Technique of anatomical single bundle ACL reconstruction with rounded rectangle femoral dilator

Nakase, Junsuke; Toratani, Tatsuhiro; Kosaka, Masahiro; Ohashi, Yoshinori; Numata, Hitoaki; Oshima, Takeshi; Takata, Yoshinobu; Tsuchiya, Hiroyuki

doi:10.1016/j.knee.2015.07.005

Cited by 38 publications

(30 citation statements)

References 26 publications

(30 reference statements)

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“…With such placement, both AM and PL bundle function can be reproduced with a single-bundle graft. 28,50,71,75 On the other hand, some studies recommended placing the femoral tunnel at the center of AM bundle footprint. 6,24,25,44,56,61,76,93,98 The center of the AM bundle footprint is placed deep and low in the intercondylar notch, it can better stabilize the anterior-posterior laxity of the knee when compared with a tunnel placed at the center of the native ACL footprint.…”

Section: Discussionmentioning

confidence: 99%

Systematic Review of Surgical Technique and Tunnel Target Points and Placement in Anatomical Single-Bundle ACL Reconstruction

Iriuchishima¹,

Goto²

2020

J Knee Surg

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The purpose of this systematic review was to reveal the trend in surgical technique and tunnel targets points and placement in anatomical single-bundle anterior cruciate ligament (ACL) reconstruction. Following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement, data collection was performed. PubMed, EMBASE, and Cochran Review were searched using the terms “anterior cruciate ligament reconstruction,” “anatomic or anatomical,” and “single bundle.” Studies were included when they reported clinical results, surgical technique, and/or tunnel placement evaluation. Laboratory studies, technical reports, case reports, and reviews were excluded from this study. From these full article reviews, graft selection, method of creating the femoral tunnel, and femoral and tibial tunnel target points and placement were evaluated. In the 79 studies included for data evaluation, the selected grafts were: bone patella tendon bone autograft (12%), and hamstring autograft (83%). The reported methods of creating the femoral tunnel were: transportal technique (54%), outside-in technique (15%), and transtibial technique (19%). In the 60 studies reporting tunnel target points, the target point was the center of the femoral footprint (60%), and the center of the anteromedial bundle footprint (22%). In the 23 studies evaluating tunnel placement, the femoral tunnel was placed in a shallow–deep direction (32.3%) and in a high–low direction (30.2%), and the tibial tunnel was placed from the anterior margin of the tibia (38.1%). The results of this systematic review revealed a trend in anatomical single-bundle ACL reconstruction favoring a hamstring tendon with a transportal technique, and a tunnel target point mainly at the center of the ACL footprint. The level of evidence stated is Systematic review of level-III studies.

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Section: Discussionmentioning

confidence: 99%

Systematic Review of Surgical Technique and Tunnel Target Points and Placement in Anatomical Single-Bundle ACL Reconstruction

Iriuchishima¹,

Goto²

2020

J Knee Surg

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“…Nowadays, femoral oval The Journal of Knee Surgery tunnel technique has been gradually accepted in clinical practice and achieved a satisfactory function of the knee. [23][24][25] Based on previous studies, this study was conducted to evaluate the objective and subjective clinical results of the SBR, SBO, and DB techniques for anatomical ACL reconstruction. Compared with the conventional SBR group, the SBO and DB groups had better clinical functions with significant statistical difference.…”

Section: Discussionmentioning

confidence: 99%

“…Based on these findings, researchers have attempted the femoral oval tunnel technique for ACL reconstruction to find a simple, safe, and effective surgical method. [23][24][25] Based on previous studies, this study was conducted to evaluate the objective and subjective clinical results of conventional single-bundle femoral round (SBR) tunnel technique, single-bundle femoral oval (SBO) tunnel technique, and DB surgical technique for anatomic ACL reconstruction using hamstring tendon autografts.…”

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confidence: 99%

Anatomical Anterior Cruciate Ligament Reconstruction with Hamstring Tendon Autografts: A Comparative Study of Three Different Techniques

et al. 2020

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The ideal procedure for anterior cruciate ligament (ACL) reconstruction is one that can achieve anatomical restoration for a better ACL function. This retrospective comparative study was conducted to evaluate the objective and subjective clinical results of the conventional single-bundle femoral round (SBR) tunnel technique, the single-bundle femoral oval (SBO) tunnel technique, and the double-bundle (DB) surgical technique for anatomical ACL reconstruction with hamstring tendon autografts. Patients who underwent the SBO, SBR, and DB ACL reconstructions from January 2016 to August 2017 were included in this study. A total of 163 patients underwent different surgical techniques; 41 patients underwent the SBO procedure, 78 patients received SBR, and the remaining 44 patients underwent the DB procedure. The Lachman's test, pivot-shift test, Lysholm's score, International Knee Documentation Committee (IKDC) score, and Tegner's score were compared among groups postoperatively. KT-1000 was used to measure the anterior laxity of the knee. Magnetic resonance imaging was used to compare the ACL graft maturity. Second-look arthroscopy was conducted to compare the graft status and synovial coverage. Significant differences among groups were found with respect to the Lysholm's score, Tegner's score, and IKDC score. Patients in the SBO and DB groups acquired higher functional scores than the SBR group. More patients with positive pivot-shift test were observed in the SBR group than other groups at 12- and 24-month postoperative follow-ups. The postoperative KT-1000 was better in the SBO and DB groups than in the SBR group. The mean signal/noise quotient (SNQ) of the SBO group was 2.70 ± 0.92, significantly lower than 3.58 ± 1.21 of the SBR group. Despite a higher proportion of patients with grade B or C synovial coverage and partial graft injury found in the SBR group, there were no significant differences among the groups. The SBO and DB technique achieved better clinical results than the SBR technique. The SBO technique was indeed an ideal surgical procedure for ACL reconstruction provided that the shortcoming of DB technique must be taken into account. This is a Level III, retrospective comparative study.

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“…All reconstructions were performed arthroscopically by one orthopedic surgeon (JN) in our institution. Details of the surgical technique have been published previously7 ) .…”

Section: Participants and Methodsmentioning

confidence: 99%

Relationship between the deep flexion of the knee joint and the dynamics of the infrapatellar fat pad after anterior cruciate ligament reconstruction via ultrasonography

et al. 2019

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[Purpose] A sufficient flexion angle of the knee joint after knee surgery leads to higher quality of their life; therefore, here we investigated the relationship between the dynamics of the infrapatellar fat pad and seiza-style sitting via ultrasonography. [Participants and Methods] Twenty-eight patients were enrolled 3 months post-operatively after anterior cruciate reconstruction. They were divided into a “possible” group and “impossible” group, according to whether they could sit in the seiza style. The thickness of the superficial part of the infrapatellar fat pad was measured at 10° and 90° knee flexion on reconstructed knees in the sitting position via ultrasound evaluation. Images were taken to capture the patella apex and tibial tuberosity. The thickness of the superficial part of the infrapatellar fat pad was measured, and the thickness change ratio was calculated. The characteristics of each group were compared. [Results] The superficial part of the infrapatellar fat pad was significantly thinner in the possible group at a 10° knee flexion. The thickness change ratio of the infrapatellar fat pad was significantly greater in the possible group. [Conclusion] The thickness of the infrapatellar fat pad at a 10° knee flexion and the thickness change ratio of the infrapatellar fat pad could affect the possibility of sitting in the seiza style.

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Technique of anatomical single bundle ACL reconstruction with rounded rectangle femoral dilator

Cited by 38 publications

References 26 publications

Systematic Review of Surgical Technique and Tunnel Target Points and Placement in Anatomical Single-Bundle ACL Reconstruction

Systematic Review of Surgical Technique and Tunnel Target Points and Placement in Anatomical Single-Bundle ACL Reconstruction

Anatomical Anterior Cruciate Ligament Reconstruction with Hamstring Tendon Autografts: A Comparative Study of Three Different Techniques

Relationship between the deep flexion of the knee joint and the dynamics of the infrapatellar fat pad after anterior cruciate ligament reconstruction via ultrasonography

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