Arthroscopic anterior cruciate ligament reconstruction using a patellar tendon graft in press-fit technique: Surgical technique and follow-up

Boszotta, H.

doi:10.1016/s0749-8063(97)90030-x

Cited by 76 publications

(54 citation statements)

References 22 publications

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“…25 Good mechanical and functional outcome analyses after 5 and 10 years have been published following the BPTB press-fit technique. 5,11 Hamstring tendon reconstruction of the ACL is a method that is used more and more frequently. The technique is associated with less donor site morbidity.…”

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confidence: 99%

Femoral Press-Fit Fixation of the Hamstring Tendons for Anterior Cruciate Ligament Reconstruction

et al. 2004

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mentioning

confidence: 99%

Femoral Press-Fit Fixation of the Hamstring Tendons for Anterior Cruciate Ligament Reconstruction

et al. 2004

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“…The most important advantage of press-fit technique is a stable bony fixation on the femoral site without interference screw. It enables direct bone to bone healing and reduces the number of disadvantages associated with hardware fixation, like the inadvertent graft advancement, graft laceration, bone resorption or chronic synovitis, allergic reactions [21,23,24]. Another important feature of this fixation technique is easier revision of ACL reconstruction [20,37].…”

Section: Discussionmentioning

confidence: 99%

“…The presented technique was originally developed in 1987 for femoral press-fit fixation and in 1989 for tibial press-fit fixation [19,20]. Afterwards it was used and popularized by other authors [21-24]. The press-fit fixation was reported to have a similar pull-out strength and stiffness when compared to hardware fixations [24-26] and accepted as an effective and cost reducing method for ACL reconstruction.…”

Section: Introductionmentioning

confidence: 99%

Femoral press-fit fixation in ACL reconstruction using bone-patellar tendon-bone autograft: results at 15 years follow-up

Widuchowski

Widuchowska

czy

et al. 2012

BMC Musculoskelet Disord

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BackgroundIf anterior cruciate ligament (ACL) reconstruction is to be performed, decision regarding graft choice and its fixation remains one of the most controversial. Multiple techniques for ACL reconstruction are available. To avoid disadvantages related to fixation devices, a hardware-free, press-fit ACL reconstruction technique was developed.The aim of this study was to evaluate clinical outcome and osteoarthritis progression in long term after ACL reconstruction with central third patellar-tendon autograft fixed to femur by press-fit technique.MethodsFifty two patients met inclusion/excusion criteria for this study. The patients were assessed preoperatively and at 15 years after surgery with International Knee Documentation Committee Knee Ligament Evaluation Form, Lysholm knee score, Tegner activity scale and radiographs.ResultsGood overall clinical outcomes and self-reported assessments were documented, and remained good at 15 years. The mean Lysholm and Tegner scores improved from 59.7 ± 18.5 and 4.2 ± 1.0 preoperatively to 86.4 ± 5.6 (p = 0.004) and 6.9 ± 1.4 (p = 0.005) respectively at follow-up. The IKDC subjective score improved from 60.1 ± 9.2 to 80.2 ± 8.1 (p = 0.003).According to IKDC objective score, 75% of patients had normal or nearly normal knee joints at follow-up. Grade 0 or 1 results were seen in 85% of patients on laxity testing. Degenerative changes were found in 67% of patients. There was no correlation between arthritic changes and stability of knee and subjective evaluation (p > 0.05).ConclusionsACL reconstruction with patellar tendon autograft fixed to femur with press-fit technique allows to achieve good self-reported assessments and clinical ligament evaluation up to 15 years. Advantages of the bone-patellar-tendon-bone (BPTB) press-fit fixation include unlimited bone-to-bone healing, cost effectiveness, avoidance of disadvantages associated with hardware, and ease for revision surgery. BPTB femoral press-fit fixation technique can be safely applied in clinical practice and enables patients to return to preinjury activities including high-risk sports.

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“…Two thirds of the circumference of this specific hollow burr had sharp teeth, while the other 1/3 was blunt (Figure 1b, c). Using the hollow burr with an inner diameter of 9.4 mm, a cylindrical bone cylinder of 20 mm length could be harvested from the proximal aspect of the patella in the technique described by Boszotta [3]. Thus, a graft with a strip of 50 mm quadriceps tendon attached to a cylindrical bone block 20 mm in length was available to be used for ACL reconstruction.…”

Section: Methodsmentioning

confidence: 99%

Anterior cruciate ligament (ACL) reconstruction with quadriceps tendon autograft and press-fit fixation using an anteromedial portal technique

Akoto

Hoeher²

2012

BMC Musculoskelet Disord

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BackgroundThis article describes an arthroscopic anterior cruciate ligament (ACL) reconstruction technique with a quadriceps tendon autograft using an anteromedial portal technique.MethodsA 5 cm quadriceps tendon graft is harvested with an adjacent 2 cm bone block. The femoral tunnel is created through a low anteromedial portal in its anatomical position. The tibial tunnel is created with a hollow burr, thus acquiring a free cylindrical bone block. The graft is then passed through the tibial tunnel and the bone block, customized at its tip, is tapped into the femoral tunnel through the anteromedial portal to provide press-fit fixation. The graft is tensioned distally and sutures are tied over a bone bridge at the distal end of the tibial tunnel. From the cylindrical bone block harvested from the tibia the proximal end is customized and gently tapped next to the graft tissue into the tibial tunnel to assure press fitting of the graft in the tibial tunnel. The distal part of the tibial tunnel is filled up with the remaining bone.All patients were observed in a prospective fashion with subjective and objective evaluation after 6 weeks, 6 and 12 months.ResultsThirty patients have been evaluated at a 12 months follow-up. The technique achieved in 96.7% normal or nearly normal results for the objective IKDC. The mean subjective IKDC score was 86.1 ± 15.8. In 96.7% the Tegner score was the same as before injury or decreased one category. A negative or 1+ Lachman test was achieved in all cases. Pivot-shift test was negative or (+) glide in 86.7%. The mean side-to-side difference elevated by instrumental laxity measurement was 1.6 ± 1.1 mm. Full ROM has been achieved in 92.3%. The mean single one-leg-hop index was 91.9 ± 8.0 at the follow-up.ConclusionsPotential advantages include minimum bone loss specifically on the femoral side and graft fixation without implants.

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Arthroscopic anterior cruciate ligament reconstruction using a patellar tendon graft in press-fit technique: Surgical technique and follow-up

Cited by 76 publications

References 22 publications

Femoral Press-Fit Fixation of the Hamstring Tendons for Anterior Cruciate Ligament Reconstruction

Femoral Press-Fit Fixation of the Hamstring Tendons for Anterior Cruciate Ligament Reconstruction

Femoral press-fit fixation in ACL reconstruction using bone-patellar tendon-bone autograft: results at 15 years follow-up

Anterior cruciate ligament (ACL) reconstruction with quadriceps tendon autograft and press-fit fixation using an anteromedial portal technique

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