Combined All-Inside Anterior Cruciate Ligament Reconstruction and Minimally Invasive Posterolateral Corner Reconstruction Using Ipsilateral Semitendinosus and Gracilis Autograft

Borton, Zakk M.; Yasen, Sam K.; Britton, Edward M.; Heaton, Samuel; Palmer, Harry C.; Wilson, Adrian

doi:10.1016/j.eats.2016.10.007

Cited by 4 publications

(3 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…All patients underwent anatomic (tunnel locations in the center of the footprint of the torn ligament) single-bundle, all-inside ACL reconstruction with a single autologous quadrupled semitendinosus tendon graft with the same tunnel position and diameter by 1 senior surgeon (T.B.). 7,19 Femoral and tibial fixations were performed by using 2 Tight-Ropes (Arthrex). Randomization of the patients was performed using dedicated software.…”

Section: Methodsmentioning

confidence: 99%

Does the Application of Platelet-Rich Fibrin in Anterior Cruciate Ligament Reconstruction Enhance Graft Healing and Maturation? A Comparative MRI Study of 44 Cases

Beyzadeoğlu

Pehlivanoğlu

Yıldırım³

et al. 2020

Orthopaedic Journal of Sports Medicine

View full text Add to dashboard Cite

Background: Anterior cruciate ligament (ACL) reconstruction performed with growth factors and activated platelets has been suggested to accelerate tendon ligamentization, leading to earlier return to daily activities and sports. Hypotheses: Platelet-rich fibrin (PRF) will result in improved graft maturation and healing as evaluated by magnetic resonance imaging (MRI) in patients undergoing hamstring ACL reconstruction. Hemostatic and analgesic properties of PRF will lead to less postoperative blood loss and pain. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 44 patients with isolated ACL injuries who underwent arthroscopic all-inside anatomic single-bundle ACL reconstruction with semitendinosus tendon graft were enrolled. Group 1 included 23 patients who had PRF sprayed to the surface of the graft; group 2 included 21 patients for whom no PRF was used. Patients were discharged after 24 hours and examined for hemarthrosis that needed to be aspirated. MRI was performed at the fifth postoperative month. A blinded radiologist evaluated graft maturation according to its signal intensity and the presence of synovial fluid at the tunnel-graft interface. Results: PRF-treated grafts demonstrated lower MRI signal intensity and less fluid in the graft-tunnel interface as compared with controls for the entire length of the graft. The mean full-length MRI signal intensities were 9.19 versus 16.59 ( P = .047) for groups 1 and 2, respectively. Subgroup analysis of the semitendinosus grafts demonstrated a signal intensity of 11.57 versus 23.98 ( P = .044) for the proximal third, 9.53 versus 13.83 ( P = .237) for the midbody, and 6.48 versus 11.98 ( P = .087) for the distal third. Synovial fluid at the graft-tunnel interface was detected in 1 patient in group 1 (4.3%) and 3 patients in group 2 (14.3%; P < .001). Patients in group 1 had significantly less hemarthrosis that needed to be aspirated ( P = .003), while postoperative analgesia requirements were similar in both groups ( P = .08). No clinical benefit of PRF could be demonstrated in clinical outcomes. Conclusion: Application of PRF led to superior graft integration and maturation in the proximal third of the ACL graft. There was no significant difference in MRI signal intensity in the midbody or distal tibial graft. Application of PRF also resulted in significantly lower rates of postoperative hemarthrosis that needed to be aspirated.

show abstract

Section: Methodsmentioning

confidence: 99%

Does the Application of Platelet-Rich Fibrin in Anterior Cruciate Ligament Reconstruction Enhance Graft Healing and Maturation? A Comparative MRI Study of 44 Cases

Beyzadeoğlu

Pehlivanoğlu

Yıldırım³

et al. 2020

Orthopaedic Journal of Sports Medicine

View full text Add to dashboard Cite

show abstract

“…The semitendinosus distal tendon is specially prepared and most often used for reconstruction of the anterior cruciate ligament. Arthroscopic reconstruction surgeries are currently becoming very popular [6,15,34,40,44,51,56].…”

Section: Introductionmentioning

confidence: 99%

Morphology and morphometry of the semitendinosus distal tendon in adults and foetuses

et al. 2020

View full text Add to dashboard Cite

Background:The distal tendon of the semitendinosus is often used as a graft in orthopedic reconstructive surgery. Knowledge of the exact morphology of this tendon, and also the ability to predict its morphometric data are certainly helpful when planning the procedure of surgery. Comparison of the semitendinosus distal tendon anatomy in adults and foetuses may be scientifically relevant. There are no scientific reports on this tendon anatomy in foetuses. Materials and methods: Seventy semitendinosus muscles from cadavers were obtained using standard dissection techniques (50 muscles were obtained from adults and 20 from foetuses). Moreover, ultrasound examinations of 20 muscles were performed in living individuals. Results: Two main parts of the distal tendon were distinguished -the external part not covered with muscle fibres and the internal part, which is partially or entirely hidden within the muscle belly (venter). The average length of the distal tendon was 32.34 cm, while the average lengths of the external and internal parts were 9.65 cm and 12.59 cm, respectively. The external part was solid and cylindrical. The internal part was flat and rolled like a trough, thus making the tendon a poor transplant material. Similarly, the distal tendon in foetuses consisted of two parts, including the external and internal part. Conclusions: The proportions between the lengths of different muscle parts were very similar in adults and foetuses.

show abstract

“…4 PLC reconstruction with autografts is not a new concept, but none have replicated the LaPrade technique. [17][18][19] The all-autograft nature of the reported technique is a novel approach to 2-tailed anatomic reconstruction using suspensory fixation on the tibia, ipsilateral or contralateral semitendinosus and gracilis tendons, and frequent biceps femoris tenodesis augmentation. Of the 29 patients, 21 underwent biceps tenodesis because of grade III varus instability on clinical examination or quadrupled hamstring autograft size of <8 mm.…”

mentioning

confidence: 99%

Editorial Commentary: Anatomic Posterolateral Corner Reconstruction: All-Autograft Technique

Martin

Stuart

Levy

2019

Arthroscopy: The Journal of Arthroscopic & Related Surgery

View full text Add to dashboard Cite

Several techniques for posterolateral corner reconstruction have been described in the literature, typically using allogeneic tissue. Autograft reconstruction has potential value because of decreased cost and limited allograft supply in some locations. Initial results of this hamstring autograft tendon technique are promising, but further research is needed to directly compare reconstruction graft sources. See related article on page 1676 I n this month's journal, Franciozi, Albertoni, Kubota, Abdalla, Luzo, Cohen, and LaPrade present the results of a novel technique for posterolateral corner (PLC) reconstruction with their article, "A Hamstring-Based Anatomic Posterolateral Knee Reconstruction With Autografts Improves Both Radiographic Instability and Functional Outcomes." 1 Their technique uses hamstring autograft for anatomic reconstruction in patients with chronic grade III PLC deficiency. 2 The authors report improved clinical and radiographic success, with significant improvement in Lysholm, International Knee Documentation Committee, and Tegner subjective scores, varus stress radiography, external rotation (dial test), and recurvatum deformity compared with preoperative measurements. The study cohort included 29 patients who underwent hamstring-based PLC reconstruction an average of 8.8 months after injury, with 2-to 5-year follow-up. Four of the 29 patients underwent a first-stage proximal tibial osteotomy to correct double or triple varus. All patients had complete disruption of the PLC, including the fibular collateral ligament, popliteofibular ligament, and popliteus tendon. There were no cases of isolated PLC

show abstract

Combined All-Inside Anterior Cruciate Ligament Reconstruction and Minimally Invasive Posterolateral Corner Reconstruction Using Ipsilateral Semitendinosus and Gracilis Autograft

Cited by 4 publications

References 24 publications

Does the Application of Platelet-Rich Fibrin in Anterior Cruciate Ligament Reconstruction Enhance Graft Healing and Maturation? A Comparative MRI Study of 44 Cases

Does the Application of Platelet-Rich Fibrin in Anterior Cruciate Ligament Reconstruction Enhance Graft Healing and Maturation? A Comparative MRI Study of 44 Cases

Morphology and morphometry of the semitendinosus distal tendon in adults and foetuses

Editorial Commentary: Anatomic Posterolateral Corner Reconstruction: All-Autograft Technique

Contact Info

Product

Resources

About