Computer-assisted anatomically placed double-bundle ACL reconstruction: An in vitro experiment with different tension angles for the AM and the PL graft

Luites, J.W.H.; Wymenga, A. B.; Blankevoort, Leendert; Kooloos, J.M.G.

doi:10.1016/j.medengphy.2011.11.004

Cited by 7 publications

(6 citation statements)

References 41 publications

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“…3,57,58 Modifications of surgical techniques including doublebundle reconstruction 62 and anatomic single-bundle reconstruction 7,42 have been proposed in an attempt to address the problem of persistent anterolateral rotatory laxity. Although a number of biomechanical studies have shown improvements in rotatory control with these techniques, 28,30,60 no clinical study has resulted in superior patient-reported outcomes over conventional techniques. 35,53 Additionally, higher failure rates have been reported in a number of studies in which an anatomic surgical technique was performed, suggesting that a more anatomic ACL graft placement may lead to greater forces being placed on the ACL graft, resulting in a subsequent increase in risk of graft rupture.…”

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confidence: 99%

Lateral Extra-articular Tenodesis Reduces Failure of Hamstring Tendon Autograft Anterior Cruciate Ligament Reconstruction: 2-Year Outcomes From the STABILITY Study Randomized Clinical Trial

Getgood¹,

Bryant²,

Litchfield³

et al. 2020

Am J Sports Med

403

439

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Background: Persistent anterolateral rotatory laxity after anterior cruciate ligament (ACL) reconstruction (ACLR) has been correlated with poor clinical outcomes and graft failure. Hypothesis: We hypothesized that a single-bundle, hamstring ACLR in combination with a lateral extra-articular tenodesis (LET) would reduce the risk of ACLR failure in young, active individuals. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: This is a multicenter, prospective, randomized clinical trial comparing a single-bundle, hamstring tendon ACLR with or without LET performed using a strip of iliotibial band. Patients 25 years or younger with an ACL-deficient knee were included and also had to meet at least 2 of the following 3 criteria: (1) grade 2 pivot shift or greater, (2) a desire to return to high-risk/pivoting sports, (3) and generalized ligamentous laxity (GLL). The primary outcome was ACLR clinical failure, a composite measure of rotatory laxity or a graft rupture. Secondary outcome measures included the P4 pain scale, Marx Activity Rating Scale, Knee injury Osteoarthritis and Outcome Score (KOOS), International Knee Documentation Committee score, and ACL Quality of Life Questionnaire. Patients were reviewed at 3, 6, 12, and 24 months postoperatively. Results: A total of 618 patients (297 males; 48%) with a mean age of 18.9 years (range, 14-25 years) were randomized. A total of 436 (87.9%) patients presented preoperatively with high-grade rotatory laxity (grade 2 pivot shift or greater), and 215 (42.1%) were diagnosed as having GLL. There were 18 patients lost to follow-up and 11 who withdrew (~5%). In the ACLR group, 120/298 (40%) patients sustained the primary outcome of clinical failure, compared with 72/291 (25%) in the ACLR+LET group (relative risk reduction [RRR], 0.38; 95% CI, 0.21-0.52; P < .0001). A total of 45 patients experienced graft rupture, 34/298 (11%) in the ACLR group compared with 11/291 (4%) in the ACL+LET group (RRR, 0.67; 95% CI, 0.36-0.83; P < .001). The number needed to treat with LET to prevent 1 patient from graft rupture was 14.3 over the first 2 postoperative years. At 3 months, patients in the ACLR group had less pain as measured by the P4 ( P = .003) and KOOS ( P = .007), with KOOS pain persisting in favor of the ACLR group to 6 months ( P = .02). No clinically important differences in patient-reported outcome measures were found between groups at other time points. The level of sports activity was similar between groups at 2 years after surgery, as measured by the Marx Activity Rating Scale ( P = .11). Conclusion: The addition of LET to a single-bundle hamstring tendon autograft ACLR in young patients at high risk of failure results in a statistically significant, clinically relevant reduction in graft rupture and persistent rotatory laxity at 2 years after surgery. Registration: NCT02018354 ( ClinicalTrials.gov identifier)

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confidence: 99%

Lateral Extra-articular Tenodesis Reduces Failure of Hamstring Tendon Autograft Anterior Cruciate Ligament Reconstruction: 2-Year Outcomes From the STABILITY Study Randomized Clinical Trial

Getgood¹,

Bryant²,

Litchfield³

et al. 2020

Am J Sports Med

403

439

View full text Add to dashboard Cite

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“…20,35 As a consequence, better clinical performance and a lower incidence of osteoarthritis (OA) should be observed in patients undergoing DB reconstruction. 10,16,18,37 In recent years, therefore, anatomic DB ACLR has gained popularity. The definition of anatomic ACLR is the functional restoration of the ACL to its native dimension, collagen orientation, and insertion site.…”

mentioning

confidence: 99%

“…On the other hand, there are many arguments for DB reconstruction based on kinematic, cadaveric, in vivo, and clinical outcome studies. 10,16,18,37 Graft options for ACLR include bone-patellar tendonbone (BPTB) autografts, hamstring tendon autografts, quadriceps autografts, and various allografts. 34 For many years, the BPTB autograft was regarded as the gold standard for ACLR.…”

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confidence: 99%

Irradiated Hamstring Tendon Allograft Versus Autograft for Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction

et al. 2016

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“…In this study we focused on the computer assisted femoral ACL placement; in another study the effect of method application at knee laxity results was evaluated in an in vitro study . However, at this stage we do not know what the clinical implications are of the errors found in this study.…”

Section: Discussionmentioning

confidence: 98%

Accuracy of a computer-assisted planning and placement system for anatomical femoral tunnel positioning in anterior cruciate ligament reconstruction

Luites

Wymenga

Blankevoort

et al. 2013

Int J Med Robotics Comput Assist Surg

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Computer-assisted anatomically placed double-bundle ACL reconstruction: An in vitro experiment with different tension angles for the AM and the PL graft

Cited by 7 publications

References 41 publications

Lateral Extra-articular Tenodesis Reduces Failure of Hamstring Tendon Autograft Anterior Cruciate Ligament Reconstruction: 2-Year Outcomes From the STABILITY Study Randomized Clinical Trial

Lateral Extra-articular Tenodesis Reduces Failure of Hamstring Tendon Autograft Anterior Cruciate Ligament Reconstruction: 2-Year Outcomes From the STABILITY Study Randomized Clinical Trial

Irradiated Hamstring Tendon Allograft Versus Autograft for Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction

Accuracy of a computer-assisted planning and placement system for anatomical femoral tunnel positioning in anterior cruciate ligament reconstruction

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