Anatomic single-bundle anterior cruciate ligament reconstruction improves walking economy: hamstrings tendon versus patellar tendon grafts

Iliopoulos, Efthymios; Galanis, Nikiforos; Zafeiridis, Andreas; Iosifidis, Michael; Papadopoulos, Pericles; Potoupnis, Michael; Geladas, Nickos D.; Vrabas, Ioannis S.; Kirkos, John M.

doi:10.1007/s00167-016-4229-4

Cited by 9 publications

(8 citation statements)

References 47 publications

(66 reference statements)

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“…Valgus rotation (32,34), our results also showed that anatomical ACLR can restore knee kinematics during level walking. However, as was demonstrated by Figure 9, the non-anatomical ACLR in our study can also restore knee kinematics during level walking.…”

Section: Distal Translationsupporting

confidence: 70%

“…They found that the ACLR knees can maintain tibial rotational stability. Iliopoulos et al (32) summarized that nearly normalized locomotion economy was observed in anatomical ACLR with either hamstrings tendon or bone-patellar tendonbone graft during flat, uphill, and downhill walking. Akpinar et al (34) concluded no significant difference of knee kinematics was observed between anatomic ACLR knees and native knees at 24-month follow-up during downhill running.…”

Section: Discussionmentioning

confidence: 99%

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In vivo gait kinematics of the knee after anatomical and non-anatomical single-bundle anterior cruciate ligament reconstruction—a prospective study

Yan

et al. 2019

Ann Transl Med

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Background: The factors that influence functions of knees after anterior cruciate ligament reconstruction (ACLR) still remains uncertain. The functional restoration of knees after ACLR can be reflected on gait kinematics restoration. The purpose of this study was to evaluate the gait kinematics and clinical outcomes of knees after anatomical and non-anatomical single-bundle ACLR during level walking.Methods: Thirty-four patients with unilateral primary single-bundle ACLR and 18 healthy people were recruited. Patients were divided into anatomical reconstruction group (AR group; n=13) and nonanatomical reconstruction group (Non-AR group; n=21) according to Bernard Quadrant method. The ACL graft orientations on coronal and sagittal planes were measured on 3D models from medical images. The 6 degrees of freedom (DOF) kinematics of knees and range of motion (ROM) of 6 DOF kinematics were measured with a portable optical tracking system. The comparison of 6 DOF kinematics and ROM of 6 DOF kinematics were performed between the ACLR knees and contralateral knees. The following assessments were also performed including clinical examination, KT-2000 arthrometer measurement, International Knee Documentation Committee (IKDC) and Lysholm scores.Results: All patients reached a minimum follow-up of 6 months (10±4 months). For AR group and Non-AR group, no statistically significant differences were observed in gait kinematics between the ACLR knees and contralateral knees. No statistically significant differences between the ACLR knees and contralateral knees were observed in terms of ROM of 6 DOF kinematics in AR group. However, in Non-AR group, the ACLR knees exhibited significant ROM of anterior-posterior translation by approximately 0.5 cm than contralateral knees (P=0.0080). No statistically significant differences between the two groups were observed regarding IKDC subjective score, Lysholm score and KT-2000 arthrometer test.Conclusions: The anatomical ACLR can restore close to normal gait kinematics and ROM of 6 DOF kinematics compared with non-anatomical ACLR. The ACL graft after anatomical ACLR simulated native ACL fibers to function in terms of graft orientation.

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Section: Distal Translationsupporting

confidence: 70%

Section: Discussionmentioning

confidence: 99%

In vivo gait kinematics of the knee after anatomical and non-anatomical single-bundle anterior cruciate ligament reconstruction—a prospective study

Yan

et al. 2019

Ann Transl Med

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“…Revisão da Literatura Iliopoulos et al (2017), compararam a eficácia da reconstrução anatômica do LCA com enxertos de tendões dos isquiotibiais (HAM) e osso -tendão patelar -osso (BPTB) na melhora e normalização do custo energético e reservas fisiológicas durante caminhadas planas, subidas e descidas. Para tanto, 20 indivíduos do sexo masculino com lesão unilateral do LCA foram aleatoriamente designados para reconstrução do LCA com enxerto HAM (n = 10) ou BPTB (n = 10).…”

Section: Resultsunclassified

Reconstrução do ligamento cruzado anterior com a utilização de enxerto do tendão patelar: revisão de ensaios clínicos

Matiola

2022

JHMReview

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Introdução: Em muitos países, a incidência de lesões que necessitam de reconstrução do ligamento cruzado anterior (LCA) tem aumentado constantemente. Uma vez que uma lesão do LCA é diagnosticada, o procedimento cirúrgico padrão-ouro, a reconstrução, é o mais indicado. Para tanto, o uso de diferentes enxertos pode resultar em resultados diferentes e, por isso, a seleção desses enxertos pelo cirurgião é um ponto importante a ser discutido. Dentro deste contexto, existem três principais tipos de enxertos para reconstrução do LCA: auto enxertos, aloenxertos e enxertos sintéticos, sendo os auto enxertos do tendão patelar (TP), os mais amplamente utilizados. Objetivo: Avaliar ensaios clínicos que discutam sobre as técnicas de reconstrução do LCA com a utilização de enxerto do TP, caracterizando suas vantagens e desvantagens. Método: Para a seleção dos trabalhos foi utilizada a base PubMed, empregando o seguinte algoritmo booleano: "anterior cruciate ligament"[title] and reconstruction[title] AND patellar[title]”. Resultados: Esta revisão contou com 8 artigos publicados entre os anos de 2017 e 2021 e que atenderam adequadamente a estratégia de busca previamente estabelecida. Síntese de evidências: Com base nos ensaios clínicos revisados, foi possível constatar que a reconstrução do LCA utilizando enxertos do TP, o que inclui o enxerto osso - tendão patelar - osso (BPTB), é atualmente a técnica mais indicada.

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“…Sufficient biomechanical strength and better clinical results concerning these grafts have been reported. 3,8,48,54,68,92,96 In addition, the quadriceps autograft is another choice of autograft. 3,36 It has been reported that the quadriceps autograft has the same level of strength with similarly good clinical results and without severe complications.…”

Section: Discussionmentioning

confidence: 99%

Systematic Review of Surgical Technique and Tunnel Target Points and Placement in Anatomical Single-Bundle ACL Reconstruction

Iriuchishima¹,

Goto²

2020

J Knee Surg

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The purpose of this systematic review was to reveal the trend in surgical technique and tunnel targets points and placement in anatomical single-bundle anterior cruciate ligament (ACL) reconstruction. Following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement, data collection was performed. PubMed, EMBASE, and Cochran Review were searched using the terms “anterior cruciate ligament reconstruction,” “anatomic or anatomical,” and “single bundle.” Studies were included when they reported clinical results, surgical technique, and/or tunnel placement evaluation. Laboratory studies, technical reports, case reports, and reviews were excluded from this study. From these full article reviews, graft selection, method of creating the femoral tunnel, and femoral and tibial tunnel target points and placement were evaluated. In the 79 studies included for data evaluation, the selected grafts were: bone patella tendon bone autograft (12%), and hamstring autograft (83%). The reported methods of creating the femoral tunnel were: transportal technique (54%), outside-in technique (15%), and transtibial technique (19%). In the 60 studies reporting tunnel target points, the target point was the center of the femoral footprint (60%), and the center of the anteromedial bundle footprint (22%). In the 23 studies evaluating tunnel placement, the femoral tunnel was placed in a shallow–deep direction (32.3%) and in a high–low direction (30.2%), and the tibial tunnel was placed from the anterior margin of the tibia (38.1%). The results of this systematic review revealed a trend in anatomical single-bundle ACL reconstruction favoring a hamstring tendon with a transportal technique, and a tunnel target point mainly at the center of the ACL footprint. The level of evidence stated is Systematic review of level-III studies.

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Anatomic single-bundle anterior cruciate ligament reconstruction improves walking economy: hamstrings tendon versus patellar tendon grafts

Abstract: II.

Cited by 9 publications

References 47 publications

In vivo gait kinematics of the knee after anatomical and non-anatomical single-bundle anterior cruciate ligament reconstruction—a prospective study

In vivo gait kinematics of the knee after anatomical and non-anatomical single-bundle anterior cruciate ligament reconstruction—a prospective study

Reconstrução do ligamento cruzado anterior com a utilização de enxerto do tendão patelar: revisão de ensaios clínicos

Systematic Review of Surgical Technique and Tunnel Target Points and Placement in Anatomical Single-Bundle ACL Reconstruction

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