Patellar tendon length after anterior cruciate ligament reconstruction: a comparative magnetic resonance imaging study between patellar and hamstring tendon autografts

Hantes, Michael; Zachos, Vasilios C.; Bargiotas, K.; Basdekis, Georgios; Karantanas, Apostolos H.; Malizos, Konstantinos N.

doi:10.1007/s00167-006-0272-x

Cited by 29 publications

(19 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This alteration, known as patellar infera , has been observed following Fulkerson osteotomy,2 total and uni‐condylar knee replacement3–5 and anterior cruciate ligament reconstruction (ACLR) 6–18. ACLR has the highest reported association with postoperative patella infera,6–18 in particular, following resection of the bone–PT–bone (BPTB) complex from the central one‐third of the PT in an autograft fashion. Whilst patella infera has been shown to produce alterations in retro‐patellar contact mechanics,19–21 the implications of resection of the BPTB complex in isolation to ACL deficiency on PT length, L T , and knee kinematics remains largely unknown.…”

mentioning

confidence: 99%

Effects of patellar position and defect healing on in vitro stifle joint kinematics following removal of the central one‐third of the patellar tendon in an ovine model

Bertollo

Bell

et al. 2010

Journal Orthopaedic Research

View full text Add to dashboard Cite

Harvest of the central one-third of the patella tendon (PT) is routinely performed for anterior cruciate ligament reconstruction (ACLR). Patella infera may ensue. In this study we unilaterally resected the central one-third of the PT in 20 sheep, without reconstructing or defunctionalizing the native ACL, and examined the effects at 3, 6, 12, and 24 weeks postoperatively on PT length, histological appearance of the donor defect and in vitro stifle joint kinematics. Mean length increases ( p > 0.263) in the operated tendons of 0.3%, 2.8%, 0.5%, and 2.4% were observed at 3, 6, 12, and 24 weeks. A significant proximal shift of the patella correlated well with a mean 2.358 retardation of patellar flexion (r ¼ 0.440, p ¼ 0.001). A mean net 4.98 decrease in medial patellar tilt was also observed ( p < 0.001), but was not coupled with changes in tibial rotation. Donor defect tissue showed a distinct progression of healing with time, remodeling from dense scar tissue at 3 weeks to bundles of well-organized collagen enveloped by vascularized loose connective tissue at 24 weeks but was not associated with the restoration of kinematics. These results suggest that resection of the central one-third of the PT and leaving the defect open in the ovine stifle joint may be associated with increased PT length and changes in patellar kinematics which do not recover 6 months postoperatively. The lack of patella infera may render this animal model unsuitable for the interpretation of joint kinematics following PT resection for human ACLR. ß

show abstract

mentioning

confidence: 99%

Effects of patellar position and defect healing on in vitro stifle joint kinematics following removal of the central one‐third of the patellar tendon in an ovine model

Bertollo

Bell

et al. 2010

Journal Orthopaedic Research

View full text Add to dashboard Cite

show abstract

“…The patellar thickness with including the skin and subcutaneous area is 22.8 (range: 19-31 mm) prior to total knee arthroplasty (33). The patellar height of the normal knee is 43.95 mm (range: 35.6-46.3 mm) (34). So, it is suitable to use a 47 mm coil for the imaging of the chondromalacia patella.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Chondromalacia Patella Using a Microscopy Coil: Comparison of the Two-Dimensional Fast Spin Echo Techniques and the Three-Dimensional Fast Field Echo Techniques

et al. 2011

View full text Add to dashboard Cite

ObjectiveWe wanted to compare the two-dimensional (2D) fast spin echo (FSE) techniques and the three-dimensional (3D) fast field echo techniques for the evaluation of the chondromalacia patella using a microscopy coil.Materials and MethodsTwenty five patients who underwent total knee arthroplasty were included in this study. Preoperative MRI evaluation of the patella was performed using a microscopy coil (47 mm). The proton density-weighted fast spin echo images (PD), the fat-suppressed PD images (FS-PD), the intermediate weighted-fat suppressed fast spin echo images (iw-FS-FSE), the 3D balanced-fast field echo images (B-FFE), the 3D water selective cartilage scan (WATS-c) and the 3D water selective fluid scan (WATS-f) were obtained on a 1.5T MRI scanner. The patellar cartilage was evaluated in nine areas: the superior, middle and the inferior portions that were subdivided into the medial, central and lateral facets in a total of 215 areas. Employing the Noyes grading system, the MRI grade 0-I, II and III lesions were compared using the gross and microscopic findings. The sensitivity, specificity and accuracy were evaluated for each sequence. The significance of the differences for the individual sequences was calculated using the McNemar test.ResultsThe gross and microscopic findings demonstrated 167 grade 0-I lesions, 40 grade II lesions and eight grade III lesions. Iw-FS-FSE had the highest accuracy (sensitivity/specificity/accuracy = 88%/98%/96%), followed by FS-PD (78%/98%/93%, respectively), PD (76%/98%/93%, respectively), B-FFE (71%/100%/93%, respectively), WATS-c (67%/100%/92%, respectively) and WATS-f (58%/99%/89%, respectively). There were statistically significant differences for the iw-FS-FSE and WATS-f and for the PD-FS and WATS-f (p < 0.01).ConclusionThe iw-FS-FSE images obtained with a microscopy coil show best diagnostic performance among the 2D and 3D GRE images for evaluating the chondromalacia patella.

show abstract

“…Muitas causas têm sido propostas, incluindo limitações da ADM após a cirurgia, condromalácia, programa de reabilitação inadequado, dor no sítio doador de enxerto, presença de contratura fixa, redução do tamanho do TP, patela baixa, alterações no glucamato e substância-P (18)(19)(20)(21) . Deehan et al (16) encontraram baixa incidência (8%) de crepitação na articulação femoropatelar, após a reconstrução do LCA com tendão patelar.…”

Section: Discussionunclassified

“…Não foi encontrada lesão da articulação femoropatelar. Foram realizadas uma menis- (6) 0,00 Bloqueio frequente (2) 0,00 Joelho bloqueado no exame (0) 0,00 Instabilidade (25 pontos) Nunca (25) 17 100,00 Raramente durante exercícios severos (20) 0,00 Frequentemente durante exercícios severos (15) 0,00 Ocasionalmente em atividades diárias (10) 0,00 Frequentemente em atividades diárias (5) 0,00 A todo momento (0) 0,00 Recorrencia < 1 dia = 6 0,00 Recorrencia < 1 semana = 2 0,00 Recorrencia > 1 semana = 0 0,00 Frequencia Nenhuma = 10 17 100,00 1 por ano = 8 0,00 2-6 por ano = 6 0,00 1 por mês = 4 0,00 1 por semana = 2 0,00 Diário = 0 0,00 …”

Section: Metodologiaunclassified

Reconstrução do ligamento cruzado anterior com o terço central do tendão do músculo quadríceps: análise de resultados após 10 anos

Guimarães¹,

Carvalho²,

Terra³

2009

Rev. bras. ortop.

View full text Add to dashboard Cite

RESUMOObjetivo: Avaliar os resultados clínicos utilizando dois diferentes protocolos, 10 anos após a cirurgia de reconstrução do LCA (Ligamento Cruzado Anterior) com o terço central do tendão do múscu-lo quadríceps (TQ). Método: Entre novembro/1997 e abril/1998, 25 pacientes foram submetidos a 25 reconstruções do LCA com TQ pela técnica transtibial. A parte óssea do enxerto foi fixada no túnel femoral com parafuso de interferência e a parte tendinosa no túnel tibial, com parafuso em poste com arruela. Dois pacientes romperam o novo ligamento em entorses durante futebol. Seis não foram encontrados para reavaliação (24%). Foram avaliados 17 pacientes, sendo 15 homens e duas mulheres, com média de idade na cirurgia de 28,53 ± 6,64 anos. Todos foram examinados com seis meses, um ano e dez anos de cirurgia. A avaliação clí-nica foi realizada com a escala de Lysholm e a do o joelho, com a do Hospital for Special Surgery. Resultados: As lesões foram operadas após 9,87 ± 14,42 meses do acidente. Segundo a escala de Lysholm, os resultados ao fim do primeiro ano foram de 98,71 ± 2,47 e, ao fim de dez anos, de 97,35 ± 3,12. Usando a escala do Hospital for Special Surgery, a pontuação foi de 95,07 ± 5,23 com um ano e de 94,87 ± 4,16 após 10 anos. Todos os pacientes retornaram ao trabalho nas mesmas condições. Quinze (88,24%) retornaram ao mesmo esporte, um com modificação na prática e outro mudou de esporte. Nenhum paciente se queixou dor na área doadora do enxerto após quatro semanas da cirurgia até a última avaliação. Quatro pacientes sofreram ruptura do LCA contralateral em atividades esportivas, sendo três entorses no futebol e uma durante dança. Conclusão: O enxerto do TQ é boa opção para a reconstrução do LCA, mesmo quando decorridos 10 anos do procedimento cirúrgico. Não houve dor na área doadora do enxerto a médio e longo prazo. A taxa de retorno ao esporte foi excelente e não houve alteração da articulação femoropatelar. Descritores

show abstract

Patellar tendon length after anterior cruciate ligament reconstruction: a comparative magnetic resonance imaging study between patellar and hamstring tendon autografts

Cited by 29 publications

References 25 publications

Effects of patellar position and defect healing on in vitro stifle joint kinematics following removal of the central one‐third of the patellar tendon in an ovine model

Effects of patellar position and defect healing on in vitro stifle joint kinematics following removal of the central one‐third of the patellar tendon in an ovine model

Evaluation of the Chondromalacia Patella Using a Microscopy Coil: Comparison of the Two-Dimensional Fast Spin Echo Techniques and the Three-Dimensional Fast Field Echo Techniques

Reconstrução do ligamento cruzado anterior com o terço central do tendão do músculo quadríceps: análise de resultados após 10 anos

Contact Info

Product

Resources

About