No long-term tunnel enlargement following anterior cruciate ligament reconstruction using autograft hamstring tendon with dual suspensory fixation
AbstractPurposeBone tunnel widening following anterior cruciate ligament reconstruction (ACLR) is well documented, although the aetiology and clinical significance of this phenomenon remain unclear. At mid-term follow-up, a greater prevalence of tunnel enlargement has been reported with the use of hamstring (HS) grafts. However, there are paucity of data on what happens in the longer term. The aim of this study was to assess the change in femoral and tibial tunnel dimensions 15 years after four-strand HS ACLR.MethodsThis is a retrospective review of 15 patients who underwent arthroscopic ACLR using HS autograft tendon and were followed up radiographically at 4 months, 2 years and 15 years. Suspensory fixation was used for both ends of the graft. The diameters of the bone tunnels on posteroanterior (PA) and lateral radiographs were measured using digital callipers. Repeated measures analysis of variance (ANOVA) was used to examine change in tunnel widt h over time.ResultsRadiographic tunnel width did not significantly change between 4 months and 2 years. However, a significant decrease in width was found for both the femoral and tibial tunnels between the 2- and 15-year follow-up (P
ConclusionBimeniscal replacement by an allograft and/or substitute provides good short-term functional and anatomical outcomes. Nevertheless, this procedure is warranted only in highly selected patients.Level of evidenceIV, retrospective study.
ConclusionsAnatomic ACL reconstruction could restore not only the normal anterior knee laxity, but also the normal tibiofemoral relationship even under an anterior tibial load.
J Knee Surg DOI: 10.1055/s-0039-1695040Patellar bone–tendon–bone (pBTB) autografts are often considered the “gold standard” for complete anterior cruciate ligament (ACL) reconstruction and are also associated with significant complications and early-onset knee osteoarthritis (OA). A novel quadriceps tendon allograft with synthetic augmentation, or “internal brace” (QTIB), has been reported to have potential advantages for ACL reconstruction based on animal model data. In this preclinical canine comparison study, we hypothesized that QTIB allograft compared with pBTB autograft would provi...
AbstractPurposeTo determine demographic, anatomic, and surgical factors associated with static and dynamic Anterior Tibial Translation (ATT) following ACL reconstruction. The hypothesis was that both static and dynamic ATT would be greater in knees with high tibial slope or that required meniscectomy.MethodsThe authors prospectively enrolled 280 consecutive patients that had primary ACL reconstruction using hamstring autografts at one center for which preoperative tear type, meniscal tears, and medial tibial slope were documented. A total of 137 were excluded due to concomitant extra-articular tenodesis or surgical a...
ConclusionsPreoperative measurements of the patella-to-condyle and the patella-to-notch distances in AP knee radiographs can be valuable tools, with good sensitivities and specificities, for the determination of the patellar tendon length when using a BPTB graft for an ACLR. They had an acceptable level of discrimination capability and excellent reliability.
AbstractPurposeThe purpose of this study was to compare femoral graft bending angle between patients with femoral tunnel reamed at less than 80 ° of knee flexion and those with 80° and above in anatomical anterior cruciate ligament (ACL) reconstruction using modified transtibial technique.MethodsForty-eight patients who underwent ACL reconstruction using bone –patellar-tendon–bone autograft in modified transtibial technique and CT scan at 1 week postoperatively were included in this study. A femoral guidewire insertion into aimed femoral position at the medial wall of the femoral lateral condyle was sta...
To present the mid- to long-term clinical and radiographic outcomes of a series of patients who underwent revision anterior cruciate ligament (ACL) reconstruction with doubled gracilis and semitendinosus (DGST) autograft and a lateral extra-articular tenodesis (LET).
ConclusionsBone-to-bone integration on the femoral and tibial sides was complete within 5 months after surgery in all cases. Since the time required for bone integration is important in designing the postoperative rehabilitation approach, these results will serve as a useful guideline for planning rehabilitation protocols.Level of evidenceIV.
ConclusionsLess satisfactory stability and functional outcomes were noted in patients with generalized joint laxity, compared to patients without generalized joint laxity. Comparisons of stability and functional outcomes after ACL reconstruction in patients with generalized joint laxity between two different grafts demonstrated that BPTB graft achieves better results than hamstring graft.Level of evidenceIII, a retrospective cohort study.
The primary purpose of this study was to systematically review high-quality studies in the literature to compare the postoperative radiographic incidence of knee osteoarthritis (OA) after anterior cruciate ligament reconstruction (ACLR) with bone –patellar tendon–bone (BPTB) versus hamstring tendon (HT) autograft. The secondary purpose of this study was to compare other symptoms of postoperative knee OA between these 2 groups through patient-reported outcome scores and knee range of motion.