Graft Diameter as a Predictor for Revision Anterior Cruciate Ligament Reconstruction and KOOS and EQ-5D Values: A Cohort Study From the Swedish National Knee Ligament Register Based on 2240 Patients

Snaebjörnsson, Thorkell; Senorski, Eric Hamrin; Ayeni, Olufemi R.; Alentorn-Geli, Eduard; Krupić, Ferid; Norberg, Fredrik; Karlsson, Jón; Samuelsson, Kristian

doi:10.1177/0363546517704177

Cited by 125 publications

(159 citation statements)

References 32 publications

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“…In one study,11 graft diameter was not associated with the incidence of revision ACL reconstruction. In a matched case-control study (with patients who went on to revision ACL reconstruction),23 the likelihood of revision ACL reconstruction was 14% lower for every 0.5 mm increment in graft diameter from 7.0 to 10.0 mm (OR 0.86 [95% CI 0.75 to 0.99], p=0.03).…”

Section: Resultsmentioning

confidence: 99%

Factors associated with additional anterior cruciate ligament reconstruction and register comparison: a systematic review on the Scandinavian knee ligament registers

et al. 2018

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Section: Resultsmentioning

confidence: 99%

Factors associated with additional anterior cruciate ligament reconstruction and register comparison: a systematic review on the Scandinavian knee ligament registers

et al. 2018

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“…It is worth noting that the results by Snaebjörnsson et al from the Swedish registry did not parallel these findings. 18 In their patient-reported outcomes, measured through the KOOS and EQ-5D questionnaires, there was no demonstrable correlation between increased graft size and patient-reported outcome.…”

Section: Discussionmentioning

confidence: 90%

“…17 The recent cohort study by Snaebjörnsson et al based on the Swedish knee ligament register similarly reported a 0.86 times lower likelihood of revision with every 0.5-mm increment in graft diameter in graft sizes between 7 and 10 mm. 18 Larger graft sizes have also been reported to produce better patient-reported outcomes. 1,9,10 The Multicentre Orthopaedic Outcomes Network (MOON) cohort study of 263 patients described an association between larger hamstring graft diameters and better patient-reported outcomes.…”

Section: Discussionmentioning

confidence: 99%

Five-Strand Hamstring Autograft in Primary Anterior Cruciate Ligament Reconstruction

et al. 2018

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The purpose of this study was to describe our surgical technique of using five-strand hamstring autograft with interference screw fixation in primary anterior cruciate ligament (ACL) reconstruction and to report the early postoperative outcomes of this technique. Patients who underwent primary ACL reconstruction using five-strand hamstring autografts with interference screw fixation between December 2014 and June 2016 were included in this study. The five-strand configuration was used in these patients because the four-strand configuration produced a graft diameter of less than 8 mm. Subjective questionnaires, including the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the Lysholm Score, were administered preoperatively, as well as at 1- and 2-year follow-ups. Paired -test was used to compare the pre- and postoperative outcome scores. The study group comprised 25 patients. There were no intraoperative complications. The mean follow-up period was 17.8 months (12-24). There were 19 males and 6 females. The median age was 24 years (16-41), and median body mass index was 23.9 (18.5-30.2). The median diameter of the five-strand graft was 9 mm (8-10 mm), with a mean of 9.06 ± 0.60 mm. This was associated with a median graft length of 90 mm (80-100 mm). The postoperative Lysholm, KOOS symptoms, KOOS Pain, KOOS daily function, KOOS sports function, KOOS quality of life, and Short Form-36 Physical Component Summary scores improved significantly compared with the preoperative scores. The use of the five-strand hamstring graft with interference screw fixation in primary ACL reconstruction is associated with significant improvements in patient-reported outcomes in the early postoperative period. The five-strand graft technique is a useful means of increasing graft diameter when faced with an undersized hamstring graft.

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“…Australia has reported the highest incidence of anterior cruciate ligament reconstruction (ACLR) in the world (Zbrojkiewicz et al, ), where hamstring autograft harvesting continues to be the preferred technique for graft reconstruction (Lee et al, ). Although risk of re‐rupture or clinical failure of ACLR is multifactorial, an inverse relationship between graft size and revision risk has been identified from observational analyses (Conte et al, ; Snaebjörnsson et al, ). However, the desire to implant the maximal autograft diameter (Park et al, ) imposes a risk of impingement and associated complications, particularly in younger patients (Su et al, ).…”

Section: Introductionmentioning

confidence: 99%

Anatomical Variability of Intercondylar Fossa Geometry in Patients Diagnosed with Primary Anterior Cruciate Ligament Rupture

Zbrojkiewicz

Scholes²,

Zhong³

et al. 2019

Clinical Anatomy

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The aims of this study were to (1) describe the three-dimensional characteristics and sources of anatomical variability in the geometry of the intercondylar fossa ("notch") in an anterior cruciate ligament (ACL)-injured sample and (2) assess the relationship between patient factors and anatomical variability of the fossa in the context of impingement risk. A retrospective analysis of preoperative magnetic resonance imaging (MRI) for 49 patients with ACL rupture was performed. Scans were examined in the axial plane using an online picture archiving and communication system (PACS) viewer and fossa width and angle assessed at multiple slices, as well as anteroposterior depth, fossa height, and calculated total volume. Principal component analysis was performed to prioritize the sources of variability. A multivariate linear regression was performed to assess relationships between different patient factors, controlling for imaging parameters and principal component loadings. Geometric properties were normally distributed for all but fossa volume, height, and distal angle. Three principal components (PCs) were identified explaining 80% of total variance, shape (PC1), size in the coronal plane (PC2), and size in the sagittal plane (PC3). Patient factors were significantly (P < 0.05) related to PC loadings; however, a substantial amount of variance in each model remained unexplained. Intercondylar fossa characteristics vary considerably within ACL-injury patients with shape and size in coronal and axial planes, explaining most of the variance. Although patient factors are associated with anatomical characteristics, further work is required to identify the correct combination of factors accurately predicting geometry of the fossa for planning ACL reconstruction. Clin. Anat. 33:610-618, 2020.

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Graft Diameter as a Predictor for Revision Anterior Cruciate Ligament Reconstruction and KOOS and EQ-5D Values: A Cohort Study From the Swedish National Knee Ligament Register Based on 2240 Patients

Cited by 125 publications

References 32 publications

Factors associated with additional anterior cruciate ligament reconstruction and register comparison: a systematic review on the Scandinavian knee ligament registers

Factors associated with additional anterior cruciate ligament reconstruction and register comparison: a systematic review on the Scandinavian knee ligament registers

Five-Strand Hamstring Autograft in Primary Anterior Cruciate Ligament Reconstruction

Anatomical Variability of Intercondylar Fossa Geometry in Patients Diagnosed with Primary Anterior Cruciate Ligament Rupture

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