Bone-to-bone integrations were complete within 5 months after anatomical rectangular tunnel anterior cruciate ligament reconstruction using a bone–patellar tendon–bone graft

Masuda, Hideyuki; Taketomi, Shuji; Inui, Hiroshi; Shimazaki, Naoya; Nishihara, Nobuhiro; Toyooka, Seikai; Kawano, Hirotaka; Nakagawa, Takumi

doi:10.1007/s00167-018-4938-y

Cited by 8 publications

(9 citation statements)

References 42 publications

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“…For anterior cruciate ligament (ACL) reconstructions, recent efforts from Japan and Europe have intended to reproduce the anatomy of the femoral ACL insertion site by using a rectangular-shaped tunnel [ 6 , 12 , 18 , 26 , 27 ]. This allows to place the tunnel aperture into the ACL footprint and reproduce the anatomy of the native ACL and its fiber insertions.…”

Section: Introductionmentioning

confidence: 99%

Technical note: rectangular femoral tunnel for anterior cruciate ligament reconstruction using a new ultrasonic device: a feasibility study

2021

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Purpose The goal of this preliminary report was to show the use of novel Ultrasound (US) technology for anterior cruciate ligament (ACL) reconstruction surgery and evaluate its feasibility for the creation of a rectangular femoral bone tunnel during an arthroscopic procedure in a human cadaver model. Methods Two fresh frozen human cadaver knees were prepared for arthroscopic rectangular femoral tunnel completion using a prototype US device (OLYMPUS EUROPA SE & CO. KG). The desired rectangular femoral tunnel was intended to be located in the femoral anatomical ACL footprint. Its tunnel aperture was planned at 10 × 5 mm and a depth of 20 mm should be achieved. For one knee, the rectangular femoral tunnel was realized without a specific cutting guide and for the other with a 10 × 5 mm guide. One experienced orthopedic surgeon performed the two procedures consecutively. The time for femoral tunnel completion was evaluated. CT scans with subsequent three-dimensional image reconstructions were performed in order to evaluate tunnel placement and configuration. Results In the two human cadaver models the two 10 × 5x20mm rectangular femoral tunnels were successfully completed and located in the femoral anatomical ACL footprint without adverse events. The time for femoral tunnel completion was 14 min 35 s for the procedure without the guide and 4 min 20 s with the guide. Conclusion US technology can be used for the creation of a rectangular femoral bone tunnel during an arthroscopic ACL reconstruction procedure. The use of a specific cutting guide can reduce the time for femoral tunnel completion. Additional experience will further reduce the time of the procedure.

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Section: Introductionmentioning

confidence: 99%

Technical note: rectangular femoral tunnel for anterior cruciate ligament reconstruction using a new ultrasonic device: a feasibility study

2021

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“…26 In addition, Masuda et al reported that bone-to-bone integration on the femoral and tibial sides was completed within 5 months after surgery in all of their cases. 27 Taketomi et al reported that bone plug migration in the bone tunnel was observed in only 15% of the patients, and a mean difference of 0.4 AE 0.4 mm was observed between the two time points (1 week and 1 year after surgery). 28 This result indicates that bone plug migration could not affect postoperative anterior knee stability when the BPTB graft is used.…”

Section: Discussionmentioning

confidence: 99%

Chronological Changes in Anterior Knee Stability after Anatomical Anterior Cruciate Ligament Reconstruction Using Bone–Patellar Tendon–Bone and Hamstring Grafts

et al. 2019

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The clinical outcomes of anterior cruciate ligament (ACL) reconstruction are typically evaluated at specific time points only. This study aimed to characterize the chronological changes in anterior knee stability after anatomical ACL reconstruction and to compare the anterior knee stability achieved with bone–patellar tendon–bone (BPTB) and hamstring tendon (HT) grafts. A total of 59 patients underwent anatomical rectangular tunnel ACL reconstruction using the BPTB graft and 23 patients underwent anatomical double-bundle ACL reconstruction using the HT graft. Anterior knee stability was quantitatively assessed using the KneeLax 3 arthrometer at 6 months, 1 year, and 2 years after surgery using side-to-side differences. The values for anterior knee stability using the BPTB graft were 0.3 mm after 6 months, 0.2 mm after 1 year, and 0.2 mm after 2 years, and no significant differences were observed during the postoperative study period. Meanwhile, the values for anterior knee stability using the HT graft were −0.3 mm after 6 months, 0.5 mm after 1 year, and 1.2 mm after 2 years, and anterior knee stability decreased chronologically from 6 months up to 2 years. Regarding anterior stability, the HT graft showed significant laxity compared with the BPTB graft only after 2 years. No chronological changes in anterior stability were observed from 6 months up to 2 years after ACL reconstruction using the BPTB graft, whereas anterior laxity developed during the same period after ACL reconstruction using the HT graft. This is a Level IV, therapeutic case series study.

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“…A slice was defined to have achieved bone integration if there was bone trabeculae continuity between the bone plug and bone tunnel 14 (Fig 2). The sagittal plane on the femoral side and the coronal plane on the tibial side were investigated in this study using methods described in a previous study 11 (Fig 3). The ratio of bone integration was compared between both modalities by both surgeons.…”

Section: Radiographic Analysismentioning

confidence: 99%

“…Although the time required for tomosynthesis to evaluate bone graft integration was not established using a comparison of both modalities, we evaluated CT and tomosynthesis data at 3 months postoperatively during this study. Masuda et al 11 reported that bone grafts were 100% healed at 5 months postoperatively; however, only 50% were healed at 3 months. Therefore, a 50% integration rate seemed suitable for this study.…”

Section: Radiographic Analysismentioning

confidence: 99%

“…In particular, after reconstruction with the BPTB graft, evaluation of bone integration between the bone plug and bone tunnel is important because it allows for the assessment of the graft condition and the planning of postoperative therapy. 11 Standard radiography is the most commonly used examination for evaluating bone integration after ACL reconstruction with the BPTB graft 12 ; however, it lacks sensitivity and specificity. Multidetector CT is an efficient tool that is also used for the evaluation of bone integration between the bone plug and bone tunnel.…”

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Tomosynthesis Is Equivalent to Computed Tomography for Evaluating Osseous Integration After Anterior Cruciate Ligament Reconstruction

Toyooka

Masuda

Nishihara

et al. 2020

Arthroscopy, Sports Medicine, and Rehabilitation

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Purpose: To compare tomosynthesis and computed tomography (CT) for evaluating bone plug integration after anterior cruciate ligament (ACL) reconstruction with a boneepatellar tendonebone (BPTB) graft. Methods: Data of consecutive adult patients who underwent ACL reconstruction with BPTB were analyzed. Bone integration between the bone plug and bone tunnel was evaluated by tomosynthesis and CT, which were both performed 3 months postoperatively. The obtained data for both modalities were reconstructed with slice thickness of 2 mm. Evaluation of bone integration were separately performed using coronal-and sagittal-reconstructed images for the femur and tibia. The ratio of bone integration between the reconstructed slices in which bone grafting was involved, for both tomosynthesis and CT, was investigated by 2 blinded examiners. The equivalence of tomosynthesis to CT was tested by comparing the bone integration ratio for both modalities. The accuracy of diagnosing bone union using tomosynthesis and CT was also investigated. Results: The diagnostic accuracy of tomosynthesis and CT exceeded 80%. Interobserver agreement of bone integration in the sagittal plane on the femoral side was 0.92 (intraclass correlation coefficient) for CT and 0.76 (intraclass correlation coefficient) for tomosynthesis. Conclusions: Although it showed poor reliability, tomosynthesis was equivalent to CT in evaluating bone plug integration after ACL reconstruction with BPTB.

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Bone-to-bone integrations were complete within 5 months after anatomical rectangular tunnel anterior cruciate ligament reconstruction using a bone–patellar tendon–bone graft

Abstract: IV.

Cited by 8 publications

References 42 publications

Technical note: rectangular femoral tunnel for anterior cruciate ligament reconstruction using a new ultrasonic device: a feasibility study

Technical note: rectangular femoral tunnel for anterior cruciate ligament reconstruction using a new ultrasonic device: a feasibility study

Chronological Changes in Anterior Knee Stability after Anatomical Anterior Cruciate Ligament Reconstruction Using Bone–Patellar Tendon–Bone and Hamstring Grafts

Tomosynthesis Is Equivalent to Computed Tomography for Evaluating Osseous Integration After Anterior Cruciate Ligament Reconstruction

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