The Effect of Graft Tissue on Anterior Cruciate Ligament Outcomes: A Multicenter, Prospective, Randomized Controlled Trial Comparing Autograft Hamstrings With Fresh-Frozen Anterior Tibialis Allograft

Lawhorn, Keith W.; Howell, Stephen M.; Traina, Steven M; Gottlieb, John E.; Md, Thomas Meade; Freedberg, Howard I.

doi:10.1016/j.arthro.2012.05.010

Cited by 74 publications

(88 citation statements)

References 31 publications

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“…As force was applied, the force and measured displacement were plotted on an x-y plotter to record the ligament elasticity. The device has been well validated and published (Araki et al 2011;Shelbourne et al 2011;Lawhorn et al 2012).…”

Section: Measurementsmentioning

confidence: 96%

A Greater Reduction of Anterior Cruciate Ligament Elasticity in Women Compared to Men as a Result of Delayed Onset Muscle Soreness

Lee

Petrofsky

Laymon

et al. 2013

Tohoku J. Exp. Med.

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Women have a higher risk for anterior cruciate ligament (ACL) injuries compared to men. ACL elasticity and muscle flexibility are major risk factors for knee injuries. The presence of estrogen receptors in connective tissue allows estrogen to change the mechanical properties of muscles and ligaments. Delayed onset muscle soreness (DOMS) happened when begin unaccustomed levels of exercise. Thus, the purpose of this study was to examine ACL elasticity after exercise meant to produce DOMS. As a measure of DOMS, visual analog pain scale and quadriceps strength were measured. One hundred forty healthy students (age: 25.2 ± 2.4 years, height: 165.9 ± 8.0 cm, weight: 62.5 ± 10.5 kg, BMI: 22.6 ± 3.1) participated in this investigation and were divided into two groups: men (n = 70) and women (n = 70). Visual analog pain scale, ACL elasticity, and quadriceps strength were measured before and after the intervention. Subjects participated in the same exercise to induce DOMS. To provoke DOMS, subjects accomplished squats for 5 minutes for 3 rounds. Greater ACL elasticity, greater pain on the subjective pain scale and less muscle strength were found (p < 0.001) in women compared to men before and after exercise. A greater reduction of ACL elasticity (p < 0.05) was found as a result of DOMS in women compared to men. Women are likely to have the damage to the ACL and recover slower compared to men after exercise. Thus, we suggest that women should have more time for musculoskeletal recovery after heavy exercise.

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Section: Measurementsmentioning

confidence: 96%

A Greater Reduction of Anterior Cruciate Ligament Elasticity in Women Compared to Men as a Result of Delayed Onset Muscle Soreness

Lee

Petrofsky

Laymon

et al. 2013

Tohoku J. Exp. Med.

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“…Seven studies used fresh-frozen allografts [38-40, 42, 44-46]; one study used both cryopreserved and fresh-frozen allografts [41]; and one study did not report the storage method [43]. All five prospective cohort studies were high-quality [38][39][40][41]43], while none of the four randomized controlled trials was high-quality [42,[44][45][46] (Table 1).…”

Section: Study Characteristics and Qualitymentioning

confidence: 99%

“…Similarly, within each study, postoperative rehabilitation was consistent for every patient. Five studies compared BPTB grafts [38-40, 42, 43], while two compared hamstring grafts [41,45]; one compared hamstring autograft with anterior tibialis allograft [46] and one compared hamstring autograft with free tendon Achilles allograft [44]. Six of the nine eligible studies did report the use of non-irradiated allografts [39-42, 45, 46].…”

Section: Study Characteristics and Qualitymentioning

confidence: 99%

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Allograft versus autograft for anterior cruciate ligament reconstruction: an up-to-date meta-analysis of prospective studies

et al. 2012

International Orthopaedics (SICOT)

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Purpose Although a large number of anterior cruciate ligament (ACL) reconstructions are performed annually, there remains a considerable amount of controversy over whether an autograft or an allograft should be used. The aim of this meta-analysis was to compare the clinical outcomes of allograft and autograft in primary ACL reconstruction. Methods The authors systematically searched electronic databases to identify prospective studies which compared allografts with autografts for primary ACL reconstruction. The results of the eligible studies were analysed in terms of instrumented laxity measurements, Lachman test, Pivot Shift test, objective International Knee Documentation Committee (IKDC) Scores, Lysholm Scores, Tegner Scores, and clinical failures. Study quality was assessed and relevant data were extracted independently by two reviewers. A random effect model was used to pool the data. Statistical heterogeneity between trials was evaluated by the chi-square and I-square tests. Results Nine studies, with 410 patients in the autograft and 408 patients in the allograft group, met the inclusion criteria. Five studies compared bone-patellar tendon-bone (BPTB) grafts, and four compared soft-tissue grafts. Four studies were randomized controlled trials, and five were prospective cohort studies. The results of the meta-analysis showed that there were no significant differences between allograft and autograft on all the outcomes in terms of instrumented laxity measurements (P 00.59), Lachman test (P 00.41), Pivot

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“…17 However, recent data have shown that outcomes with tibialis anterior allograft are good in the correct patient population. [18][19][20] Second, transtibial femoral drilling has come under scrutiny; however, in a widely cited study the trans-tibial group and accessory portal drilling group did not differ in their rate of revision ACL reconstruction. 21 We have shown that it is technically feasible to achieve an anatomic femoral tunnel through a transtibial method (Fig 3).…”

Section: E90mentioning

confidence: 99%

Technique for Arthroscopic-Assisted Primary Anterior Cruciate Ligament Reconstruction Using Doubled Tibialis Anterior Tendon

Rose

Crawford

2017

Arthroscopy Techniques

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Advances in surgical technique and our knowledge of anterior cruciate ligament (ACL) anatomy have resulted in a marked increase in options for ACL reconstruction. Currently, patient age and activity level, surgeon preference and experience, and cost are factors influencing the type of reconstruction recommended to address knee instability. We present a simplified transtibial method of ACL reconstruction using a single-bundle, doubled tibialis anterior allograft. This method uses fixation with a suspensory device on the femur and a bio-composite interference screw on the tibia. We recommend this simplified technique for primary ACL reconstruction because it minimizes total steps, thus limiting variance, maximizing efficiency, and reducing potential technical error.A nterior cruciate ligament (ACL) reconstruction is one of the most common procedures performed by orthopaedic surgeons with the goal of restoring functional stability.1 Advances in surgical technique have resulted in a marked improvement in outcomes, and current options for surgical reconstruction are numerous.2,3 The choice of reconstruction technique is dependent on surgeon experience and numerous patient factors, in balance with considerations of cost, efficacy, and long-term outcomes. We propose a single-bundle transtibial method using a doubled tibialis anterior allograft fixed with a suspensory device on the femoral cortex and a bio-composite interference screw in the tibia. We believe this technique simplifies ACL reconstruction by limiting the number of steps with an aim at reducing potential errors while providing an anatomic reconstruction. Surgical TechniqueACL reconstruction (Video 1) is performed by combining general anesthesia and a continuous-infusion femoral nerve catheter (0.2% ropivacaine) left in place for 72 hours to maximize pain control and minimize need for systemic narcotics. The patient is placed supine on a standard operating table, and full examination of the knee is performed including grading of the Lachman, anterior drawer, and pivot-shift tests. A lateral post is placed high on the thigh, and the leg is prepared and draped in sterile fashion. The leg is allowed to hang laterally over the side of the table and flexed to a minimum of 90. A lateral parapatellar portal is then made with a No. 11 blade even with the distal pole of the patella, creating an incision larger at the skin than the joint (one-way valve). A complete diagnostic evaluation is performed using lactated Ringer solution with epinephrine (1 mL of 1:1,000 per 5 L) and gravity flow. Concomitant meniscal or chondral pathology is noted and addressed. A medial working portal is then created with a No. 11 blade after localization with a spinal needle. The portal is placed just proximal and medial to the anterior horn of the medial meniscus. A 4.5-mm vacuum shaver is introduced through a medial working portal, and the torn fibers of the ACL are debrided minimally, focusing on those subluxated anteriorly and the midsubstance elements that are displaced. Ca...

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The Effect of Graft Tissue on Anterior Cruciate Ligament Outcomes: A Multicenter, Prospective, Randomized Controlled Trial Comparing Autograft Hamstrings With Fresh-Frozen Anterior Tibialis Allograft

Cited by 74 publications

References 31 publications

A Greater Reduction of Anterior Cruciate Ligament Elasticity in Women Compared to Men as a Result of Delayed Onset Muscle Soreness

A Greater Reduction of Anterior Cruciate Ligament Elasticity in Women Compared to Men as a Result of Delayed Onset Muscle Soreness

Allograft versus autograft for anterior cruciate ligament reconstruction: an up-to-date meta-analysis of prospective studies

Technique for Arthroscopic-Assisted Primary Anterior Cruciate Ligament Reconstruction Using Doubled Tibialis Anterior Tendon

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