Graft maturity of the reconstructed anterior cruciate ligament 6 months postoperatively: a magnetic resonance imaging evaluation of quadriceps tendon with bone block and hamstring tendon autografts

The ideal procedure for anterior cruciate ligament (ACL) reconstruction is one that can achieve anatomical restoration for a better ACL function. This retrospective comparative study was conducted to evaluate the objective and subjective clinical results of the conventional single-bundle femoral round (SBR) tunnel technique, the single-bundle femoral oval (SBO) tunnel technique, and the double-bundle (DB) surgical technique for anatomical ACL reconstruction with hamstring tendon autografts. Patients who underwent the SBO, SBR, and DB ACL reconstructions from January 2016 to August 2017 were included in this study. A total of 163 patients underwent different surgical techniques; 41 patients underwent the SBO procedure, 78 patients received SBR, and the remaining 44 patients underwent the DB procedure. The Lachman's test, pivot-shift test, Lysholm's score, International Knee Documentation Committee (IKDC) score, and Tegner's score were compared among groups postoperatively. KT-1000 was used to measure the anterior laxity of the knee. Magnetic resonance imaging was used to compare the ACL graft maturity. Second-look arthroscopy was conducted to compare the graft status and synovial coverage. Significant differences among groups were found with respect to the Lysholm's score, Tegner's score, and IKDC score. Patients in the SBO and DB groups acquired higher functional scores than the SBR group. More patients with positive pivot-shift test were observed in the SBR group than other groups at 12- and 24-month postoperative follow-ups. The postoperative KT-1000 was better in the SBO and DB groups than in the SBR group. The mean signal/noise quotient (SNQ) of the SBO group was 2.70 ± 0.92, significantly lower than 3.58 ± 1.21 of the SBR group. Despite a higher proportion of patients with grade B or C synovial coverage and partial graft injury found in the SBR group, there were no significant differences among the groups. The SBO and DB technique achieved better clinical results than the SBR technique. The SBO technique was indeed an ideal surgical procedure for ACL reconstruction provided that the shortcoming of DB technique must be taken into account. This is a Level III, retrospective comparative study.

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“…The lower the value of the SNQ g, the lower the water content of the graft and the more mature the ACL graft was. 35,36…”

Section: Radiographic and Magnetic Resonance Image Evaluationmentioning

confidence: 99%

Anatomical Anterior Cruciate Ligament Reconstruction with Hamstring Tendon Autografts: A Comparative Study of Three Different Techniques

et al. 2020

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“…Concerns regarding the slower healing involved with tendon to bone incorporation have limited its use as a first line graft in the elite athletic population [59,60]. In addition, some studies have suggested that the failure rate with hamstring autografts may be somewhat higher than bone-patella-bone autograft [61].…”

Section: Graft Choicementioning

confidence: 99%

Kinematic outcomes following ACL reconstruction

Naendrup

Zlotnicki

Chao

et al. 2016

Curr Rev Musculoskelet Med

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Anterior cruciate ligament (ACL) reconstruction aims to restore the translational and rotational motion to the knee joint that is lost after injury. However, despite technical advancements, clinical outcomes are less than ideal, particularly in return to previous activity level. A major issue is the inability to standardize treatment protocols due to variations in materials and approaches used to accomplish ACL reconstruction. These include surgical techniques such as the transtibial and anteromedial portal methods that are currently under use and the wide availability of graft types that will be used to reconstruct the ACL. In addition, concomitant soft tissue injuries to the menisci and capsule are frequently present after ACL injury and, if left unaddressed, can lead to persistent instability even after the ACL has been reconstructed. Advances in the field of biomechanics that help to objectively measure motion of the knee joint may provide more precise data than current subjective clinical measurements. These technologies include extra-articular motion capture systems that measure the movement of the tibia in relation to the femur. With data gathered from these devices, a threshold for satisfactory knee stability may be established in order to correctly identify a successful reconstruction following ACL injury.

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“…Amerika Birleşik Devletleri'nde yaklaşık olarak her yıl iki yüz bin üzerinde ÖÇB yaralanması meydana gelirken yüz bin üzerinde ÖÇB rekonstrüksiyonu ameliyatı yapılmaktadır (2,3). ÖÇB rekonstrüksiyonu ameliyatında kullanılan her birisinin avantaj ve dezavantajları olan birçok greft tipi mevcuttur (4,5). Hastadan alınarak yapılan otogreft ile ÖÇB rekonstrüksiyonu donör saha morbiditesi ve cerrahi travma gibi riskler barındırmaktadır (6)(7)(8).…”

Section: Introductionunclassified

Comparison of long-term clinical, radiological and donor site morbidity results of the arthroscopic anterior cruciate ligament reconstruction by using bone-patellar tendon-bone autograft or four-semitendinosus autograft

Öztürk¹,

Taşkıran²

2019

Ege Tıp Dergisi

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Amaç: Çok sayıda değişkenin arasından ön çapraz bağ kopuğu sonrası kemik-patellar tendon-kemik otogrefti veya dörtlü semitendinöz otogreft kullanılarak artroskopik ön çapraz bağ rekonstrüksiyonu uygulanan iki hasta grubu ile, hastaların uzun dönem takibinde radyolojik, klinik sonuçlarını, donör saha morbiditelerini değerlendirmek ve karşılaştırmak amaçlanmıştır. Gereç ve Yöntem: Bu çalışmada, Ege Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji polikliniğine Ocak 1994 ve Aralık 2002 tarihleri arasında artroskopik ön çapraz bağ rekonstrüksiyonu ameliyatı olan 81 hasta retrospektif olarak değerlendirildi. Hastalar kemik-patellar tendon-kemik (PT) otogrefti veya dörtlü semitendinöz (ST) otogrefti kullanılanlar olarak iki gruba ayrıldı. Ameliyat öncesi verilere hastane kayıtlarından ulaşıldı. Son kontrolde klinik muayeneleri ile Cybex ve KT-1000 ölçümleri yapıldı. Radyolojik inceleme ile tibial ve femoral tünel yerleri, patellanın yüksekliği ve osteoartrit durumu değerlendirildi. Bulgular: Post operatif diz önü ağrısı, patella baja, çıplak diz ile sert zeminde yürümede ağrı, PT grubunda ST grubuna oranla yüksek bulundu. Diz önünde duyu kusuru, PT grubunda yüksek bulundu. Radyolojik evre 2, kronik dönemde opere edilenlerde subakut dönemde opere edilenlere göre ve menüsküs dikişi uygulananlarda eksize edilenlere göre daha yüksek bulundu. Sonuç: ST veya PT otogreftleri kullanılarak yapılan artroskopik rekonstrüksiyonun klinik ve fonksiyonel açıdan karşılaştırılması sonucunda her iki otogreft materyali ile yeterli fonksiyonel stabilite sağlamaktadır. Donör saha morbiditesi ile uyumlu olarak diz önü sorunları PT grubunda daha fazla olmaktadır.

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Graft maturity of the reconstructed anterior cruciate ligament 6 months postoperatively: a magnetic resonance imaging evaluation of quadriceps tendon with bone block and hamstring tendon autografts

Cited by 81 publications

References 30 publications

Anatomical Anterior Cruciate Ligament Reconstruction with Hamstring Tendon Autografts: A Comparative Study of Three Different Techniques

Anatomical Anterior Cruciate Ligament Reconstruction with Hamstring Tendon Autografts: A Comparative Study of Three Different Techniques

Kinematic outcomes following ACL reconstruction

Comparison of long-term clinical, radiological and donor site morbidity results of the arthroscopic anterior cruciate ligament reconstruction by using bone-patellar tendon-bone autograft or four-semitendinosus autograft

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