A comprehensive in vivo kinematic, quantitative MRI and functional evaluation following ACL reconstruction — A comparison between mini-two incision and anteromedial portal femoral tunnel drilling

Lansdown, Drew A.; Allen, Christina R.; Zaid, Musa B.; Wu, Samuel; Souza, Richard B.; Li, Xiaojuan; Benjamin, C.

doi:10.1016/j.knee.2014.12.005

Cited by 10 publications

(9 citation statements)

References 35 publications

(44 reference statements)

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“…The length of femoral and tibial sockets ranged from 20 to 35mm long each for 29.5% of patients. 6,[17][18][19][20] Graft Fixation…”

Section: Drilling Techniquementioning

confidence: 99%

“…This systematic review includes studies that primarily used ACLR rehabilitation protocols similar to those used for other techniques. 17,18,[20][21][22][23][24] The immediate goal was to obtain fullextension to prevent gait abnormalities, patellofemoral pain, and future degenerative joint diseases. 17,[20][21][22]25 Jogging was permitted at 2, 3, and 4 months postoperatively in 7.7%, 38.5%, and 15.4% studies, respectively.…”

Section: Rehabilitation Protocolmentioning

confidence: 99%

“…17,[20][21][22]25 Jogging was permitted at 2, 3, and 4 months postoperatively in 7.7%, 38.5%, and 15.4% studies, respectively. 6,[17][18][19][20][21][22][23] Return to sport was permitted at 4 and 6 months postoperatively in 7.7% and 61.5% of studies, respectively(►Supplementary Table S2, available in the online version). 6,[17][18][19][20][21][22][23][24][25][26] Outcomes and Complications…”

Section: Rehabilitation Protocolmentioning

confidence: 99%

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All-Inside Anterior Cruciate Ligament Reconstruction—A Systematic Review of Techniques, Outcomes, and Complications

Shanmugaraj

Weidman

et al. 2018

J Knee Surg

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The all-inside technique (AIT) for anterior cruciate ligament reconstruction (ACLR) is gaining popularity as a more anatomic, less invasive, technique with the potential for more rapid recovery. This systematic review aims to critically assess components of the technique, its safety profile, outcomes, and complications. PUBMED, EMBASE, and MEDLINE were searched for studies discussing primary ACLR using the AIT. Article screening, quality assessment, and data abstraction were completed in duplicate, and a minimal clinically important difference (MCID) was used to frame the descriptive results in a clinically significant context. A total of 13 studies satisfied the inclusion criteria. Five-hundred twenty six patients (mean age 31.9 ± 5.9 years) underwent ACLR using the AIT. The mean follow-up was 18.2 ± 7.7 months. Graft choice included autograft (73.8%) and allograft (26.2%). Drilling techniques for femoral sockets were outside-in (53.4%) and through the anteromedial portal (35.4%), whereas tibial sockets were drilled outside-in (35.0%) and through the superomedial portal (3.8%). The rehabilitation protocol had an immediate focus on obtaining full knee extension, jogging permitted 2 to 4 months postoperatively in 61.5% of studies, and return to cutting and pivoting sports 6 to 9 months postoperatively in 69.2% of studies. A MCID was reached for subjective International Knee Documentation Committee scores at 6, 12, and 24 months follow-up and Lysholm knee score at 24 months follow-up. An improvement in outcomes was most notably between 6 and 12 months postoperatively. There was a total of 31 complications (5.89%) and included graft rerupture (2.47%), loss of extension of 1° to 10° (1.14%), and cartilage or meniscus injuries on the operated knee (0.760%). Complications related to the surgical technique were not reported. The AIT for ACLR shows potential as a minimally invasive approach given the low graft failure rates and short-term improvements in knee function and stability, pain and patient important outcomes from this approach. Comparative studies with large sample sizes and a long-term follow-up are required to assess the proposed advantages of this technique. This is a Level IV study.

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“…The length of femoral and tibial sockets ranged from 20 to 35mm long each for 29.5% of patients. 6,[17][18][19][20] Graft Fixation…”

Section: Drilling Techniquementioning

confidence: 99%

Section: Rehabilitation Protocolmentioning

confidence: 99%

Section: Rehabilitation Protocolmentioning

confidence: 99%

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All-Inside Anterior Cruciate Ligament Reconstruction—A Systematic Review of Techniques, Outcomes, and Complications

Shanmugaraj

Weidman

et al. 2018

J Knee Surg

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“…A previous study has not corroborated this finding in which both methods resulted in similar outcomes. 13…”

Section: Discussionmentioning

confidence: 99%

Surgical Predictors of Clinical Outcomes After Revision Anterior Cruciate Ligament Reconstruction

Allen¹,

Anderson²,

Cooper³

et al. 2017

Am J Sports Med

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Background Revision anterior cruciate ligament (ACL) reconstruction has been documented to have worse outcomes compared with primary ACL reconstructions. The reasons why remain varied. The purpose of this study was to determine whether previous or current surgical factors noted at the time of revision ACL reconstruction are significant predictors towards activity level, sports function, and osteoarthritis (OA) symptoms at 2-year follow-up. Hypothesis Certain factors under the control of the surgeonat the time of revision surgery can both negatively and positively impact outcome. Study Design Cohort Study; Level of evidence, 2. Methods Revision ACL reconstruction patients were identified and prospectively enrolled between 2006 and 2011. Data collected included baseline demographics, intra-operative surgical technique and joint pathology, and a series of validated patient-reported outcome instruments (International Knee Documentation Committee [IKDC], Knee Injury and Osteoarthritis Outcome Score [KOOS], Western Ontario McMaster Universities Osteoarthritis Index [WOMAC], and Marx activity rating score) completed prior to surgery. Patients were followed up for 2 years, and asked to complete the identical set of outcome instruments. Regression analysis was used to control for age, gender, body mass index (BMI), activity level, baseline outcome scores, revision number, time since last ACL reconstruction, and a variety of previous and current surgical variables, in order to assess the surgical risk factors for clinical outcomes 2 years after revision ACL reconstruction. Results A total of 1205 patients (697 [58%] males) met the inclusion criteria and were successfully enrolled. The median age was 26 years, and median time since their last ACL reconstruction was 3.4 years. Two-year follow-up was obtained on 82% (989/1205). Both previous as well as current surgical factors were found to be significant contributors towards poorer clinical outcomes at 2 years. The most consistent surgical factors driving outcome in revision patients were prior surgical approach (arthrotomy vs. no arthrotomy), prior tibial tunnel position, femoral fixation at the time of revision, and having a notchplasty. Having a previous arthrotomy (non-arthroscopic open approach) for ACL reconstruction compared to the one-incision technique resulted in significantly poorer outcomes on 2-year IKDC (p=0.037; odds ratio[OR]=2.43; 95% CI, 1.05–5.88) and KOOS pain, sports/rec, and quality of life (QOL) subscales (p≤0.05; OR range=2.38–4.35; 95% CI, 1.03–10.0). Using a metal interference screw for current femoral fixation resulted in significantly better outcomes in 2-year KOOS symptoms, pain, and QOL subscales (p≤0.05; OR range=1.70–1.96; 95% CI, 1.00–3.33), as well as WOMAC stiffness (p=0.041; OR=1.75; 95% CI, 1.02–3.03). Not having a notchplasty at revision significantly improved 2-year outcomes of the IKDC (p=0.013; OR=1.47; 95% CI, 1.08–1.99), KOOS activities of daily living (ADL) and QOL subscales (p≤0.04; OR range=1.40–1.41; 95% CI, 1.03–1.93)...

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“…The repeatability of the kinematic measures for this approach is on the order of 1.0 mm and 1.5 degrees for tibiofemoral and patellofemoral translations and rotations. 74 Knee kinematics can similarly be characterized using dynamic "4D" MRI scans, with the knee moving cyclically during the scan.…”

Section: Bone Shape Modeling and Kinematicsmentioning

confidence: 99%

Quantitative MRI for Evaluation of Musculoskeletal Disease

et al. 2022

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Magnetic resonance imaging (MRI) is a valuable tool for evaluating musculoskeletal disease as it offers a range of image contrasts that are sensitive to underlying tissue biochemical composition and microstructure. Although MRI has the ability to provide high-resolution, information-rich images suitable for musculoskeletal applications, most MRI utilization remains in qualitative evaluation. Quantitative MRI (qMRI) provides additional value beyond qualitative assessment via objective metrics that can support disease characterization, disease progression monitoring, or therapy response. In this review, musculoskeletal qMRI techniques are summarized with a focus on techniques developed for osteoarthritis evaluation. Cartilage compositional MRI methods are described with a detailed discussion on relaxometric mapping (T2, T2*, T1ρ) without contrast agents. Methods to assess inflammation are described, including perfusion imaging, volume and signal changes, contrast-enhanced T1 mapping, and semiquantitative scoring systems. Quantitative characterization of structure and function by bone shape modeling and joint kinematics are described. Muscle evaluation by qMRI is discussed, including size (area, volume), relaxometric mapping (T1, T2, T1ρ), fat fraction quantification, diffusion imaging, and metabolic assessment by 31P-MR and creatine chemical exchange saturation transfer. Other notable technologies to support qMRI in musculoskeletal evaluation are described, including magnetic resonance fingerprinting, ultrashort echo time imaging, ultrahigh-field MRI, and hybrid MRI-positron emission tomography. Challenges for adopting and using qMRI in musculoskeletal evaluation are discussed, including the need for metal artifact suppression and qMRI standardization.

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A comprehensive in vivo kinematic, quantitative MRI and functional evaluation following ACL reconstruction — A comparison between mini-two incision and anteromedial portal femoral tunnel drilling

Cited by 10 publications

References 35 publications

All-Inside Anterior Cruciate Ligament Reconstruction—A Systematic Review of Techniques, Outcomes, and Complications

All-Inside Anterior Cruciate Ligament Reconstruction—A Systematic Review of Techniques, Outcomes, and Complications

Surgical Predictors of Clinical Outcomes After Revision Anterior Cruciate Ligament Reconstruction

Quantitative MRI for Evaluation of Musculoskeletal Disease

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