Knee stability, athletic performance and sportspecific tasks in non-professional soccer players after ACL reconstruction: comparing trans-tibial and antero-medial portal techniques

Abstract

SummaryBackground: a wrong position of bone tunnels, in particular on the femur, is one of the most frequent causes of a failed anterior cruciate ligament (ACL) reconstruction. Several studies demonstrated that drilling the femoral tunnel through the antero-medial portal (AMP) allows a more anatomical placement on the lateral femoral condyle and higher knee stability, compared to trans-tibial (TT) technique. The aim of this study was to retrospectively evaluate two groups of soccer players operated on for ACL reconstruction according to either one of these two techniques. Methods: two groups of non-professional soccer players operated on for a single bundle ACL reconstruction with hamstrings autograft using either a TT (20 patients) or an AMP (23 patients) technique were retrospectively evaluated with KT-1000 arthrometer, manual pivot shift test, isokinetic test, the incremental treadmill-running test, athletic and sport specific tasks, and knee scores (IKDC, Lysholm and KOOS). Results: the AMP group showed better results at pivot shift test and KOOS, but lower flexion angles at single leg squat test. There were no differences in all the other considered outcomes. Conclusions: the better rotational stability of the knee achieved in AMP group did not lead to sig-

Surgical time for graft preparation using different suture techniques

“…In the last two decades, an increase in the use of hamstring grafts for several surgical ligament reconstruction procedures has been observed. In fact, autogenous gracilis and semitendinosus tendons are the first choice of many orthopaedic surgeons when reconstructing the anterior and posterior cruciate ligaments [1][2][3] . Because of low site morbidity, hamstring has started to be used in other surgical procedures such as coracoacromial ligament reconstruction, ulnar collateral ligament reconstruction of the elbow and rotator cuff repair [4][5][6][7] .…”

Correlation between fixation systems elasticity and bone tunnel widening after ACL reconstruction

“…went ACL reconstruction (bone to elderly or donor animal) 7,8 . The direction of force application in tests to evaluate ultimate tensile load or pull-out strength is only in one direction, while other movements are excluded; or femoral and tibial fixation systems are tested separately, forgiving the complexity of femoral and tibial bone-graft-device system 9 .…”

Correlation between fixation systems elasticity and bone tunnel widening after ACL reconstruction

“…1 a, b). Comparative studies between vary fixation systems are encumbered by intrinsic limits as they often compare systems with biomechanical characteristics and engineering philosophy completely different, implanted on bone with density and biomechanical property far away from those young typical patient that under-Correlation between fixation systems elasticity and bone tunnel widening after ACL reconstruction went ACL reconstruction (bone to elderly or donor animal) 7,8 . The direction of force application in tests to evaluate ultimate tensile load or pull-out strength is only in one direction, while other movements are excluded; or femoral and tibial fixation systems are tested separately, forgiving the complexity of femoral and tibial bone-graft-device system 9 .…”