All-Inside Quadrupled Semitendinosus Autograft Shows Stability Equivalent to Patellar Tendon Autograft Anterior Cruciate Ligament Reconstruction: Randomized Controlled Trial in Athletes 24 Years or Younger

Smith, Patrick A.; Cook, Corey S.; Bley, Jordan A.

doi:10.1016/j.arthro.2020.01.048

Cited by 24 publications

(28 citation statements)

References 127 publications

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“… 5 The all-inside technique also has been shown to have equivalent stability testing at 2 years' follow-up to BTB standard reconstructions. 6 The quadriceps tendon graft has advantages, including its cross-sectional area, and has been shown to have as low as a 4.2% failure rate. 7 Similar techniques have previously been described for partial-thickness quadriceps tendon harvest.…”

Section: Discussionmentioning

confidence: 99%

Minimally Invasive Quad Harvest Featuring Endoscopic Closure and Preparation With Adjustable Suspensory Fixation Device Incorporated With Braided Suture

Lavender

Fravel

Patel

et al. 2021

Arthroscopy Techniques

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The quad tendon has increasingly became a very common option for anterior cruciate ligament reconstruction. Minimally invasive approaches are one of the many advantages to the quad tendon graft. One of the issues with a small incision is assuring appropriate proximal closure. In this technique, we use the arthroscope to view proximally and a Scorpion (Arthrex) device to close our proximal quad harvest. We also describe the updated preparation of the quad tendon with FiberTag TightRope (Arthrex) and FiberTag ABS (Arthrex). These implants have FiberTag incorporated to the suspensory devices that creates a stable construct that is faster to incorporate into the quad with the slotted clamp. Together, these updates to the preparation and harvest should make the construct more reproducible and decrease donorsite morbidity respectively.

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Section: Discussionmentioning

confidence: 99%

Minimally Invasive Quad Harvest Featuring Endoscopic Closure and Preparation With Adjustable Suspensory Fixation Device Incorporated With Braided Suture

Lavender

Fravel

Patel

et al. 2021

Arthroscopy Techniques

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“…Overall, all-inside ACL reconstruction has been shown to have equivalent outcomes to classic S-G and BPTB reconstruction at mid-term follow-up [6,11,17,18,23]. Even in the more demanding younger patients, where the failure rates have been higher [24] the all-inside technique has wielded favorable outcomes [25]. There is, however, a paucity of studies with longer follow-up, possibly due to the novelty of the technique.…”

Section: Discussionmentioning

confidence: 99%

“…Given the equivalence in failure rates, some of the benefits of the less-invasive nature of the technique have caused an increased usage among surgeons. Donor site morbidity has been shown to be reduced both in terms of anterior knee pain compared to BPTB graft [25,26] and overall VAS pain scores compared to S-G harvest [11]. Kouloumentas et al [23] reported improved knee flexion strength at two years following a single semitendinosus graft compared to S-G grafts.…”

Section: Discussionmentioning

confidence: 99%

Anterior Cruciate Ligament Reconstruction With the All-Inside Technique: Equivalent Outcomes and Failure Rate at Three-Year Follow-Up Compared to a Doubled Semitendinosus-Gracilis Graft

Kyriakopoulos¹,

Manthas²,

Vlachou³

et al. 2021

Cureus

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Purpose: To compare in terms of failure rates, clinical and functional outcomes the all-inside anterior cruciate ligament (ACL) reconstruction with double suspensory fixation and quadrupled semitendinosus autograft with anteromedial portal doubled semitendinosus-gracilis autograft with suspensory femoral and tibial interference screw fixation.Methods: Forty-four patients were sequentially allocated into two groups and followed up prospectively for a 3-year period. The first group was the all-inside group and the second was the "classic" AM portal with S-G graft. Each group comprised 22 patients. All patients underwent KT-1000 testing preoperatively and at a minimum of six months postoperatively. Visual pain analog was recorded preoperatively and during both the immediate postoperative period and throughout the follow-up. The Lysholm knee score was used comparing the preoperative and 24-month timepoints.Results: The visual analog scale (VAS) pain scores showed a significant difference at two weeks (2.4 vs 1.8, p < 0.01 ) in favor of the all-inside group, but that difference disappeared in the later follow-up visits. Similarly, there was no significant difference with Lysholm knee scores at two years and the side-to-side anterior translation measured with the KT-1000. At the three-year mark, there were no failures in either of the groups. Conclusion:The all-inside technique appears to be equivalent in terms of outcomes to the classic S-G technique, and given the less-invasive nature and versatility in graft choices is a safe and effective technique for primary ACL reconstruction.

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“…4 It has also been reported in the literature that the results of the new technique are similar to those of the classical techniques. 2 5…”

mentioning

confidence: 99%

Comparative Results of Anterior Cruciate Ligament Reconstruction with Full Tibial Tunnel: Quadrupled Semitendinosus Suspensory Femoral and Tibial Fixation versus Quadrupled Semitendinosus and Gracilis Suspensory Femoral and Tibial Screw and Staple Fixation

et al. 2022

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This study compared the clinical outcomes of patients treated with described “modified all-inside” anterior cruciate ligament reconstruction (ACLR) technique with those of patients treated with suspensory femoral fixation and a bioabsorbable tibial interference screw with the ACLR technique. From 2017 to 2019, 98 patients who underwent ACLR surgery by two surgeons using either of the techniques were included in this study. Patients in group 1 were treated with the “modified all-inside” ACLR technique. In this technique, only the semitendinosus tendon was harvested as a four-strand graft and fixed to the tibia and femur with suspensory buttons. Patients in group 2 were treated with suspensory femoral fixation and a bioabsorbable tibial interference screw ACL reconstruction technique. Patients' functional outcomes were evaluated by the Lysholm score, Tegner activity scale, and International Knee Documentation Committee (IKDC) subjective score. Postoperative knee stability of the patients was evaluated using the Lachman test and the pivot-shift test. The mean ages of the patients were 31.1 (16–55) and 28.7 (18–48) years in groups 1 and 2, respectively. The average follow-up durations were 26 (20–30) and 25.9 (22–30) months for both groups. There was no significant difference between the preoperative and postoperative Lysholm's score, Tegner's activity score, and IKDC subjective score in groups 1 and 2. There were no major complications or reruptures in either group. ACLR incorporating the “modified all-inside” ACLR technique obtained significant clinical outcomes compared to ACLR with a suspensory femoral fixation and a bioabsorbable tibial interference screw.

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All-Inside Quadrupled Semitendinosus Autograft Shows Stability Equivalent to Patellar Tendon Autograft Anterior Cruciate Ligament Reconstruction: Randomized Controlled Trial in Athletes 24 Years or Younger

Cited by 24 publications

References 127 publications

Minimally Invasive Quad Harvest Featuring Endoscopic Closure and Preparation With Adjustable Suspensory Fixation Device Incorporated With Braided Suture

Minimally Invasive Quad Harvest Featuring Endoscopic Closure and Preparation With Adjustable Suspensory Fixation Device Incorporated With Braided Suture

Anterior Cruciate Ligament Reconstruction With the All-Inside Technique: Equivalent Outcomes and Failure Rate at Three-Year Follow-Up Compared to a Doubled Semitendinosus-Gracilis Graft

Comparative Results of Anterior Cruciate Ligament Reconstruction with Full Tibial Tunnel: Quadrupled Semitendinosus Suspensory Femoral and Tibial Fixation versus Quadrupled Semitendinosus and Gracilis Suspensory Femoral and Tibial Screw and Staple Fixation

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