Outcomes and Revision Rate After Bone–Patellar Tendon–Bone Allograft Versus Autograft Anterior Cruciate Ligament Reconstruction in Patients Aged 18 Years or Younger With Closed Physes

Ellis, Henry B.; Matheny, Lauren M.; Briggs, Karen K.; Pennock, Andrew T.; Steadman, J. Richard

doi:10.1016/j.arthro.2012.06.016

Cited by 99 publications

(129 citation statements)

References 36 publications

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“…1,2 Failure to effectively stabilize the knees of these young patients can lead to an increase in meniscal tearing, osteochondral lesions, 3 and early degenerative joint disease. 4 Controversy exists concerning the appropriate graft choice for ACL reconstruction in this particular patient population.…”

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confidence: 99%

“…9,10 Other studies suggest the issue is not the graft material but differing activity levels 11 or graft processing. 2 Allograft preparation can have a significant effect on outcome. Irradiation or chemical processing of allografts may result in an increased incidence of graft rupture.…”

mentioning

confidence: 99%

“…A recent study reported no significant difference in function, activity, or satisfaction between allograft and autograft reconstructions in a younger patient population, although the allograft group had a much higher failure rate than the autograft group. 2 The purpose of this study was to compare clinical outcomes and revision rates for ACL reconstructions using boneepatellar tendonebone (BPTB) allografts versus BPTB autografts in a population of patients aged 25 and younger. The hypothesis was that there is no difference in outcomes or revision rates between the 2 graft options at a minimum follow-up of 24 months.…”

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confidence: 99%

See 2 more Smart Citations

Revision Rates After Anterior Cruciate Ligament Reconstruction Using Bone–Patellar Tendon–Bone Allograft or Autograft in a Population 25 Years Old and Younger

Barber

Cowden

Sanders

2014

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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confidence: 99%

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confidence: 99%

mentioning

confidence: 99%

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Revision Rates After Anterior Cruciate Ligament Reconstruction Using Bone–Patellar Tendon–Bone Allograft or Autograft in a Population 25 Years Old and Younger

Barber

Cowden

Sanders

2014

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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“…Successful surgical reconstruction of such tissues depends on the osteo-integration of an autograft or allograft and the re-establishment of the fibrocartilage interface [2][3][4], termed the enthesis. However current ACL reconstruction techniques generally fail to regenerate the graded structure of the enthesis, predisposing the tissue at the bone insertion site to high stress concentrations which is believed to contribute to high failure rates [5][6][7]. This has motived the development of tissue engineering (TE) strategies for ligament regeneration [8,9].…”

Section: Introductionmentioning

confidence: 99%

Modulating microfibrillar alignment and growth factor stimulation to regulate mesenchymal stem cell differentiation

et al. 2017

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The ideal tissue engineering (TE) strategy for ligament regeneration should recapitulate the bonecalcified cartilage -fibrocartilage -soft tissue interface. Aligned electrospun-fibers have been shown to guide the deposition of a highly organized extracellular matrix (ECM) necessary for ligament TE.However, recapitulating the different tissues observed in the bone-ligament interface using such constructs remains a challenge. This study aimed to explore how fiber alignment and growth factor stimulation interact to regulate the chondrogenic and ligamentous differentiation of mesenchymal stem cells (MSCs). Without growth factor stimulation, MSCs on aligned-microfibers showed higher levels of tenomodulin (TNMD) and aggrecan gene expression compared to MSCs on randomlyoriented fibers. MSCs on aligned-microfibers stimulated with transforming growth factor β3 (TGFβ3) formed cellular aggregates and underwent robust chondrogenesis, evidenced by increased type II collagen expression and sulphated glycosaminoglycans (sGAG) synthesis compared to MSCs on randomly-oriented scaffolds. Bone morphogenetic protein 2 (BMP2) and type I collagen gene expression were higher on randomly-oriented scaffolds stimulated with TGFβ3, suggesting this substrate was more supportive of an endochondral phenotype. In the presence of connective tissue growth factor (CTGF), MSCs underwent ligamentous differentiation, with increased TNMD expression on aligned compared to randomly aligned scaffolds. Upon sequential growth factor stimulation, MSCs expressed types I and II collagen and deposited higher overall levels of collagen compared to scaffolds stimulated with either growth factor in isolation. These findings demonstrate that modulating the alignment of microfibrillar scaffolds can be used to promote either an endochondral, chondrogenic, fibro-chondrogenic or ligamentous MSC phenotype upon presentation of appropriate biochemical cues.

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“…[4][5][6][7][8][9]11 Furthermore, one study has shown that BPTB autografts have an advantage because the allograft group had a failure rate 15 times greater than that in the autograft group. 18 Thus, diminishing the harvest-site morbidity associated with BPTB autografts is necessary.…”

Section: Discussionmentioning

confidence: 99%

Anterior Cruciate Ligament Reconstruction Using a Bone–Patellar Tendon–Bone Autograft to Avoid Harvest-Site Morbidity in Knee Arthroscopy

Koh¹,

Takemura

et al. 2015

Arthroscopy Techniques

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Although anterior cruciate ligament reconstruction using a boneepatellar tendonebone (BPTB) autograft has many advantages (e.g., high strength and solid fixation), there are also several complications (e.g., anterior knee pain or kneeling pain) due to harvest-site morbidity associated with the use of this graft type compared with the use of hamstring tendon. Therefore the ultimate goal of anterior cruciate ligament reconstruction using a BPTB graft is to minimize harvestsite morbidity. We have used a technique for harvesting central-third BPTB grafts that involves only a 3-cm-long, longitudinal, curved incision in the medial tibial tuberosity for both graft harvesting and fixation. The purpose of this report is to describe the technique, which can avoid the harvest-site morbidities associated with BPTB autografts during knee arthroscopy. We believe that this less invasive reconstruction may reduce the harvest-site morbidities associated with BPTB grafts because it allows for BPTB graft harvesting without incising the synovial bursa or paratenon and mitigates scarring and adhesion formation.A nterior cruciate ligament (ACL) ruptures are among the most frequent ligament injuries. Given that obtaining sufficient regeneration is difficult in cases of a torn ACL because of its poor healing potential, reconstruction surgery is the first choice for treatment of ACL ruptures. Thus boneepatellar tendonebone (BPTB) and hamstring tendon (HS) autografts are the 2 most commonly used reconstruction techniques. In 1963 Jones 1 pioneered the use of BPTB grafts, and this technique has since been considered the gold-standard technique. The BPTB graft is most frequently used because it provides high strength and stiffness, graft size consistency, harvesting ease, early graft incorporation, and solid fixation. However, reconstruction using a BPTB graft is not a perfect solution and may result in harvest-site morbidities, including anterior knee pain or kneeling pain. To avoid the harvest-site morbidities associated with BPTB grafts, HS grafts have recently been used for ACL reconstruction 2 ; however, they are associated with graft loosening, require more expensive implants, and have the potential for knee flexion weakness. In fact, many surgeons who regularly use HS grafts advocate the use of BPTB grafts in athletes and heavy laborers. 3 We believe that the ultimate goal of ACL reconstruction, using a BPTB graft, is to minimize harvest-site morbidity.We have successfully used a technique for harvesting central-third BPTB grafts that involves only 1 longitudinal, curved incision, approximately 3 cm in length, in the medial tibial tuberosity for both graft harvesting and fixation. This technique, performed using devices previously developed by us, not only involves a small skin incision but also allows for BPTB graft harvesting without incising the synovial bursa or paratenon. Subsequently, the BPTB graft can be fixed through the same incision using an all-inside technique. In this report we describe our technique, which m...

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Outcomes and Revision Rate After Bone–Patellar Tendon–Bone Allograft Versus Autograft Anterior Cruciate Ligament Reconstruction in Patients Aged 18 Years or Younger With Closed Physes

Cited by 99 publications

References 36 publications

Revision Rates After Anterior Cruciate Ligament Reconstruction Using Bone–Patellar Tendon–Bone Allograft or Autograft in a Population 25 Years Old and Younger

Revision Rates After Anterior Cruciate Ligament Reconstruction Using Bone–Patellar Tendon–Bone Allograft or Autograft in a Population 25 Years Old and Younger

Modulating microfibrillar alignment and growth factor stimulation to regulate mesenchymal stem cell differentiation

Anterior Cruciate Ligament Reconstruction Using a Bone–Patellar Tendon–Bone Autograft to Avoid Harvest-Site Morbidity in Knee Arthroscopy

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