Hamstring Graft Incorporation According to the Length of the Graft Inside Tunnels

Cavaignac, Étienne; Marot, Vincent; Faruch, Marie; Reina, Nicolas; Murgier, Jérôme; Accadbled, Franck; Bérard, Emilie; Chiron, Philippe

doi:10.1177/0363546517733472

Cited by 41 publications

(61 citation statements)

References 57 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…43,54 A dedicated knee coil was used in 11 studies, only 3 of which mentioned the number of channels used (8 or 15 channels). 8,49,50 The type of coil used was not specified in 23 studies. Of the 34 included studies, 20 studies mentioned the type of MRI sequence used (turbo spin-echo [TSE], n = 10, †† conventional spin-echo [SE], n = 7, ‡‡ and gradient-echo [GRE], n = 3 5,42,44 ), whereas 13 studies §§ mentioned only the type of contrast-weighting.…”

Section: Resultsmentioning

confidence: 99%

“…The following measures were used to evaluate the SI:1. SNQ = SI graft – SI quadriceps tendon /SI background (n = 8 1,31–33,35,40,48,56 ) = SI graft – SI posterior cruciate ligament /SI background (n = 3 8,9,23 ) = SI graft – SI patellar tendon /SI background (n = 1 53 )2. Signal-to-noise ratio (SNR) = SI graft /SD background (n = 2 44,45 )3.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Assessment of Anterior Cruciate Ligament Graft Maturity With Conventional Magnetic Resonance Imaging: A Systematic Literature Review

Zazulia

Smekens

et al. 2019

Orthopaedic Journal of Sports Medicine

View full text Add to dashboard Cite

Background: Magnetic resonance imaging (MRI) signal intensity (SI) measurements are being used increasingly in both clinical and research studies to assess the maturity of anterior cruciate ligament (ACL) grafts in humans. However, SI in conventional MRI with weighted images is a nonquantitative measure dependent on hardware and software. Purpose: To conduct a systematic review of studies that have used MRI SI as a proxy for ACL graft maturity and to identify potential confounding factors in assessing the ACL graft in conventional MRI studies. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review was conducted by searching the MEDLINE/PubMed, Scopus, and Cochrane Library electronic databases according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines to identify studies that examined the healing of the intra-articular portion of the ACL graft by assessing SI on MRIs. Results: A total of 34 studies were selected for inclusion in this systematic review. The MRI acquisition techniques and methods to evaluate the ACL graft SI differed greatly across the studies. No agreement was found regarding the time frames of SI changes in MRI reflecting normal healing of the ACL tendon graft, and the graft SI and clinical outcomes after ACL reconstruction were found to be poorly correlated. Conclusion: The MRI acquisition and evaluation methods used to assess ACL grafts are very heterogeneous, impeding comparisons of SI between successive scans and between independent studies. Therefore, quantitative MRI-based biomarkers of ACL graft healing are greatly needed to guide the appropriate time of returning to sports after ACL reconstruction.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Assessment of Anterior Cruciate Ligament Graft Maturity With Conventional Magnetic Resonance Imaging: A Systematic Literature Review

Zazulia

Smekens

et al. 2019

Orthopaedic Journal of Sports Medicine

View full text Add to dashboard Cite

show abstract

“…Tunnel convergence can become a major issue if the lack of a strong femoral attachment causes the reconstructed ACL to be inefficient. The femoral tunnel that we use for ACL reconstruction is a 10-mm-long blind tunnel, which has been shown to be sufficient for hamstring graft integration 14 …”

Section: Discussionmentioning

confidence: 99%

“…The semitendinosus tendon, used as the ACL graft, is prepared in 4 strands on a TightRope device (Arthrex, Naples, FL) with a FiberWire suture (No. 2; Arthrex) at the distal end 14 . The gracilis tendon is not prepared.…”

Section: Surgical Techniquementioning

confidence: 99%

“…The tibial tunnel is drilled completely from the hamstring incision with an outside-in guide. An inside-out guide is used to drill a 10-mm-long femoral tunnel 14 . The graft is passed from distal to proximal, the TightRope fixation system (Arthrex) is secured on the femoral cortex, and the graft is tightened with a BioComposite interference screw (Arthrex) on the tibial side in 30° of flexion.…”

Section: Surgical Techniquementioning

confidence: 99%

See 1 more Smart Citation

Minimally Invasive Ultrasound-Guided Anterolateral Ligament Reconstruction With Autologous 2-Strand Gracilis Graft

Cavaignac

Castoldi

Marot

et al. 2019

Arthroscopy Techniques

Self Cite

View full text Add to dashboard Cite

We describe an ultrasound-guided anterolateral ligament (ALL) reconstruction technique that uses the gracilis tendon and can be added to any anterior cruciate ligament reconstruction technique. Preoperative ultrasound imaging is used to view the ruptured ALL and confirm the location of bony landmarks. Two minimally invasive incisions are made: one posterior to the lateral epicondyle and one posterior to the Gerdy tubercle. After anterior cruciate ligament graft fixation, the 2-strand gracilis tendon is introduced from the tibial incision, under the fascia lata, toward the femoral incision. The ALL graft is secured to the femur with a 5.5-mm anchor, positioned posteriorly and proximally to the lateral epicondyle. The distal end of the graft is tightened in full extension and fixed to the tibia with a ligament staple posterior to the Gerdy tubercle. This ALL technique requires no graft preparation.

show abstract

Lateral extra‐articular tenodesis does not enhance ACL graft healing, however, does reduce graft tunnel widening

Jacob,

Lim,

Brito

et al. 2024

Knee surg. sports traumatol. arthrosc.

View full text Add to dashboard Cite

PurposeThe study hypothesized that the addition of lateral extra‐articular tenodesis (LEAT) in anterior cruciate ligament reconstruction (ACLR) had a significant effect on ACL graft healing.MethodsA total of 80 patients were divided into two cohorts matched for gender, age, body mass index, time from surgery to post‐operative MRI and graft diameter. Forty patients underwent ACL reconstruction alone, while 40 underwent ACLR in addition to LEAT. Patients underwent a magnetic resonance imaging scan at 12 months post‐surgery; tunnel apertures were measured using multiplanar reformation, graft healing was assessed using signal‐to‐noise quotient (SNQ) in three regions of interest and finally graft maturity and integration were classified using the Howell and Ge scale, respectively. In addition, clinical evaluation and patient‐reported outcome measures were collected.ResultsThe mean femoral tunnel widening at 12 months post‐surgery was 39.8 ± 14.0% in the ACLR + LEAT group and 55.2 ± 12.7% in the ACLR alone group (p < 0.05). The mean tibial tunnel widening was 29.3 ± 12.7% in the ACLR + LEAT group and 44.4 ± 12.1% in the ACLR group (p < 0.05). The mean adjusted graft SNQ was 9.0 ± 14.9 in the ACLR + LEAT group and 9.5 ± 11.4 in the ACLR group (n.s.).ConclusionAt 1 year post‐operatively, we noted significantly less femoral and tibial tunnel widening in the ACLR + LEAT group. LEAT did not result in a statistically significant effect on graft healing.Level of EvidenceLevel III.

show abstract

Hamstring Graft Incorporation According to the Length of the Graft Inside Tunnels

Abstract: At the 1-year postoperative follow-up, incorporation and ligamentization of the STG and ST4 grafts were the same based on MRI analysis. The results were at least as good with the ST4 technique as with the standard STG technique in terms of incorporation and ligamentization.

Cited by 41 publications

References 57 publications

Assessment of Anterior Cruciate Ligament Graft Maturity With Conventional Magnetic Resonance Imaging: A Systematic Literature Review

Assessment of Anterior Cruciate Ligament Graft Maturity With Conventional Magnetic Resonance Imaging: A Systematic Literature Review

Minimally Invasive Ultrasound-Guided Anterolateral Ligament Reconstruction With Autologous 2-Strand Gracilis Graft

Lateral extra‐articular tenodesis does not enhance ACL graft healing, however, does reduce graft tunnel widening

Contact Info

Product

Resources

About