Anterior Cruciate Ligament Reconstruction Using Combined Graft of Hamstring and Fascia Lata With Extra-articular Tenodesis. A Technique in Case of Insufficient Hamstrings

Espejo-Reina, Alejandro; Espejo-Reina, María Josefa; Lombardo-Torre, Maximiano; Pino, Joaquina Ruiz-Del; Espejo-Baena, Alejandro

doi:10.1016/j.eats.2020.07.007

Cited by 4 publications

(4 citation statements)

References 8 publications

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“…The fascia lata as potential graft for ACL reconstruction or augmentation has been consistently described in the last decades. 17 A study by Ekstrand et al. published in 1989 outlined good clinical and functional outcomes using a fascia lata stripe for ACL reconstruction.…”

Section: Discussionmentioning

confidence: 99%

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Anterior Cruciate Ligament Reconstruction Using a Fascia Lata Graft With FiberTape Augmentation

Weninger¹,

Steffel²,

Rabel³

et al. 2023

Arthroscopy Techniques

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Section: Discussionmentioning

confidence: 99%

“… 9 Another recent study by Espejo-Reina describes ACL reconstruction using a combined hamstring and fascia lata graft. 12 …”

Section: Introductionmentioning

confidence: 99%

Anterior Cruciate Ligament Reconstruction Using a Fascia Lata Graft With FiberTape Augmentation

Weninger¹,

Steffel²,

Rabel³

et al. 2023

Arthroscopy Techniques

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“…Espejo-Reina et al published a surgical technique of ACL reconstruction augmented with fascia lata and anterolateral tenodesis. The advantages were to be able to perform an anatomical technique and augment the ACL without damaging another autograft area, without adding allograft or artificial material and using a single femoral tunnel for the ACL and for the anterolateral tenodesis [13]. ACL augmentation with quadricipital tendon has the advantages of not hav-ing to add allograft or synthetic material and being able to extract it from the ipsilateral knee, although morbidity is added due to the use of a new autograft.…”

Section: Discussionmentioning

confidence: 99%

Untitled

2023

BJSTR

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Introduction: Anterior cruciate ligament (ACL) reconstruction is a very frequent surgery, hamstring autograft is one of the most commonly used grafts. Currently, it appears that graft diameter equal to or less than 8 mm has been associated with an increased risk of rupture. There is a lack of consensus as to how a small diameter graft is managed intraoperatively.Objective: To know the current trend in our country regarding ACL augmentation techniques.Material and Methods: Online survey sent from the Spanish Arthroscopy Association (AEA) to all its members.Results: 187 answers were obtained (14.38%). A total of 38.2% of surgeons always performed some augmentation technique. 45.9% prepared the graft in more than 4 fascicles, 16.7% used other techniques, 13.4% used fascia lata, 8.6% used quadricipital tendon or no technique and 7% used hybrid auto-allograft. Synthetic material was added in 12.4%, biological augmentation in 5.3% and anterolateral reinforcement in 29.9%. Conclusion:Currently, there is no consensus in our country regarding the intraoperative management of a hamstring graft equal to or less than 8 mm. In general, the current tendency is to prepare the graft in more than 4 fascicles. More studies are needed to know which is the most recommended technique.

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“…14,21,51 LET techniques started with Lemaire, as he used the iliotibial band (ITB) for isolated extra-articular reconstruction, 31 and later with MacIntosh for intra-and extraarticular reconstruction. 3 Several surgeons have modified the MacIntosh ITB technique because of lower biomechanical forces when used alone 26,29 and have described intraarticular augmentation with both 15 or single 13 hamstring tendons, specifically the combined ITB and semitendinosus tendon technique described by Zarins and Rowe in 1986. 53 The use of the ITB in revision ACLR is of great advantage in terms of shortage of grafts and allows ACLR and LET to be achieved from a single harvest site while potentially preserving the knee's flexion and extension mechanisms.…”

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confidence: 99%

Comparison of Revision ACL Reconstruction Using Iliotibial Band Augmented With Allograft Versus Bone–Patellar Tendon–Bone Autograft With Lateral Extra-articular Tenodesis

Abou Al Ezz,

Gerometta,

Valentin

et al. 2023

Orthopaedic Journal of Sports Medicine

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Background: Bone–patellar tendon–bone (BTB) anterior cruciate ligament reconstruction (ACLR) is one of the conventional techniques in the revision setting especially after a primary hamstring tendon graft. The use of the iliotibial band (ITB) augmented with allograft (AG) is an encouraging graft alternative for ACLR in terms of clinical and biomechanical data in the literature. Purpose: To compare the clinical outcomes of BTB graft with lateral extra-articular tenodesis, modified Lemaire (BTB-LET), and an ITB graft augmented with hamstring AG (ITB-AG) in the setting of revision ACLR. Study Design: Cohort study; Level of evidence, 3. Methods: Descriptive data and clinical outcomes were prospectively collected from patients who underwent revision ACLR with either the BTB-LET or ITB-AG technique between 2012 and 2020 and who had a minimum follow-up of 2 years. The clinical outcomes were assessed by the Lysholm, Tegner, Anterior Cruciate Ligament–Return to Sport after Injury, International Knee Documentation Committee subjective knee evaluation form, and Knee injury and Osteoarthritis Outcome Score. Return to sports, complications, and revisions were also analyzed. Results: A total of 167 patients were included, with 106 patients in the BTB-LET group and 61 patients in the ITB-AG group. There were no significant group differences in sociodemographic characteristics; however, the mean follow-up was significantly longer in the BTB-LET compared with the ITB-AG group (52.0 vs 38.8 months, respectively; P = .0001). There were no significant differences in postoperative outcome scores; however, patients in the ITB-AG group had a higher rate of return to competitive pivoting sports (32.8% vs 17.9%; P = .0288) and a higher overall rate of return to preinjury sport (63.9% vs 47.2%; P = .0365). Complications, including revisions for meniscal or chondral lesions and retears (8 [8.3%] in the BTB-LET group and 2 [4.0%] in the ITB-AG group), were not significantly different. All retears were due to sports-related accidents. Conclusion: In this study, ITB-AG was not different from BTB-LET in terms of functional outcomes scores but allowed better return to sport rate. Performing ITB-AG reconstruction in the setting of revision ACLR appears to be safe, effective, and associated with a satisfying return-to-sports rate.

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Anterior Cruciate Ligament Reconstruction Using Combined Graft of Hamstring and Fascia Lata With Extra-articular Tenodesis. A Technique in Case of Insufficient Hamstrings

Cited by 4 publications

References 8 publications

Anterior Cruciate Ligament Reconstruction Using a Fascia Lata Graft With FiberTape Augmentation

Anterior Cruciate Ligament Reconstruction Using a Fascia Lata Graft With FiberTape Augmentation

Untitled

Comparison of Revision ACL Reconstruction Using Iliotibial Band Augmented With Allograft Versus Bone–Patellar Tendon–Bone Autograft With Lateral Extra-articular Tenodesis

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