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Two time patellar tendon graft for ACL

A Hardy, L Casabianca, K Andrieu, L Baverel, T Noailles
Anterior cruciate ligament (ACL) reconstruction can be performed with an autograft, which is most often harvested from the patient's hamstring tendon (HT) or patellar tendon (PT). However, autograft harvesting leads to morbidity that is by no means insignificant. A systematic review of literature was performed to define the incidence of complications related to graft harvesting and the methods to prevent these complications. In March 2017, a systemic review of literature was performed using the keywords"harvesting", "harvest", "morbidity", "complication", "cruciate ligament"...
September 6, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
Bertrand Sonnery-Cottet, Adnan Saithna, Maxime Cavalier, Charles Kajetanek, Eduardo Frois Temponi, Matt Daggett, Camilo Partezani Helito, Mathieu Thaunat
BACKGROUND: Graft failure and low rates of return to sport are major concerns after anterior cruciate ligament (ACL) reconstruction, particularly in a population at risk. PURPOSE: To evaluate the association between reconstruction techniques and subsequent graft rupture and return-to-sport rates in patients aged 16 to 30 years participating in pivoting sports. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: A prospective study of patients undergoing primary ACL reconstruction with a bone-patellar tendon-bone (B-PT-B) graft, quadrupled hamstring tendon (4HT) graft, or hamstring tendon graft combined with anterolateral ligament reconstruction (HT+ALL) was conducted by the Scientific ACL NeTwork International (SANTI) Study Group...
June 2017: American Journal of Sports Medicine
Adrian Kurz, Nathan Evaniew, Marco Yeung, Kristian Samuelsson, Devin Peterson, Olufemi R Ayeni
PURPOSE: This systematic review examined the methodological credibility and quality of reporting of all meta-analyses which have compared bone-patellar tendon-bone (BPTB) versus hamstring tendon (HT) for anterior cruciate ligament (ACL) reconstruction (ACLR). METHODS: EMBASE, MEDLINE, and The Cochrane Library were systematically searched, and two reviewers independently assessed eligibility, credibility according to the Users' Guide to medical literature, and completeness of reporting according to the preferred reporting items for systematic review and meta-analyses (PRISMA) checklist...
February 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Patrick W Kane, Jocelyn Wascher, Christopher C Dodson, Sommer Hammoud, Steven B Cohen, Michael G Ciccotti
PURPOSE: The purpose of this study is to evaluate the clinical outcomes and revision rates of skeletally mature patients aged 25 years or younger who have undergone either BPTB autograft or deep-frozen, non-irradiated BPTB allograft ACL reconstruction by a single surgeon. METHODS: Two hundred and twenty-four patients aged 25 or younger at the time of surgery were identified as having a transtibial ACL reconstruction with either a BPTB autograft or deep-frozen, non-irradiated BPTB allograft by one senior surgeon (101 autografts vs...
November 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Ravi Gupta, Dheeraj Kapoor, Love Kapoor, Anubhav Malhotra, Gladson David Masih, Anil Kapoor, Shweta Joshi
BACKGROUND: Pain in the immediate post-operative period after anterior cruciate ligament (ACL) surgery, apart from an unpleasant experience for the patient, can act as a barrier for static quadriceps contractions and optimum execution of the initial rehabilitation protocol resulting in slow recovery and a later return to full function for a sportsperson. There is no report in the literature comparing pain in the immediate post-operative period after using the two most widely used autografts, bone patellar tendon bone (BPTB) graft and hamstring graft...
June 8, 2016: Journal of Orthopaedic Surgery and Research
Sally Arno, Christopher P Bell, Michael J Alaia, Brian C Singh, Laith M Jazrawi, Peter S Walker, Ankit Bansal, Garret Garofolo, Orrin H Sherman
BACKGROUND: Considerable debate remains over which anterior cruciate ligament (ACL) reconstruction technique can best restore knee stability. Traditionally, femoral tunnel drilling has been done through a previously drilled tibial tunnel; however, potential nonanatomic tunnel placement can produce a vertical graft, which although it would restore sagittal stability, it would not control rotational stability. To address this, some suggest that the femoral tunnel be created independently of the tibial tunnel through the use of an anteromedial (AM) portal, but whether this results in a more anatomic footprint or in stability comparable to that of the intact contralateral knee still remains controversial...
July 2016: Clinical Orthopaedics and related Research
Yuji Takazawa, Hiroshi Ikeda, Yoshitomo Saita, Muneaki Ishijima, Masataka Nagayama, Haruka Kaneko, Yohei Kobayashi, Shinnosuke Hada, Ryo Sadatsuki, Kazuo Kaneko
BACKGROUND: Using intra-operative findings and clinical results, including return to play (RTP) at the pre-injury level, this study investigated the causes of primary graft failure after revision anterior cruciate ligament (ACL) reconstruction with bone-patellar-tendon-bone (BPTB) autografts. METHODS: A total of 54 patients were followed for a mean of 38.2 ± 10.2 months post-surgery. Subjective and objective results were evaluated using single assessment numeric evaluation (SANE) scores, Lachman tests, KT-2000 arthrometer results, and pivot-shift tests...
December 2015: Knee
Luca Andriolo, Berardo Di Matteo, Elizaveta Kon, Giuseppe Filardo, Giulia Venieri, Maurilio Marcacci
Current research is investigating new methods to enhance tissue healing to speed up recovery time and decrease the risk of failure in Anterior Cruciate Ligament (ACL) reconstructive surgery. Biological augmentation is one of the most exploited strategies, in particular the application of Platelet Rich Plasma (PRP). Aim of the present paper is to systematically review all the preclinical and clinical papers dealing with the application of PRP as a biological enhancer during ACL reconstructive surgery. Thirty-two studies were included in the present review...
2015: BioMed Research International
Nicholas Mohtadi, Rhamona Barber, Denise Chan, Elizabeth Oddone Paolucci
OBJECTIVE: Complications/adverse events of anterior cruciate ligament (ACL) surgery are underreported, despite pooled level 1 data in systematic reviews. All adverse events/complications occurring within a 2-year postoperative period after primary ACL reconstruction, as part of a large randomized clinical trial (RCT), were identified and described. DESIGN: Prospective, double-blind randomized clinical trial. Patients and the independent trained examiner were blinded to treatment allocation...
May 2016: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
Nicholas Mohtadi, Denise Chan, Rhamona Barber, Elizabeth Oddone Paolucci
OBJECTIVE: To compare 3 anatomically positioned autografts for anterior cruciate ligament (ACL) reconstruction, by measuring patient-reported disease-specific quality of life at 2 years postoperatively. DESIGN: Double-blinded, randomized clinical trial with intraoperative computer-generated treatment allocation. Patients and an independent trained evaluator were blinded. SETTING: University-based orthopedic referral practice. PATIENTS: Three hundred thirty patients (14-50 years; 183 male patients) with isolated ACL deficiency were equally randomized to: (1) patellar tendon, PT: 28...
July 2015: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
Rocco Papalia, Francesco Franceschi, Andrea Tecame, Stefano D'Adamio, Nicola Maffulli, Vincenzo Denaro
PURPOSE: The risk for re-tear following anterior cruciate ligament (ACL) reconstruction is influenced by several hormonal, neuromuscular, biomechanical and anatomic factors. One of the most important negative prognostic factors that markedly increase the risk for ACL re-tear is the presence of high knee-abduction moment (KAM), which can be measured immediately by landing on both feet after a vertical jump. We evaluated the effect in postoperative values for KAM according to the type of graft used for ACL reconstruction (hamstring vs patellar tendon) and a specific rehabilitation protocol focusing on recovery of muscular strength, proprioception and joint stabilisation...
March 2015: International Orthopaedics
Johannes Leitgeb, Julia Köttstorfer, Julia Koettsdorfer, Rupert Schuster, Florian M Kovar, Patrick Platzer, Silke Aldrian
INTRODUCTION: ACL reconstruction with quadruple hamstring graft (HT) as well as bone-patellar tendon-bone autograft (PT) is a frequent procedure in athletes after ACL rupture. Both techniques are reported to provide for satisfying results but only few articles compare both techniques. MATERIAL AND METHODS: Prospective evaluation was performed on 96 patients with isolated ACL rupture undergoing reconstruction with a HT or PT autograft by a single surgeon at our institution...
July 2014: Wiener Klinische Wochenschrift
M M Sarzaeem, F Najafi, M Razi, M A Najafi
PURPOSE: The gold standard in ACL reconstructions has been the bone-patellar tendon-bone autograft fixed with interference screws. This prospective, randomized clinical trial aimed to compare two methods of fixation for BPTB grafts: press-fit fixation vs. interference screw, over a 12-month follow-up interval. METHODS: 158 patients with an average age of 29.8 years, between 2011 and 2012, were treated for torn ACL. 82 patients underwent reconstruction with BPTB autograft with a press fit fixation technique, and in 76 cases an interference screw was used...
July 2014: Archives of Orthopaedic and Trauma Surgery
Charles L Cox, Kurt P Spindler, James P Leonard, Brent J Morris, Warren R Dunn, Emily K Reinke
BACKGROUND: Bioabsorbable interference screws are used frequently for graft fixation in ACL (anterior cruciate ligament) reconstruction. The resorption properties of many available screws that are marketed as bioabsorbable are not well defined. The CALAXO (Smith & Nephew Endoscopy) and MILAGRO (DePuy Synthes) bioabsorbable screws contain polymers of poly(lactic-co-glycolic acid) (PLGA) plus additives to encourage osseointegration over time. The purpose of this study was to evaluate radiographic and magnetic resonance imaging (MRI) properties and compare patient-reported outcomes at a minimum of two years of follow-up after ACL reconstruction using CALAXO or MILAGRO bioabsorbable interference screws...
February 5, 2014: Journal of Bone and Joint Surgery. American Volume
Annette Heijne, Maria Hagströmer, Suzanne Werner
PURPOSE: The aim of the present study was to evaluate and compare objective and subjective outcome in patients 2 and 5 years after anterior cruciate ligament (ACL) reconstruction with either bone-patellar tendon-bone (BPTB) or hamstring grafts. The second aim was to report the prevalence of re- and contralateral ACL ruptures. METHODS: Sixty-eight patients (BPTB, n = 34 and hamstring graft, n = 34) were evaluated preoperatively, 2 and 5 years after ACL reconstruction...
March 2015: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Farshid Mohammadi, Mahyar Salavati, Behnam Akhbari, Masood Mazaheri, Seyed Mohsen Mir, Yasaman Etemadi
BACKGROUND: The choice of graft for anterior cruciate ligament (ACL) reconstruction remains controversial. Although many outcome studies comparing bone-patellar tendon-bone and semitendinosus and gracilis tendon grafts have been performed, most have not included tests of functional outcomes that challenge the graft. The objective of the current study was to compare the functional performances of soccer players after ACL reconstruction that was performed with either a bone-patellar tendon-bone or a semitendinosus and gracilis tendon graft...
July 17, 2013: Journal of Bone and Joint Surgery. American Volume
Aikaterini Ntoulia, Frederica Papadopoulou, Franceska Zampeli, Stavros Ristanis, Maria Argyropoulou, Anastasios Georgoulis
OBJECTIVE: The aim of this study was to evaluate, with contrast-enhanced-magnetic resonance imaging (MRI), the changing imaging appearance of an anterior cruciate ligament (ACL) graft during the revascularization phase by quantitatively assessing the morphological and signal intensity changes taking place at its cross-sectional surface over time. MATERIALS AND METHODS: Fifty patients underwent contrast-enhanced-MRI on the third postoperative day and at a mean of 6, 12, and 24 months time interval after surgery...
April 2013: Skeletal Radiology
Peter A Indelicato, Michael G Ciccotti, Joel Boyd, Laurence D Higgins, Benjamin S Shaffer, C Thomas Vangsness
PURPOSE: To compare the clinical outcomes of bone-patellar tendon-bone (BTB) allografts processed via a novel sterilization system with the traditional aseptically processed BTB allografts for anterior cruciate ligament (ACL) reconstruction. METHODS: A total of 67 patients undergoing ACL reconstruction at 6 independent investigation sites were randomized into one of two intervention groups, BioCleanse-sterilized or aseptic BTB allografts. Inclusion criteria included an acute, isolated, unilateral ACL tear, and exclusion criteria included prior ACL injury, multi-ligament reconstruction, and signs of degenerative joint disease...
September 2013: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Wojciech Widuchowski, Malgorzata Widuchowska, Bogdan Koczy, Szymon Dragan, Andrzej Czamara, Wieslaw Tomaszewski, Jerzy Widuchowski
BACKGROUND: If anterior cruciate ligament (ACL) reconstruction is to be performed, decision regarding graft choice and its fixation remains one of the most controversial. Multiple techniques for ACL reconstruction are available. To avoid disadvantages related to fixation devices, a hardware-free, press-fit ACL reconstruction technique was developed. The aim of this study was to evaluate clinical outcome and osteoarthritis progression in long term after ACL reconstruction with central third patellar-tendon autograft fixed to femur by press-fit technique...
June 27, 2012: BMC Musculoskeletal Disorders
Gül Baltaci, Güldeniz Yilmaz, Ahmet Ozgür Atay
OBJECTIVE: In this study, we aimed to evaluate and compare the functional performance and muscle strength of cases of ACL reconstruction using bone-patellar tendon-bone graft followed by rehabilitation with those of healthy subjects. METHODS: This study included fifteen patients (range: 20 to 35 years) who underwent ACL reconstruction 18 to 24 months previously and a control group of 15 healthy volunteers with similar characteristics. Cases were evaluated with physical examinations, functional tests, subjective scales (Lysholm, Hospital for Special Surgery Knee Score (HSSS), and Tegner activity scale) and isokinetic test...
2012: Acta Orthopaedica et Traumatologica Turcica
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