Comparison of Clinical Results and Second-Look Arthroscopy Findings After Arthroscopic Anterior Cruciate Ligament Reconstruction Using 3 Different Types of Grafts

Lee, Jung Hwan; Bae, Dae Kyung; Song, Sang Jun; Cho, Seung Mok; Yoon, Kyoung Ho

doi:10.1016/j.arthro.2009.06.026

Cited by 61 publications

(73 citation statements)

References 37 publications

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“…[16] Lee ve arkadaşla-rı [27] farklı greftlerle ÖÇB onarımı yaptıkları 338 hastanın (KPTK allogreft 60, ATT allogreft 153 ve DHT otogreft 125 olguda) allogreft olgularının AS daha iyi EHA'ya sahip olduklarını ancak otogreft grubunda IKDC skorlarının daha iyi olduğunu bildirmişler-dir. Harner ve arkadaşları [3] 26 otogreft ve 64 allogrefti 36-75 ay ortalarna 45 ay izlemişler ve allogreft grubunda %48, otogreft grubunda %38 olguda IKDC A-B sonuç bildirmişlerdir.…”

Section: Discussionunclassified

“…Bu durum kliniğimizde önceleri çoğun-lukla ATT allogreft ile ÖÇB rekonstrüksiyonu yapılır-ken, Transfix ® tekniğiyle DHT otogreft rekonstrüksi-yonun nispeten daha yeni olmasından kaynaklanmaktadır. AS dönemde 52. haftada allogreftlerle otogreftler arasındaki farkın büyük oranda kalkmasından dolayı, [27] bu farklılığın çalışmamızın sonuçlarını etkilemediğini düşünmekteyiz. Diğer bir kısıtlılık ise, KT-100 ile objektif klinik değerlendirme yapılamaması olarak sayılabilir.…”

Section: Tutoplastunclassified

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Anterior cruciate ligament injuries: do affect surgical treatment with otograft and allograft options, clinical results?

Aslan¹,

Özer²,

Baydar³

et al. 2012

Ulus Travma Acil Cerrahi Derg

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AMAÇBu çalışmada, allogreft ya da otogreft ile ön çapraz bağ (ÖÇB) rekonstrüksiyonun klinik sonuçları araştırıldı. GEREÇ VE YÖNTEMAnterior tibial tendon (ATT) allogreft (n=52) ya da dörtlü hamstring (DHT) otogreft (n=30) ile ön çapraz bağ (ÖÇB) rekonstrüksiyonu uygulanan 82 hastanın sonuçları geriye dönük olarak değerlendirildi. Hastalar son kontrolde, Uluslararası Diz Dokümantasyon Komitesi'nin (IKDC) diz skoru ve Lysholm skoru, performans (tek bacak zıplama) ve laksite (pivot-shift, Lachman, öne çekmece) testleri ile değerlendirildi. BULGULARİki grup arasında yaş, cinsiyet dağılımı, ameliyat edilen taraf, ameliyat öncesi süre ve eşlik eden yaralanmalar açısın-dan farklılık yoktu (p>0,05). IKDC, Lysholm, performans ve laksite bakımndan her iki grupta da sonuçlar tatmin ediciydi ancak gruplar arasında anlamlı fark yoktu (p>0,05). Fakat, ATT allogreft grubunda DHT otogreft grubuna göre daha fazla effüzyona rastlandı. SONUÇBu çalışmanın sonuçları ATT allogreft ya da DHT otogreft ile ÖÇB rekonstrüksiyonunun klinik sonuçlarının benzer olduğunu göstermektedir. Bununla birlikte allogreftlerde görülen immün yanıta çözümler geliştirilmesiyle ÖÇB rekonstrüksi-yonunda iyi bir greft alternatifi olabileceğini düşünüyoruz.Anahtar Sözcükler: Anterior tibial tendon allogreft; hamstring tendon otogreft; ön çapraz bağ yaralanması.

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Section: Discussionunclassified

Section: Tutoplastunclassified

Anterior cruciate ligament injuries: do affect surgical treatment with otograft and allograft options, clinical results?

Aslan¹,

Özer²,

Baydar³

et al. 2012

Ulus Travma Acil Cerrahi Derg

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“…Lee et al [33] reported of comparative analysis of clinical results and corresponding second-look arthroscopic findings after ACL reconstruction using three different types of grafts. They found no significant difference with regard to objective knee testing measures among the three different grafts except that the allograft group showed a greater postoperative ROM than the autograft group.…”

Section: Discussionmentioning

confidence: 99%

“…Even though studies by Seitz et al [12] on sheep could demonstrate that, in particular, the PET augmentation device may count as the best acceptable and most solid augmentation, and still has its value in endoprosthetic tumour joint surgery and posterior cruciate ligament reconstruction, the same investigations indicated a high incidence of adverse foreign body reactions and concomitant synovitis mainly in cases of structural discontinuity of the synthetic augmentation [7,8,27,29,30]. Studies focusing on arthroscopic morphological graft condition and biomechanical graft function, particularly the clinical status have been published only occasionally [16,[31][32][33][34]. Despite the past results there is a revival of interest in the ligament as a non-absorbable synthetic ligament made of terephthalic polyethylene polyester fibres.…”

Section: Discussionmentioning

confidence: 99%

Second-look arthroscopic findings and clinical results after polyethylene terephthalate augmented anterior cruciate ligament reconstruction

Struewer¹,

Ziring

Ishaque

et al. 2012

International Orthopaedics (SICOT)

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Purpose Based on the revival of artificial ligaments containing polyethylene terephthalate, this study aimed to evaluate objective intra-articular findings within scheduled secondlook arthroscopy, patient-reported clinical outcome and stability after isolated augmented ACL reconstruction with polyethylene terephthalate (Trevira®) augmented patella-bonetendon-bone graft. Methods In a retrospective analysis of our institutional database, we found 126 patients with polyethylene terephthalate (Trevira®) augmented ACL reconstruction. All these patients underwent standardised second-look arthroscopic evaluation when removal of the augmentation became necessary. These second-look arthroscopic analyses focused on graft integration and remodelling in line with the polyethylene terephthalate augmentation. Arthroscopic re-examination comprised a graft evaluation including a structural and functional classification according to the Marburger Arthroscopy Score (MAS).Additional clinical evaluation was performed via the IKDC score and the scores of Tegner and Lysholm. Instrumental anterior laxity testing was carried out with a KT-1000™ arthrometer. Furthermore, a correlation analysis between the clinical parameters, the instrumental stability assessment and the corresponding arthroscopic graft condition was performed.Results The arthroscopic evaluation showed rupture of 87 (69 %) of 126 augmentation devices. In 27 (31 %) of these 87 cases, synovial reactions were found particularly in the anterior compartment. An intact synthetic augmentation with signs of graft integration with intact synovial coating was only found in 30 %. Evaluation according to the MAS showed good to excellent structural and functional characteristics in 88 % of patients. Presence of a type III graft (MAS) was found in an additional 11 %. A rudimentary (type IV) graft was only detected once. Eighty-five percent of patients were graded A or B according to IKDC score. The Lysholm score was 92.4± 4.8. Correlation analysis demonstrated a significant relationship between clinical outcome according to the IKDC score (p<0.05), instrumental stability performance according to the KT-1000™ assessment (p<0.05) and the corresponding arthroscopic graft evaluation according to the MAS. Conclusion Graft integration and remodelling has complex and multi-factorial origins, particularly with artificial augmentation. Correlation analysis showed a significant relation between clinical condition, instrumental stability performance and arthroscopic graft constitution. The release of polyethylene terephthalate fibres caused inflammation of synovial tissue of the knee. Characteristic sub-clinical graft changes of structural, morphological and functional qualities of the inserted graft appear on second-look arthroscopy despite good clinical results.

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“…The synovial fluid contains cytokines, including IL-6, IL-8 and tumor necrosis factor, proteolytic enzymes, and growth factor inhibitors, which are known to results in osteolysis and bone tunnel enlargement by means of inhibiting bone formation and stimulating osteoclastic activity 22 . Through second-look arthroscopy, Lee et al 23 compared synovial coverage of the graft after ACL reconstruction with autografts or allografts and found the autograft had earlier and better synovial coverage. Synovial coverage and synovialization of the graft are able to seal the tunnel intra-articular entrance so as to decrease the back flow of the synovial fluid and inhibit tunnel enlargement.…”

Section: Acta Cir Bras 2017;32(12):1064-1074mentioning

confidence: 99%

Tibial tunnel enlargement and joint instability after anterior cruciate ligament reconstruction. A prospective comparison between autograft and allograft

Zhang

Hao

et al. 2017

Acta Cir. Bras.

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IVTibial tunnel enlargement and joint instability after anterior cruciate ligament reconstruction. A prospective comparison between autograft and allograft 1 Abstract Purpose: To investigate tibial tunnel widening and knee instability after ACL reconstruction with hamstring autograft or irradiated soft tissue allograft. Methods: Eight-two patients were divided into two groups: autograft group and allograft group. Radiographic and clinical evaluations were performed. Results: Seventy patients were followed up with median of 36.3 months (range 36-38 months). Tibial tunnel widening was at or greater than 30% for nine patients in the autograft group and 15 patients in the allograft group (P = 0.0417). The average percentage of tibial tunnel widening was 26.7 ± 4.0 % and 29.7 ± 5.3 % in autograft and allograft groups, respectively (P = 0.0090). Knee range of motion was not affected by the reconstruction operation or different grafts. Thigh atrophy improved significantly within 24 months after ACL reconstructions in both groups. ACL reconstruction with the allograft leaded to less knee stability than that with the autograft from one year after operation (P = 0.0023). There was no significant difference between two groups with respect to Lysholm score (P = 0.1925) and Tegner score (P =0 .0918) at the final follow-up. Conclusion:The allograft group reported significantly more tibial tunnel widening and knee instability compared with the autograft group.

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Comparison of Clinical Results and Second-Look Arthroscopy Findings After Arthroscopic Anterior Cruciate Ligament Reconstruction Using 3 Different Types of Grafts

Cited by 61 publications

References 37 publications

Anterior cruciate ligament injuries: do affect surgical treatment with otograft and allograft options, clinical results?

Anterior cruciate ligament injuries: do affect surgical treatment with otograft and allograft options, clinical results?

Second-look arthroscopic findings and clinical results after polyethylene terephthalate augmented anterior cruciate ligament reconstruction

Tibial tunnel enlargement and joint instability after anterior cruciate ligament reconstruction. A prospective comparison between autograft and allograft

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