Difference in Graft Maturity of the Reconstructed Anterior Cruciate Ligament 2 Years Postoperatively

Li, Hong; Tao, Hongyue; Cho, Samson; Chen, Shuang; Yao, Zhenjun; Chen, Shiyi

doi:10.1177/0363546512443050

Cited by 88 publications

(58 citation statements)

References 30 publications

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“…44 , 57 , 71 , 74 Nineteen articles were excluded because they included patients of all ages and did not stratify their outcomes by age. 5 , 10 , 18 , 23 - 25 , 32 , 38 , 42 , 49 , 56 , 61 , 62 , 66 , 76 , 78 - 80 , 83 Twenty-one studies were excluded because duration of follow-up was less than 2 years. 1 , 13 , 14 , 31 , 35 , 39 - 41 , 43 , 51 , 52 , 58 , 65 , 70 , 73 , 75 , 84 , 87 , 89 - 91 Three studies were excluded because they did not report on failure (2 reported on muscle strength and 1 on transplantation safety).…”

Section: Resultsmentioning

confidence: 99%

A Systematic Review of Failed Anterior Cruciate Ligament Reconstruction With Autograft Compared With Allograft in Young Patients

Wasserstein

Sheth

Cabrera

et al. 2015

Sports Health: A Multidisciplinary Approach

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Context:The advantages of allograft anterior cruciate ligament reconstruction (ACLR), which include shorter surgical time, less postoperative pain, and no donor site morbidity, may be offset by a higher risk of failure. Previous systematic reviews have inconsistently shown a difference in failure prevalence by graft type; however, such reviews have never been stratified for younger or more active patients.Objective:To determine whether there is a different ACLR failure prevalence of autograft compared with allograft in young, active patients.Data Sources:EMBASE, MEDLINE, Cochrane trials registry.Study Selection:Comparative studies of allograft versus autograft primary ACL reconstruction in patients <25 years of age or of high-activity level (military, Marx activity score >12 points, collegiate or semiprofessional athletes).Study Design:Systematic review with meta-analysis.Level of Evidence:Level 3.Data Extraction:Manual extraction of available data from eligible studies. Quantitative synthesis of failure prevalence and Lysholm score (outcomes in ≥3 studies) and I2 test for heterogeneity. Assessment of study quality using CLEAR NPT and Newcastle-Ottawa Scale (NOS).Results:Seven studies met inclusion criteria (1 level 1; 2 level 2, 4 level 3), including 788 patients treated with autograft tissue and 228 with various allografts. The mean age across studies was 21.7 years (64% male), and follow-up ranged between 24 and 51 months. The pooled failure prevalence was 9.6% (76/788) for autografts and 25.0% (57/228) for allografts (relative risk, 0.36; 95% CI, 0.24-0.53; P < 0.00001; I2 = 16%). The number needed to benefit to prevent 1 failure by using autograft was 7 patients (95% CI, 5-10). No difference between hamstrings autograft and patella tendon autograft was noted. Lysholm score was reported in 3 studies and did not differ between autograft and allograft.Conclusion:While systematic reviews comparing allograft and autograft ACLR have been equivocal, this is the first review to examine young and active patients in whom allograft performs poorly.

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Section: Resultsmentioning

confidence: 99%

A Systematic Review of Failed Anterior Cruciate Ligament Reconstruction With Autograft Compared With Allograft in Young Patients

Wasserstein

Sheth

Cabrera

et al. 2015

Sports Health: A Multidisciplinary Approach

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“…Females were excluded because of different hormonal level, which might greatly influence graft maturity. One senior surgeon (S. Chen) performed all the operations using arthroscopic single-bundle ACL reconstruction techniques as described by Li et al 22 For the autograft reconstruction, the semitendinosus and gracilis tendons were harvested and prepared as a 4-strand double-looped hamstring autograft with a minimum of 12 cm in length. In the allograft group, a fresh-frozen tibialis anterior allograft tendon (Osteolink Biomaterial Co) was thawed in sterile physiologic fluid at room temperature and prepared as a 4-strand double-looped graft similar to the autograft.…”

Section: Methodsmentioning

confidence: 99%

“…The SNQ of each graft site (femoral-adjacent, middle, and tibial-adjacent) was estimated using the following equation: SNQ = (signal of ACL graft − signal of quadriceps tendon)/signal of background ( Figure 1 ). 22 The SNQ value of the graft was calculated by averaging the SNQ value of the 3 sites. In addition, the sagittal ACL angle and the ACL–Blumensaat line angle were measured.…”

Section: Methodsmentioning

confidence: 99%

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Correlation Analysis of Potential Factors Influencing Graft Maturity After Anterior Cruciate Ligament Reconstruction

Chen

Tao

et al. 2014

Orthopaedic Journal of Sports Medicine

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Background:Postoperatively, signal changes of the reconstructed anterior cruciate ligament (ACL) graft on magnetic resonance imaging (MRI) images commonly occurs, which may be a cause for concern. The signal intensity changes are usually expressed by signal/noise quotient (SNQ) value, representing graft maturity. To date, little is known about the factors influencing the SNQ value of the reconstructed ACL graft.Purpose:To evaluate ACL graft SNQ value and associated factors after ACL reconstruction.Study Design:Case series; Level of evidence, 4.Methods:Male patients who underwent ACL reconstruction using autograft or allograft tendon from September 2004 to September 2011 were randomly invited to take part in this investigation, including functional scores, physical examination, and MRI scan. The femoral side graft was fixed with Endobutton CL or Rigidfix pins, and the tibial side graft was fixed with a bio-intrafix. SNQ values of each graft were measured on MRI to represent graft maturity. Sagittal ACL angle, ACL–Blumensaat line angle, and medial and lateral posterior tibial slope (PTS) were measured using MRI 3-dimensional dual-echo steady-state images. Potential risk factors, including age, body mass index, postoperative time, Tegner activity scale (TAS), sagittal ACL angle, ACL–Blumensaat line angle, medial PTS, lateral PTS, and primary graft diameter, were tested for their association with the graft SNQ value by multivariate stepwise regression analysis.Results:A total of 104 male subjects (mean follow-up, 30.7 months) were examined, including 62 allograft and 42 autograft reconstructions. There was a significant association between graft SNQ and postoperative time (r = −0.431, P < .001), TAS (r = 0.295, P = .002), and ACL–Blumensaat line angle (r = −0.304, P = .002). Univariate regression analysis showed that TAS (β = 6.15, P < .001) positively correlated, postoperative time (β = −0.26, P < .001) negatively correlated, and ACL–Blumensaat line angle (β = −0.40, P = .038) negatively correlated with graft SNQ. Multivariate stepwise regression analysis showed that TAS, postoperative time, ACL–Blumensaat line angle, and age were significant independent factors associated with graft SNQ.Conclusion:The graft SNQ value had a significant positive correlation with physical activity level and a significant negative correlation with postoperative time in this study. Males with a shorter postoperative time and a higher physical activity level had higher graft signal intensity postoperatively.

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“…На сегодня в литературе недостаточно информации относительно МРТ-характеристик интеграции аутотрансплантата из сухожилий полусухожильной и нежной мышц в костном канале у пациентов, которым выполнено восстановление ПКС [7,9,11,13]. Магнитно-резонансная томография (МРТ) -это метод исследования, который дает возможность оценить состояние интеграции трансплантата на границе «сухожилиекость», а также определить интенсивность сигнала от трансплантата в костном канале.…”

unclassified

MRI signs of anterior cruciate ligament graft restructuring in bone canal

Krasnoperov¹,

Golovakha²,

Sheveliev³

2018

ORTHOPAEDICS, TRAUMATOLOGY and PROSTHETICS

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1 Запорожский государственный медицинский университет. Украина 2 Медицинский центр «Медикум», Запорожье. Украина Однією зі складових успішної реконструкції передньої схрещеної зв'язки (ПСЗ) є процес ремоделювання трансплантата і його перебудови на межі «сухожилля -кістка» в кістковому каналі. Цей фактор впливає на механічну стабільність колінного суглоба після реконструкції ПСЗ і визначає програму реабілітації. Мета: розробити МРТ-критерії перебудови трансплантата в кісткових каналах після реконструкції ПСЗ. Методи: у дослідження включені 90 пацієнтів, яких розділили на дві групи: у 1-й (47) застосовано техніку «all-inside», у 2-й (43) -наскрізну транстібіальну техніку свердління великогомілкового каналу. У 8 пацієнтів проведено МРТ-дослідження. Результати: запропоновано такі критерії оцінювання перебудови трансплантата в кісткових каналах стегнової і великогомілкової кісток на підставі аналізу МРТ: 1) ознаки перебудови трансплантата на межі «сухожилля -кістка»; 2) синовіальна рідина в кісткових каналах; 3) кістковий набряк стегнової та великогомілкової кісток. Чисельність хворих із І ступенем (повна перебудова трансплантата), із відсутністю синовіальної рідини у кістковомозковому каналі збільшувалася в період із 3 до 9 міс. Кількість пацієнтів із відсутністю кісткового набряку підвищувалася від 3 до 12 міс. (35,6; 54,4; 74,5 і 84,5 %). Виявлено, що вже через 6 міс. у 1-й групі пацієнтів із І ступенем перебудови було більше (60 %) порівняно з 2-ю (42,2 %). Стосовно наявності синовіальної рідини в каналі достовірну різницю визначено вже через 3 міс. -75,5 % у 1-й групі проти 78,9 % у 2-й. Висновки: динаміка перебудови (інкорпорації) трансплантата в кістковому каналі досягає свого піку до 9 міс. після операції і далі залишається практично незмінною. Техніка «all-inside» сприяє швидшій та якіснішій перебудові трансплантата в кістковому каналі завдяки меншій травматизації проксимального метаепіфіза великогомілкової кістки і відсутності імплантата (інтерферентних гвинтів) у великогомілковому каналі. Ключові слова: передня схрещена зв'язка, трансплантат, МРТ-дослідження. © Красноперов С. Н., Головаха М. Л., Шевелев А. В., 2018 One of the reason for succeed anterior cruciate ligament reconstruction is the process of graft remodeling on the border «tendon-bone» in the bone canal. This factor can influence on the mechanical stability of the knee joint after anterior cruciate ligament reconstruction and can determine the rehabilitation exercises. Objective: to work out MRI criteria of graft reconstruction in bone canals. Methods: we included 90 patients, who were divided into two groups: the 1 st one (47) we used the technique «all-inside», in the 2 nd group (43) -cross transtibial drilling technique. In 8 patients MRI was made. Results: we suggested the next criteria for the assessment of graft reconstruction in femoral and tibia bone canals: 1) signs of reconstruction on the border «tendon-bone»; 2) synovial fluid in the bone canals; 3) femoral and tibia bone marrow edema. Number of patients with the 1st stage (full ...

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Difference in Graft Maturity of the Reconstructed Anterior Cruciate Ligament 2 Years Postoperatively

Abstract: The allograft group had a significantly higher SNQ value compared with the autograft group in this study, indicating that allograft tendons might have inferior graft maturity than autograft tendons in ACL reconstruction at 2 years postoperatively.

Cited by 88 publications

References 30 publications

A Systematic Review of Failed Anterior Cruciate Ligament Reconstruction With Autograft Compared With Allograft in Young Patients

A Systematic Review of Failed Anterior Cruciate Ligament Reconstruction With Autograft Compared With Allograft in Young Patients

Correlation Analysis of Potential Factors Influencing Graft Maturity After Anterior Cruciate Ligament Reconstruction

MRI signs of anterior cruciate ligament graft restructuring in bone canal

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