Clinical and Functional Outcomes After Anterior Cruciate Ligament Reconstruction Using Cortical Button Fixation Versus Transfemoral Suspensory Fixation: A Systematic Review of Randomized Controlled Trials

Saccomanno, Maristella F.; Shin, Jason J.; Mascarenhas, Randhir; Haro, Marc S.; Verma, Nikhil N.; Cole, Brian J.; Bach, Bernard R.

doi:10.1016/j.arthro.2014.05.028

Cited by 52 publications

(48 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Thus laxity tests performed at 02 year follow-up was statistically significant suggesting improvement in the stability of knee between pre-operative and post-operative status of patients in our study. These results are comparable to the results achieved by various other authors Beynnon et al [17] Saccomanno et al [33] and Poolman et al [34] Functional Outcome H. E. Bourke et al [35] reported the outcome of 'isolated' anterior cruciate ligament (ACL) ruptures treated with anatomical endoscopic reconstruction using hamstring tendon autograft at a mean of 15 years. A total of 152 patients underwent subjective assessment at 15 years.…”

Section: Laxity Testssupporting

confidence: 78%

A prospective study of functional outcome of ACL reconstruction with quadrupled semitendinosus tendon autograft using Endobutton and bioabsorbable interference screw

Mishra¹,

Girish²

2018

Int. J. Orthop. Sci.

View full text Add to dashboard Cite

Background: The Anterior Cruciate ligament (ACL) is the primary stabilizer of the knee and prevents the knee against anterior translation. It is also important in counteracting rotational and valgus stress. Anterior Cruciate Ligament (ACL) reconstruction is an established and widely practiced surgical procedure with proven efficacy and a low morbidity profile. The arthroscopically aided approach has the advantages of smaller skin and capsular incisions, improved viewing of the intercondylar notch for placement of the tunnel and attachment sites, less postoperative pain, fewer adhesions, earlier motion, and easier rehabilitation. The advantages with semitendinosus grafts are availability of a greater sectional area and unaffected integrity of the extensor mechanism. Moreover tensile strength of quadrupled hamstring is found to be even better than a normal ACL. The rate of complications like extension loss, anterior knee pain and surgical site infections was also lower than other procedures like in BPTB grafts. Cortical suspension devices have the necessary biomechanical properties with regard to ultimate failure strength, displacement, and stiffness for initial fixation of soft tissue in the femoral tunnel for ACL reconstruction. The aperture fixation methods like the interference screws allows for early firm fixation and heal with tight bone-tendon interface. Objectives: To evaluate functional outcome of arthroscopy assisted ACL reconstruction with quadrupled semitendinosus tendon graft using Endobutton and Bioabsorbable interference screw. Methodology: The study results included 120 patients (serving soldiers) admitted with clinical and radiological deficiency of ACL during march 2015 to march 2018, in Department of Orthopaedics, Armed Forces Medical College, Pune. Study aims to assess the functional outcome of arthroscopy assisted anterior cruciate ligament reconstruction with quadrupled semitendinosus tendon graft using Endobutton and Bioabsorbable interference screw in terms of range of motion, postoperative knee stability, graft site morbidity, subjective knee functions and prospective assessment of functional outcome using Tegner Lysholm knee scoring system. Results: All the patients included in the study were serving male soldiers. The analysis of the studied cases revealed that the most common affected age group was between 18 to 24 years (n=41, 34.2%) and the mean age was 30.53 ± 7.24 years. Majority of patients (n=76, 64.4%) were operated more than 6 months after injury. Sports/BPET (Battle Physical Efficiency Test) injuries was the most common mode of injury (n=79, 65.8%). The mean size of graft used was 8.2±0.39.Post-operatively at 02 year follow up, 08 case (6.7%) had a positive Pivot shift test with a "Glide" (Grade-I), whereas remaining 112 cases (93.3%) had a negative Pivot shift test. None of the patients had grade III laxity. The mean postoperative rolimeter measurement at 02 year follow up was 3.86±1.06 SD. The mean postoperative Lysholm score improved from pre-operative score of 66±5....

show abstract

Section: Laxity Testssupporting

confidence: 78%

A prospective study of functional outcome of ACL reconstruction with quadrupled semitendinosus tendon autograft using Endobutton and bioabsorbable interference screw

Mishra¹,

Girish²

2018

Int. J. Orthop. Sci.

View full text Add to dashboard Cite

show abstract

“…Many studies showed no significant difference in the use of suspension devices and interference screws to fix the ACL graft at the femoral side, nor in their functional scores and biomechanical results. However, different fixation devices used between the femoral and tibial tunnels can lead to different signal intensities [52][53][54]. The effect of different fixation devices between the femoral and tibial tunnels on the difference in signal intensities is unclear, due to lack of studies.…”

Section: Discussionmentioning

confidence: 97%

Graft bending angle is correlated with femoral intraosseous graft signal intensity in anterior cruciate ligament reconstruction using the outside-in technique

et al. 2016

View full text Add to dashboard Cite

“…Only one study has shown a correlation between widening and knee laxity as measured by KT-1000 on the rotational stability measured by the pivot shift test, with a higher laxity in the patients that were affected of tunnel widening [10]. In a review by Saccomanno et al [26], five Level 1 or Level 2 studies containing 317 patients were compared. They looked at the clinical and functional outcome of different fixation devices on the femoral side and concluded that the amount of tunnel widening was not found to affect the clinical results.…”

Section: Discussionmentioning

confidence: 99%

Tunnel widening in single- versus double-bundle anterior cruciate ligament reconstructed knees

Aga

Wilson

Johansen

et al. 2016

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

PurposeThe consequence of tunnel widening after ACL reconstructions is foremost of importance in case of revision surgery. Tunnel expansion leads to bone loss close to the joint, and additional surgery with bone grafting prior to revision surgery might be necessary. The purpose of the study was to measure widening of the tunnels in single-bundle (SB) and double-bundle (DB) ACL reconstructed knees during the first year after surgery, detected by a novel, semi-automated 3D CT imaging modality. Our hypothesis was that there would be a difference between the initial tunnel size and the size measured one year post-operatively due to the tunnel widening process. Further, the purpose was to evaluate whether there were any differences in the amount of tunnel widening between the two surgical techniques.MethodsTwenty patients who underwent DB ACL reconstruction, and 22 patients who underwent SB ACL reconstruction, performed a CT scan of the bony tunnels, during their first days after surgery and one year post-operatively. The CT scans were transformed into 3D CT reconstructions, and the tunnels were measured with the “best-fit cylinder” method, measurements at the level of tunnel aperture and 10.0 mm from the joint line.ResultsAll tunnels in the DB and SB ACL reconstructed knees exhibited widening during the first year after the operation (p < 0.001). The SB femoral tunnels showed more widening compared to the DB femoral AM tunnels (1.4 ± 0.9 vs. 0.5 ± 0.6 mm) (p < 0.001), and the SB tibial tunnels widened more compared to the DB tibial PL tunnels (1.0 ± 1.0 vs. 0.5 ± 0.6) (p < 0.043).ConclusionAll tunnels widened during the first year after the ACL reconstruction with a larger amount of widening in the SB tunnels compared to the DB femoral AM tunnels and the DB tibial PL tunnels. This is the first study to detect tunnel widening in DB reconstructed knees through a semi-automated 3D CT imaging modality.Level of evidenceProspective cohort study, Level III.

show abstract

Clinical and Functional Outcomes After Anterior Cruciate Ligament Reconstruction Using Cortical Button Fixation Versus Transfemoral Suspensory Fixation: A Systematic Review of Randomized Controlled Trials

Cited by 52 publications

References 25 publications

A prospective study of functional outcome of ACL reconstruction with quadrupled semitendinosus tendon autograft using Endobutton and bioabsorbable interference screw

A prospective study of functional outcome of ACL reconstruction with quadrupled semitendinosus tendon autograft using Endobutton and bioabsorbable interference screw

Graft bending angle is correlated with femoral intraosseous graft signal intensity in anterior cruciate ligament reconstruction using the outside-in technique

Tunnel widening in single- versus double-bundle anterior cruciate ligament reconstructed knees

Contact Info

Product

Resources

About