Aperture and Suspensory Fixation Equally Efficacious for Quadriceps Tendon Graft Fixation in Primary ACL Reconstruction: A Systematic Review

J Knee Surg DOI: 10.1055/s-0039-1685160This review is aimed to compare suspensory and aperture quadriceps tendon autograft femoral and tibial fixations in primary anterior cruciate ligament reconstruction (ACL-R), and the clinical outcomes and complication profiles of each fixation method. Greater understanding of the optimal graft fixation technique for quadriceps tendon (QT) autografts may assist surgeons in improving outcomes after ACL-R. PubMed, Embase, and Medline were searched from database inception to September 2017, and again to July 2018, and identified 3,670 articles, 21 studies of which satisfied inclusion/exclusion criteria. Across included studies, 1,155 QT ACL-R patients (mean age, 28.7 years [range, 15–59 years], with mean postoperative follow-up of 36.1 months [range, 3.4–120 months]), were analyzed. Suspensory fixation on both sides demonstrated a higher percentage of patients (81.7%) achieving the highest rating of “A or B” on the International Knee Documentation Committee (IKDC) knee ligament examination form compared with aperture fixation on both sides (67.7%). Moreover, suspensory fixation had a lower side-to-side difference in anterior laxity (1.6 mm) when compared with aperture fixation (2.3 mm). Among studies which reported graft failure, all of which employed aperture fixation, the rate was 3.2%. Across available data, primary ACL-R using QT grafts appears to have successful short-term outcomes with a short-term graft failure...
Source: Journal of Knee Surgery - Category: Orthopaedics Authors: Tags: Original Article Source Type: research

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Conclusions: The results of our study showed an unacceptably high rate of failure of irradiated fresh frozen Achilles allograft for primary ACL reconstruction using tibial Retroscrew fixation.
Source: Current Orthopaedic Practice - Category: Orthopaedics Tags: Original Research Source Type: research
AbstractPurposeRevision ACL surgery may be complicated by tunnel malposition and/or tunnel widening and often requires a staged treatment approach that includes bone grafting, a period of several months to allow bone graft incorporation and then definitive revision ACL reconstruction. The purpose of this study was to evaluate the results of a single-staged ACL revision reconstruction technique using a cylindrical dowel bone graft for patients who have existing posteriorly placed and/or widened tibial tunnels in the tibia at a minimum of 2  years follow-up.MethodsBetween 2010 and 2014, patients undergoing single-stage ...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - Category: Orthopaedics Source Type: research
Abstract A systematic review was performed to compare patellar tendon-bone (BTB) and hamstring tendon (HS) autografts following anterior cruciate ligament reconstruction in young females, young patients, or females. One study compared BTB and HS in young females and found a lower rate of graft failure with BTB (P
Source: Orthopedics - Category: Orthopaedics Authors: Tags: Orthopedics Source Type: research
J Knee Surg DOI: 10.1055/s-0039-1684010After the anterior cruciate ligament (ACL) reconstruction, a loss of proprioception is observed and it can continue years after the operation. The aim of this study is to evaluate proprioception in standing position at different knee flexion angles in patients who underwent ACL reconstruction with tibialis anterior tendon allograft. The study included 34 patients who underwent ACL reconstruction with tibialis anterior tendon allograft and 34 healthy individuals. Proprioception was evaluated in standing position at 15°, 30°, 60° flexion angles with the active joint position...
Source: Journal of Knee Surgery - Category: Orthopaedics Authors: Tags: Original Article Source Type: research
Condition:   ACL - Anterior Cruciate Ligament Rupture Interventions:   Procedure: Soft tissue hamstring autograft;   Procedure: Quadriceps tendon autograft Sponsors:   McMaster University;   Canadian Orthopaedic Foundation Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
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
CONCLUSION: In conclusion, similar clinical results, in terms of stability and subjective measures, can be obtained after ACL reconstruction both with a free quadriceps and a 4-strand hamstring tendons autograft. LEVEL OF EVIDENCE: Level III, Therapeutic Study. PMID: 30905626 [PubMed - as supplied by publisher]
Source: Acta Orthopaedica et Traumatologica Turcica - Category: Orthopaedics Authors: Tags: Acta Orthop Traumatol Turc 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
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
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