Quantification of tibial bone loss in antegrade versus retrograde tunnel placement for anterior cruciate ligament reconstruction

Osti, Michael; Krawinkel, Alessa; Hoffelner, Thomas; Benedetto, K. P.

doi:10.1007/s00264-015-2668-z

Cited by 11 publications

(12 citation statements)

References 14 publications

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“…Studies using X-ray and CT imaging to evaluate the sockets drilled with an all-inside ACL technique have reported less socket expansion and preserved bone stock compared to full tunnels seen in standard ACL techniques. 27,28 The importance of this is most evident when drilling the tibial socket for the all-inside ACL suspensory fixation since this can reduce tibial microfracture trauma that is seen with full tunnel tibial drilling in standard ACL techniques. 29 Also, when closedsockets are created, there will be less graft length available for the windshield-wiper and bungee cord phenomena compared to full tunnels.…”

Section: Sockets Versus Tunnelsmentioning

confidence: 99%

All-inside ACL reconstruction: How does it compare to standard ACL reconstruction techniques?

Connaughton

Geeslin

Uggen

2017

Journal of Orthopaedics

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The all-inside ACL reconstruction technique is a relatively new development in ACL surgery. Some features of this technique include closed-socket tunnels, dual suspensory graft fixation, decreased bone removal, and smaller skin incisions. The purpose of this review was to compare the unique features of the all-inside ACL versus standard ACL techniques using biomechanical and clinical studies. The all-inside ACL appears to have similar overall results on subjective and objective outcomes studies compared to standard ACL techniques and may be associated with decreased post-operative pain. There is also a concern for a higher graft failure rate with the all-inside ACL.

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Section: Sockets Versus Tunnelsmentioning

confidence: 99%

All-inside ACL reconstruction: How does it compare to standard ACL reconstruction techniques?

Connaughton

Geeslin

Uggen

2017

Journal of Orthopaedics

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“…There is concern about the windshield wiper and bungee cord phenomenon that may occur with suspensory fixation. Prior studies evaluating sockets drilled with an all-inside ACL technique have revealed less socket expansion and preserved bone stock compared to full tunnels seen in standard ACL techniques on x-ray and CT scans [ 90 , 91 ]. This is extremely crucial when drilling the tibial socket for all-inside ACL suspensory fixation because it reduces the risk of tibial microfracture trauma seen with full tunnel tibial drilling in standard ACL techniques [ 92 ].…”

Section: Discussionmentioning

confidence: 99%

Transportal versus all-inside techniques of anterior cruciate ligament reconstruction: a systematic review

et al. 2021

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Background Transportal (TP) and all-inside techniques (AIT) are the most commonly used anterior cruciate ligament (ACL) reconstruction procedures in current clinical practice. However, there is an ongoing debate over which procedure is superior. Therefore, the purpose of this systematic review was to evaluate and compare the clinical outcomes and complications of these two techniques to propose recommendations for future application. Our primary hypothesis was that AIT is a superior ACLR technique compared to TP. Methods A systematic literature review, using PRISMA guidelines, was conducted using PubMed, Medline, Google Scholar, and EMBASE, up to February 2021 to identify studies focusing on AIT and TP techniques of ACL reconstruction. We excluded animal experiments, cadaveric studies, retrospective studies, case reports, technical notes, and studies without quantitative data. Patients’ characteristics, surgical technical features, along with postoperative follow-up and complications were extracted and reported accordingly. Methodological quality of the included studies was assessed using the Modified Coleman Methodology Score (MCMS). Results A total of 44 studies were selected for this review, of which four were comparative studies. A total of 923 patients underwent AIT and 1678 patients underwent the TP technique for ACLR. A single semitendinosus graft was commonly used in the AIT compard to combined semitendinosus and gracilis graft in the TP group. The postoperative increase in International Knee Documentation Committee (IKDC), Lysholm, KT-1000, and Short Form-12 (physical and mental) scores were similar in the AIT group and the TP group. Contrastingly, the VAS pain score was significantly lower in the AIT group compared to the TP group. Furthermore, the pooled complication rates from all studies were similar between the two groups (AIT: 54 patients, 8.26% vs. PT: 55 patients, 6.62%). However, the four studies that prospectively compared AIT and TP techniques showed lesser complications in the AIT group than the TP group. Conclusion Since the future trend in orthopedic surgery is toward less invasive and patients’ satisfaction with good outcomes, AIT is a good alternative method considering preserving bony tissue and gracilis tendon with less post-operative pain, along with more knee flexor strength and equal outcomes compared to conventional ACL reconstruction surgery. Level of Evidence II.

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“…By short graft we signify the introduction of a minimum and adequate collagen tissue bundle being press fit into a limited socket in the epiphysis at the anatomic footprints of the native ACL to obtain a primary fixation and healing of the ligament. The rationale of its uses relies on the following substantial benefits as shown by Colette and Cassard: 27 bone tissue 28 and ligament sparing is of particular importance in a paediatric setting, 29 tensile strength resistance, low elongation rate when preconditioned, high stiffness and fixation with a tight 360° bone to graft contact.…”

Section: Discussionmentioning

confidence: 99%

Day surgery for anterior cruciate ligament reconstruction in children: A prospective study on feasibility and satisfaction

Barbier

N’Dele

Bennis

et al. 2019

Journal of Children's Orthopaedics

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Purpose To evaluate the feasibility of day surgery anterior cruciate ligament reconstruction (ACLR) in children. Our hypothesis was that proper patient selection, adequate information and a streamlined clinical pathway would allow for a safe and satisfactory procedure. Methods A total of 20 patients, seven girls and 13 boys, who underwent outpatient ACLR at mean age of 14 years (8 to 16) were included in this single institution prospective case series. Surgery took place under simple general anesthesia while analgesia protocol combined local anesthesia, oral analgesics for the postoperative period and compressive cryotherapy. The main failure criterion was the inability to return home the day of surgery or the need for rehospitalization during the first week after discharge. Secondary evaluation parameters were the rate of postoperative complications, postoperative pain, quality of life (QOL) and patients’ satisfaction outcome questionnaire (PSOQ) at postoperative day 1, 7 and 31. Results Of the 20 patients included, only one failed the ambulatory mode. The mean PSOQ score was, respectively for children and parents, 91.4% and 90.7% at day 7 and 94.6% and 95.7% at one month. Postoperative QOL at day 7 was very satisfying for all patients. Two minor early complications were reported. Both of the late complications, which included one partial wound dehiscence and one persistent knee swelling, resolved spontaneously. Conclusion This study indicates that, in a targeted and well-informed population, day surgery for children ACLR yields high level of patient and family satisfaction in a safely manner. Level of evidence IV, prospective case series.

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Quantification of tibial bone loss in antegrade versus retrograde tunnel placement for anterior cruciate ligament reconstruction

Abstract: Compared with conventional techniques, all-inside retrograde drilling of tibial bone sockets is effective in preserving significant bone stock, which might be beneficial for revision reconstruction in cases of eventual primary graft failure.

Cited by 11 publications

References 14 publications

All-inside ACL reconstruction: How does it compare to standard ACL reconstruction techniques?

All-inside ACL reconstruction: How does it compare to standard ACL reconstruction techniques?

Transportal versus all-inside techniques of anterior cruciate ligament reconstruction: a systematic review

Day surgery for anterior cruciate ligament reconstruction in children: A prospective study on feasibility and satisfaction

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