendinosus tendon (ST4) autograft and suspensory cortical fixation on both the femoral and tibial side vs the “conventional technique” using a semitendinosus/gracilis (ST/G) autograft fix ed with a suspensory device on the femoral side and with an interference screw on the tibial side, in terms of clinical and functional outcomes.MethodsA total of 90 patients were enrolled, randomised into two groups, and prospectively followed. Group A comprised 45 patients treated ...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - Category: Orthopaedics Source Type: research
Anatomic tunnel formation and remnant preservation are valuable aspects of anterior cruciate ligament (ACL) reconstruction. However, anatomic landmarks are difficult to observe during remnant-preserving ACL reconstruction (ACLR). The aims of this study were to evaluate the: 1) femoral tunnel location created with guidance from the apex of the deep cartilage margin (ADC) and footprint compared to anatomical reference; and 2) relationship between femoral tunnel location and outcomes of ACLR.
Source: The Knee - Category: Orthopaedics Authors: Source Type: research
AbstractPurposeThe purpose was to calculate the incidence of osteoarthritis in individuals following Anterior Cruciate Ligament Reconstruction (ACLR) in a large, national database and to examine the risk factors associated with OA development.MethodsA commercially available insurance database was queried to identify new diagnoses of knee OA in patients with ACLR. The cumulative incidence of knee OA diagnoses in patients after ACLR was calculated and stratified by time from reconstruction. Odds ratios were calculated using logistic regression to describe factors associated with a new OA diagnosis including age, sex, BMI, me...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - Category: Orthopaedics Source Type: research
Purpose Hop tests are widely used to quantify recovery from anterior cruciate ligament reconstruction (ACLR) surgery. However, there is evidence that simply measuring hop distance may not be indicative of the quality of movement or representative of potential limitations in hopping mechanics, particularly during landing. The first purpose of the present study was to compare hop distance and loading symmetry between ACLR athletes and healthy uninjured recreational athletes. The second was to determine the association between hop distance and loading symmetry. Methods Twenty-five ACLR patients and 30 healthy controls co...
Source: Medicine and Science in Sports and Exercise - Category: Sports Medicine Tags: CLINICAL SCIENCES Source Type: research
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