Trends in Anterior Cruciate Ligament Reconstruction in the Last Decade: A Web-Based Analysis

Abstract

Anterior cruciate ligament (ACL) injury is known to be one of the most common knee joint injuries. ACL reconstruction can be similar to the native ACL in respect of graft morphology, tension, position, and orientation. ACL reconstruction can be applied with different surgery techniques, graft and fixation devices, and rehabilitation as ACL reconstruction is just as important as surgery. Although commonly known as a sports injury, ACL injuries are increasingly seen in the general population. The aim of this study was to investigate the trends in ACL injury treatment in the last decade especially the graft choice. The abstracts of a total of 2,622 papers which stated ACL in the title were investigated through a search on the Web of Knowledge. Main topics were created as the ACL reconstruction theme. ACL reconstruction was examined in the abstracts with graft choice as the main theme followed by single bundle, double bundle, sports, rehabilitation, revision, complication, skeletally immature, biomechanics and kinematics, fixation devices, meniscus, anesthesia and pain, tunnel, cell, and intra-articular injection. Of the total 2,622 documents, 2,129 were original articles and 181 were reviews. Most of the documents, 436 in number (16.6%), were published in the , followed by the, , at 264. Of the total documents published, 36.3% were from the United States followed by 8.5% from Japan. The author with the most publications was F.H. Fu with 94 publications followed by B.R. Bach with 41 publications. The hamstring graft was most used at 187 single use and comprising 52% of the total graft combinations. Most papers were published in 2016. In 2012, single and double bundle grafts were determined to a total of 23. The most common title investigated in papers was biomechanics and kinematics with a total of 241 publications followed by rehabilitation at 208. Throughout the years of the study period, the most common graft choice was hamstring autograft. Biomechanics and kinematics was the most common title investigated as biomechanics and rehabilitation are known to be just as important as surgery for a successful outcome and patient satisfaction.

Unicompartmental Knee Replacement Combined to Anterior Cruciate Ligament Reconstruction: Midterm Results

“…The choice of graft in ACL reconstruction surgery is an issue of debate. Autografts constitute a popular choice, 20,21 although postoperative anterior knee pain following bonepatellar tendon-bone harvesting may result in substantial impairment for patients. 22 To minimize, reduce donor-site morbidity, operative time, and incisions, allografts have been gaining in popularity 23,24 ; however, they carry the risks of immune response, disease transmission risk, delayed graft incorporation, reduced availability, and costs which may discourage their use.…”

Comparison of the effectiveness of autologous grafts for anterior cruciate ligament reconstruction

“…Anterior cruciate ligament injury can lead to decreased knee stability, and increase the risk of meniscus injury and early osteoarthritis. [ 6 ] The purpose of ACLR is to restore the normal anatomical structure of the knee joint and reconstruct biological and mechanical stability. [ 6 ] The risk of secondary meniscus tear was significantly lower in patients treated with ACLR than in patients with nonsurgical treatment after ACL tear.…”

“…[ 6 ] The purpose of ACLR is to restore the normal anatomical structure of the knee joint and reconstruct biological and mechanical stability. [ 6 ] The risk of secondary meniscus tear was significantly lower in patients treated with ACLR than in patients with nonsurgical treatment after ACL tear. [ 7 ] There are many kinds of grafts for ACLR, including autogenous ligament, allogeneic ligament, and artificial ligament.…”

Anatomic Considerations in Hamstring Tendon Harvesting for Ligament Reconstruction

“…Vertical, horizontal, and even oblique incision methods have been proposed to reduce the risk of IPBSN injury; nevertheless, no consensus has been reached regarding the optimal incision method in the pes anserinus area for hamstring tendon harvest. 3 Sgaglione et al 10 reported a 37.5% incidence of infrapatellar paresthesia in patients who had undergone primary repair of a torn ACL with semitendinosus tendon augmentation by an open technique. During harvesting of the ST-G tendons, the knee should be flexed and the hip externally rotated to improve exposure and reduce tension on the saphenous nerve.…”

“…1 ACL reconstruction is one of the most common operations performed in the area of arthroscopy and sports medicine. 2,3 This surgical procedure is often performed using either hamstring tendon or patellar tendon autograft. It yields good results, but current techniques are not free of technical complications, especially related to graft harvesting.…”