Pain evaluation after all-inside anterior cruciate ligament reconstruction and short term functional results of a prospective randomized study

Benea, Horea; Ramos-Pascual, Sonia; Klouche, Shahnaz; Bauer, Thomas; Tomoaia, Gheorghe; Hardy, Philippe

doi:10.1016/j.knee.2013.09.006

Cited by 77 publications

(109 citation statements)

References 16 publications

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“…FTDs have been extensively tested in vivo 4,5,22,26,33 and ex vivo in isolated device setups, 1,11,20,27,30 as well as in porcine knee ACL reconstructions. 11,24,25,27,28,30,37,38 Petre et al 30 implemented an isolated device testing protocol with the same preload and cyclic loading limits and similar travel velocity.…”

Section: Discussionmentioning

confidence: 99%

Biomechanical Evaluation of a Novel Loop Retention Mechanism for Cortical Graft Fixation in ACL Reconstruction

Götschi

Rosenberg

et al. 2020

Orthopaedic Journal of Sports Medicine

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Background: Implant fixation by means of a cortical fixation device (CFD) has become a routine procedure in anterior cruciate ligament reconstruction. There is no clear consensus whether adjustable-length CFDs are more susceptible to loop lengthening when compared with pretied fixed-length CFDs.Purpose: To assess biomechanical performance measures of 3 types of CFDs when subjected to various loading protocols.Study Design: Controlled laboratory study.Methods: Three types of CFDs underwent biomechanical testing: 1 fixed length and 2 adjustable length. One of the adjustablelength devices is based on the so-called finger trap mechanism, and the other is based on a modified sling lock mechanism. A device-only test of 5000 cycles (n ¼ 8 per group) and a tendon-device test of 1000 cycles (n ¼ 8 per group) with lower and upper force limits of 50 and 250 N, respectively, were applied, followed by ramp-to-failure testing. Adjustable-length devices then underwent further cyclic testing with complete loop unloading (n ¼ 5 per group) at each cycle, as well as fatigue testing (n ¼ 3 per group) over a total of 1 million cycles. Derived mechanical parameters were compared among the devices for statistical significance using Kruskal-Wallis analysis of variance followed by post hoc Mann-Whitney U testing with Bonferroni correction.Results: All CFDs showed elongation <2 mm after 5000 cycles when tested in an isolated manner and withstood ultimate tensile forces in excess of estimated peak in vivo forces. In both device-only and tendon-device tests, differences in cyclic performance were found among the devices, favoring adjustable-length fixation devices over the fixed-length device. Completely unloading the suspension loops, however, led to excessive loop lengthening of the finger trap device, whereas the modified sling lock device remained stable throughout the test. The fixed-length device displayed superior ultimate strength over both adjustable-length devices. Both adjustable-length devices showed adequate fatigue behavior during high-cyclic testing.Conclusion: All tested devices successfully prevented critical construct elongation when tested with constant tension and withstood ultimate loads in excess of estimated in vivo forces during the rehabilitation phase. The finger trap device gradually lengthened excessively when completely unloaded during cyclic testing.Clinical Relevance: Critical loop lengthening may occur if adjustable-length devices based on the finger trap mechanism are repeatedly unloaded in situ.

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Section: Discussionmentioning

confidence: 99%

Biomechanical Evaluation of a Novel Loop Retention Mechanism for Cortical Graft Fixation in ACL Reconstruction

Götschi

Rosenberg

et al. 2020

Orthopaedic Journal of Sports Medicine

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“…In addition, there is emerging evidence that use of sockets may result in less postoperative pain than the use of tunnels. 20,21 The use of adjustable-loop cortical suspensory fixation devices allows accurate in situ tensioning of the graft, with recent Level III evidence supporting no difference in failure rate or knee stability at 2 years' follow-up versus fixed-loop cortical suspension. 22 The technique also obviates the need for hyperflexion of the knee, which carries the risk of iatrogenic cartilage injury during femoral drilling, among others.…”

Section: Discussionmentioning

confidence: 99%

Combined All-Inside Anterior Cruciate Ligament Reconstruction and Minimally Invasive Posterolateral Corner Reconstruction Using Ipsilateral Semitendinosus and Gracilis Autograft

Borton

Yasen

Britton

et al. 2017

Arthroscopy Techniques

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Abstract:The anterior cruciate ligament (ACL) is the most commonly injured knee ligament, particularly among adolescents and young adults. Unrecognized posterolateral laxity is understood as a major cause of ACL reconstruction failure, and concomitant injury to the posterolateral corner (PLC) is prevalent and underdetected. We advocate screening all ACLdeficient knees for PLC injury and present a technique combining minimally invasive PLC reconstruction with anatomic all-inside ACL reconstruction. The combined procedure uses only the ipsilateral hamstring tendons representing a major surgical advantage over traditional management approaches. The semitendinosus is quadrupled and attached to 2 adjustable suspensory cortical fixation devices to form the ACL graft. The gracilis tendon is looped through the fibula head and secured in a single femoral tunnel for the PLC reconstruction via 2 minimally invasive incisions. The use of a single femoral PLC tunnel combined with a single femoral ACL socket minimizes the risk of tunnel convergence.

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“…One study (3), clearly mentioning the method for randomization, appropriate blinding, and the withdrawal of patients from follow-up, scored ve points. Two studies (12,14) scored 3 points with all randomization, blinding, and withdrawals documented; however, the detailed method of randomization and blinding was not mentioned. Two studies (9,15) that only mentioned the randomization and withdrawals scored 2 points.…”

Section: Study Selection and Critical Appraisalmentioning

confidence: 99%

“…In autologous graft selection, six studies (3,14,(16)(17)(18)(19) used quadrupled semitendinosus tendon (ST4) in the all-inside group and double gracilis and semitendinosus tendon (DGST) in the full tibial tunnel group; one study did not clearly mention the autologous tendon graft donor site (15). All the studies mentioned the suspensory cortical button graft xation device was used on both the femoral and tibial side in the allinside group of patients.…”

Section: Graft Harvest and Xation Devicementioning

confidence: 99%

Is all-inside with suspensory cortical button fixation a superior technique for anterior cruciate ligament reconstruction surgery? A systematic review and meta-analysis

Chen

2020

Preprint

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Background To compare the clinical results of all-inside anterior cruciate ligament reconstruction (ACLR) using suspensory cortical button fixation and full tibial tunnel drilling Methods Systematic searches were conducted of published literature up to November 2019 on PubMed, Embase, and Cochrane for studies comparing all-inside ACLR using suspensory cortical button fixation and full tibial tunnel ACLR. Two reviewers independently determined eligibility, extracted the outcome data, and assessed the risk of bias of the eligible studies. The clinical outcome and graft reruptures were pooled by using random effects with mean differences and risk ratios for continuous and dichotomous variables, respectively. Result A total of nine studies (five randomized controlled trials and four comparative studies) involving 613 patients were included in the meta-analysis. The postoperative functional outcome, knee laxity measured with arthrometer, and graft reruptures were comparable between patients with all-inside ACLR using suspensory cortical button fixation and full tibial tunnel ACLR. However, a significantly greater thickness of autologous tendon was used and less change in drilling tunnel diameter was noted in patients with suspensory cortical button graft fixation.Conclusions All-inside ACLR with suspensory cortical button fixation was not clinically superior to full tibial tunnel ACLR with interference screw fixation in functional outcomes, knee laxity measured with arthrometer, or rerupture rate. However, the advantage of using suspensory cortical button fixation was that a thicker graft could be used for reconstruction, and brought less tibia tunnel widening compared with bioabsorbable interference screw fixation.

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Pain evaluation after all-inside anterior cruciate ligament reconstruction and short term functional results of a prospective randomized study

Cited by 77 publications

References 16 publications

Biomechanical Evaluation of a Novel Loop Retention Mechanism for Cortical Graft Fixation in ACL Reconstruction

Biomechanical Evaluation of a Novel Loop Retention Mechanism for Cortical Graft Fixation in ACL Reconstruction

Combined All-Inside Anterior Cruciate Ligament Reconstruction and Minimally Invasive Posterolateral Corner Reconstruction Using Ipsilateral Semitendinosus and Gracilis Autograft

Is all-inside with suspensory cortical button fixation a superior technique for anterior cruciate ligament reconstruction surgery? A systematic review and meta-analysis

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