No significant difference in clinical outcome and knee stability between patellar tendon and semitendinosus tendon in anterior cruciate ligament reconstruction

Konrads, Christian; Reppenhagen, Stephan; Plumhoff, Piet; Hoberg, Maik; Rudert, Maximilian; Barthel, Thomas

doi:10.1007/s00402-015-2386-4

Cited by 12 publications

(17 citation statements)

References 17 publications

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“…TDPCs have a relatively high in vitro proliferation capacity, so only a small amount of autogenous tendon is required to generate clinically useful cell numbers . In human patients, healthy tendon autografts are routinely obtained from patellar tendon and palmaris longus tendon, for cruciate and ulnar collateral ligament reconstruction, respectively. These could also be used as sources for autogenous TDPC isolation.…”

Section: Discussionmentioning

confidence: 99%

Tendon‐derived progenitor cells improve healing of collagenase‐induced flexor tendinitis

Durgam

Stewart

Sivaguru

et al. 2016

Journal Orthopaedic Research

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Tendinitis is a common and a performance-limiting injury in athletes. This study describes the value of intralesional tendon-derived progenitor cell (TDPC) injections in equine flexor tendinitis. Collagenase-induced tendinitis was created in both front superficial digital flexor (SDF) tendons. Four weeks later, the forelimb tendon lesions were treated with 1 × 10 autogenous TDPCs or saline. Tendinitis was also induced by collagenase in one hind SDF tendon, to study the survival and distribution of DiI-labeled TDPCs 1, 2, 4, and 6 weeks after injection. The remaining normal tendon was used as a "control." Twelve weeks after forelimb TDPC injections, tendons were harvested for assessment of matrix gene expression, biochemical, biomechanical, and histological characteristics. DiI-labeled TDPCs were abundant 1 week after injection but gradually declined over time and were undetectable after 6 weeks. Twelve weeks after TDPC injection, collagens I and III, COMP and tenomodulin mRNA levels were similar (p = 0.3) in both TDPC and saline groups and higher (p < 0.05) than normal tendon. Yield and maximal stresses of the TDPC group were significantly greater (p = 0.005) than the saline group's and similar (p = 0.6) to normal tendon. However, the elastic modulus of the TDPC and saline groups were not significantly different (p = 0.32). Histological assessment of the repair tissues with Fourier transform-second harmonic generation imaging demonstrated that collagen alignment was significantly better (p = 0.02) in TDPC group than in the saline controls. In summary, treating collagenase-induced flexor tendon lesions with TDPCs improved the tensile strength and collagen fiber alignment of the repair tissue. Study Design © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:2162-2171, 2016.

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Section: Discussionmentioning

confidence: 99%

Tendon‐derived progenitor cells improve healing of collagenase‐induced flexor tendinitis

Durgam

Stewart

Sivaguru

et al. 2016

Journal Orthopaedic Research

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“…The full texts of 216 studies were assessed for eligibility, of which 32 were excluded for <1 year follow-up, 32 for comparing different fixations using the same graft, 34 for quasi-randomized controlled trials, and 73 for no related data provided. Finally, 45 studies 7 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 were included for our analysis. Fig 1 shows the selection process for relevant studies.…”

Section: Resultsmentioning

confidence: 99%

“…In the included studies, the mean age of patients ranged from 20.1 to 42 years, and the percentage of female patients ranged from 13% to 100%. In terms of the grafts used, 17 studies 29 , 30 , 32 , 33 , 36 , 39 , 43 , 47 , 51 , 54 , 55 , 58 , 66 , 69 , 70 , 71 , 72 compared patellar tendon autograft (PT-AU) with hamstring tendon autograft (HT-AU), 5 studies 31 , 37 , 38 , 48 , 52 compared PT-AU with semitendinosus tendon autograft (ST-AU), 4 studies 63 , 64 , 67 , 68 compared HT-AU with hamstring tendon allograft (HT-AL), 3 studies 7 , 40 , 42 compared PT-AU with Art-L, 2 studies 41 , 46 compared HT-AU with ST-AU, 2 studies 49 , 65 compared HT-AU with tibialis anterior tendon allograft (TA-AL), 2 studies 61 , 62 compared PT-AU with patellar tendon allograft (PT-AL), 2 studies 35 , 56 compared PT-AL with HT-AL, and 1 study 50 performed a comparison among PT-AU, HT-AU, and ST-AU. In addition, 1 study compared HT-AU with tibialis posterior allograft (TP-AL), 34 1 compared HT-AU with PT-AL, 44 1 compared PT-AL with tibialis anterior allograft (TA-AL), 45 1 compared PT-AU with QT-AU, 53 1 compared HT-AU with Achilles tendon allograft (Ac-AL), 57 1 compared HT-AU with peroneus longus tendon autograft (PLT-AU), 59 and 1 compared PT-AU with ilitibial band autograft (ITB-AU).…”

Section: Resultsmentioning

confidence: 99%

“…Based on the Cochrane Risk of Bias tool, the risk of bias varied in the studies ( Appendix ). All the studies had low risk of bias in randomized sequence generation, attrition bias, and reporting bias; 15 studies 7 , 31 , 34 , 36 , 37 , 38 , 40 , 44 , 47 , 48 , 50 , 52 , 53 , 65 , 66 had low risk of bias in allocation concealment, 4 studies 40 , 41 , 46 , 55 had low risk of bias in blinding participants, and 26 trials 30 , 35 , 36 , 37 , 39 , 41 , 43 , 44 , 46 , 50 , 51 , 52 , 53 , 55 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 70 , 71 , 72 had low risk of bias in blinding outcome assessors ( Appendix ). In terms of GRADE evaluation, 110 comparisons were judged as moderate evidence, 21 as low evidence, and 5 as very low evidence ( Appendix ).…”

Section: Resultsmentioning

confidence: 99%

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Comparative Efficacy of Graft Options in Anterior Cruciate Ligament Reconstruction: A Systematic Review and Network Meta-Analysis

Liu

Yang

et al. 2020

Arthroscopy, Sports Medicine, and Rehabilitation

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Purpose To evaluate the effectiveness of various graft options for anterior cruciate ligament reconstruction using network meta-analysis. Methods A medical literature search was conducted of PubMed, the Cochrane Library, Embase, SCOPUS, and Web of Science from their inception through March 1, 2019. The outcomes, including International Knee Documentation Committee (IKDC) form, Lachman test, Lysholm score, Pivot shift test, and Tegner score, were evaluated among graft options. Data extraction was carried out according to inclusion and exclusion criteria, and a network meta-analysis was performed using STATA 14.0. Results A total of 45 trials with 3992 patients were included. The forest plots revealed no significant differences in IKDC, Lysholm, or Tegner score among the grafts. In Lachman score, a significant difference was found in the comparisons of hamstring tendon allograft (HT-AL) versus patellar tendon autograft (PT-AU) and HT-AL versus hamstring tendon autograft (HT-AU). In pivot shift test, PT-AU was superior to all the other grafts, and quadriceps tendon autograft (QT-AU) was superior to HT-AL and artificial ligament (Art-L) in the number of cases with negative results. According to surface under the cumulative ranking area (SUCRA), PT-AU had the highest probability to be the best intervention in Lachman test and Tegner score; tibialis anterior tendon allograft (TA-AL) in IKDC and Lysholm score; and QT-AU in pivot shift test. Based on the cluster analysis of SUCRA, PT-AU was considered the most appropriate intervention by IKDC and Lachman test. Conclusion This study suggests that PT-AU may be the most appropriate graft for ACL reconstruction according to IKDC and Lachman test results. Level of Evidence Level I, network meta-analysis of randomized controlled trials.

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“…ACL reconstruction, the surgical replacement of the torn ligament by an autologous tendon graft (e.g., semitendinosus or patella tendon) is the current standard treatment5). Recent high level evidence suggests that current techniques of ACL reconstruction do not substantially improve patient-reported outcomes6).…”

Section: Introductionmentioning

confidence: 99%

Mesenchymal Stem Cells Isolated from the Anterior Cruciate Ligament: Characterization and Comparison of Cells from Young and Old Donors

Prager¹,

Kunz²,

Ebert³

et al. 2018

Knee Surg Relat Res

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PurposeMesenchymal stem cells (MSCs) isolated from the anterior cruciate ligament (ACL) share multiple characteristics of bone marrow-derived mesenchymal stem cells (BMSCs), allowing their use for regenerative therapies. Injuries to the ACL can affect people of all ages. This study assesses whether the regenerative potential of ACL-derived MSCs (ACL-MSCs) from old donors is as high as the potential of ACL-MSCs from young donors.Materials and MethodsACL-MSCs were isolated from ACL tissues obtained from young and old donors at the time of ACL reconstruction or arthroplasty. Proliferative capacity, multilineage differentiation potential (chondrogenic, osteogenic, and adipogenic lineages), and transcriptome-wide gene expression were assessed and compared between young and old donors. BMSCs of middle-aged donors served as an additional comparator.ResultsNo substantial differences between ACL-MSCs from young and old donors were observed in their proliferative capacity and multilineage differentiation potential. The latter did not substantially differ between both ACL-MSC groups and BMSCs. Differential expression of genes related to the cytoskeleton and to protein dephosphorylation amongst other pathways was detected between ACL-MSCs from young and old donors.ConclusionsRegenerative potential of ACL-MSCs from old donors was not substantially lower than that from young donors, suggesting that regenerative therapies of ACL tears are feasible in both age groups. In vivo studies of the effect of age on the efficacy of such therapies are needed.

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No significant difference in clinical outcome and knee stability between patellar tendon and semitendinosus tendon in anterior cruciate ligament reconstruction

Abstract: Both, patellar tendon and semitendinosus tendon are safe autografts for ACL reconstruction. Regarding graft selection, individual patient-dependent factors should be considered. ACL reconstruction cannot fully restore pre-injury status of knee joint function in the majority of cases.

Cited by 12 publications

References 17 publications

Tendon‐derived progenitor cells improve healing of collagenase‐induced flexor tendinitis

Tendon‐derived progenitor cells improve healing of collagenase‐induced flexor tendinitis

Comparative Efficacy of Graft Options in Anterior Cruciate Ligament Reconstruction: A Systematic Review and Network Meta-Analysis

Mesenchymal Stem Cells Isolated from the Anterior Cruciate Ligament: Characterization and Comparison of Cells from Young and Old Donors

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