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All-inside anterior cruciate ligament

G Bressy, V Brun, A Ferrier, D Dujardin, N Oubaya, N Morel, N Fontanin, X Ohl
INTRODUCTION: The use of the semitendinosus tendon alone for anterior cruciate ligament reconstruction keeps the gracilis muscle intact and decreases anterior pain in comparison with the use of the patellar tendon. Recently, Lubowitz described a new all-inside technique with an ST4 tendon fixed with a cortical button in both femoral and tibial sides. We hypothesized that this type of graft with cortical button fixation provides well-controlled residual anterior tibial translation (<3mm)...
October 4, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
Bharath S Kumar, Renato Andrade, Ana Leal, André Sarmento, Hélder Pereira, Nuno Sevivas, João Espregueira-Mendes
Anatomical positioning of the graft in anterior cruciate ligament reconstruction is important to restore normal knee kinematics and prevent early joint degeneration. Inadequate position of a first attempt to place the guide pin within the center of the tibial footprint may occur. Therefore, its adjustment is important to achieve the anatomical positioning of the graft within the tibial footprint. When the guide pin exits eccentrically in an inadequate position, it is possible to correct it to the center of the footprint...
August 2016: Arthroscopy Techniques
Sam K Yasen, Zakk M Borton, Alistair I Eyre-Brook, Harry C Palmer, Stewart T Cotterill, Mike J Risebury, Adrian J Wilson
BACKGROUND: This paper reports the outcomes of patients undergoing ACL reconstruction using a TransLateral single bundle, all-inside hamstring technique at a minimum of two year follow-up. METHODS: The semitendinosus alone is harvested, quadrupled and attached in series to two adjustable suspensory fixation devices. Femoral and tibial sockets are produced using a retrograde drill. The graft is deployed, fixed and tensioned on both tibia and femur. Patients were evaluated preoperatively using the KOOS, Lysholm and Tegner scores and at six, 12 and 24months postoperatively...
September 27, 2016: Knee
N Jan, B Sonnery-Cottet, J-M Fayard, C Kajetanek, M Thaunat
INTRODUCTION: All-inside posteromedial suture for lesions of the posterior horn of the medial meniscus in anterior cruciate ligament (ACL) repair provides effective freshening and good healing. HYPOTHESIS: The posteromedial portal provides satisfactory healing rates without increasing morbidity or complications rates. MATERIAL AND METHODS: Intra- and postoperative complications were collected for a consecutive single-center series of 132 patients undergoing posteromedial hook suture of the medial meniscus in ACL repair...
September 26, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
Jorge Chahla, Chase S Dean, Gilbert Moatshe, Justin J Mitchell, Tyler R Cram, Carlos Yacuzzi, Robert F LaPrade
Meniscal ramp lesions are more frequently associated with anterior cruciate ligament (ACL) injuries than previously recognized. Some authors suggest that this entity results from disruption of the meniscotibial ligaments of the posterior horn of the medial meniscus, whereas others support the idea that it is created by a tear of the peripheral attachment of the posterior horn of the medial meniscus. Magnetic resonance imaging (MRI) scans have been reported to have a low sensitivity, and consequently, ramp lesions often go undiagnosed...
July 2016: Orthopaedic Journal of Sports Medicine
Mattia Fabbri, Edoardo Monaco, Riccardo Maria Lanzetti, Dario Perugia, Matteo Guzzini, Luca Labianca, Andrea Ferretti
BACKGROUND: The all-inside graft-link technique for anterior cruciate ligament reconstruction is performed with two cortical suspension devices with adjustable loops on both femur and tibia. This technique requires meticulous graft preparation. The aim of this study was to biomechanically test three different graft configurations resulting from differences in initial graft length. MATERIALS AND METHODS: Thirty bovine digital extensor tendons were arranged in three different ways: "half-quadrupled", "tripled" and "quadrupled"...
July 19, 2016: Journal of Orthopaedics and Traumatology: Official Journal of the Italian Society of Orthopaedics and Traumatology
Timothy S Crall, Brian B Gilmer
All-inside anterior cruciate ligament reconstruction has recently gained popularity, in part because of its bone-sparing socket preparation and reported lower pain levels after surgery. However, because this technique uses suture loops and cortical suspension buttons for graft fixation, it has mostly been limited to looped graft constructs (e.g., hamstring autograft, peroneus longus allograft). Quadriceps tendon autograft offers several advantages in anterior cruciate ligament reconstruction but, until recently, has not been compatible with suture-loop and cortical suspensory fixation...
December 2015: Arthroscopy Techniques
Mathieu Thaunat, Nicolas Jan, Jean Marie Fayard, Charles Kajetanek, Colin G Murphy, Barbara Pupim, Roland Gardon, Bertrand Sonnery-Cottet
PURPOSE: To evaluate the results of arthroscopic all-inside suture repair of medial meniscal ramp lesions through a posteromedial portal during anterior cruciate ligament (ACL) reconstruction. METHODS: All patients who underwent a suture of the posterior segment of the medial meniscus using a suture hook device through a posteromedial portal during ACL reconstruction with minimum 2 year-follow-up were included in the study. Repair was performed for longitudinal tears within the rim of less than 3 mm (capsulomeniscal junction or red-red zone) or 3 to 5 mm (red-white zone) of an unstable torn meniscus...
May 13, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Robert W Westermann, Kyle R Duchman, Annunziato Amendola, Natalie Glass, Brian R Wolf
BACKGROUND: Meniscal tears are frequently repaired during anterior cruciate ligament reconstruction (ACLR). PURPOSE: To systematically evaluate differences in clinical failures between all-inside and inside-out meniscal repairs performed during ACLR. STUDY DESIGN: Meta-analysis; Level of evidence, 4. METHODS: A systematic review was perfomed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines...
April 25, 2016: American Journal of Sports Medicine
H Zhang, X Liu, L Hong, X S Geng, H Feng
OBJECTIVE: To describe the clinical results of a one-stage operation for posterior cruciate ligament reconstruction and a posterolateral corner reconstruction of popliteus tendon reconstruction, compared with an open popliteofibular ligament reconstruction. METHODS: Our study included 33 patients who had undergone posterior cruciate ligament reconstruction with use of an achilles tendon-bone allograft and posterolateral corner reconstruction with arthroscopic anatomical reconstruction of popliteus tendon or open reconstruction of popliteofibular ligament...
April 18, 2016: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
Anant Joshi, Sajeer Usman, Bhushan Sabnis, Abhishek Kini
Posteromedial meniscocapsular separation of the knee has received renewed interest, with many articles describing a high incidence in association with anterior cruciate ligament injury. Various techniques have been described to address these lesions using all-inside meniscal repair sutures or using rotator cuff repair instruments through the posteromedial portal. Most orthopaedic surgeons are accustomed to using the "inside-out" meniscal repair technique with a double-armed suture. This technique is cost-effective and, in our opinion, more efficient in repairing such tears...
February 2016: Arthroscopy Techniques
Matthew R Prince, Michael J Stuart, Alexander H King, Paul L Sousa, Bruce A Levy
Posterior cruciate ligament (PCL) injuries account for nearly 20% of knee ligament injuries. PCL injuries can occur in isolation or, more commonly, in the setting of multiligamentous knee injuries. Isolated PCL disruptions are commonly treated nonoperatively; however, symptomatic grade III injuries, as well as PCL injuries found in multiligamentous injuries, are frequently treated surgically. Several reconstructive techniques exist for the treatment of PCL deficiency without a clear optimal approach. We describe our preferred operative technique to reconstruct the PCL using an all-inside arthroscopic approach with a quadrupled tibialis anterior or peroneus longus allograft with both tibial and femoral suspensory fixation...
October 2015: Arthroscopy Techniques
Takuya Tajima, Etsuo Chosa, Nami Yamaguchi, Noboru Taniguchi, Yasuyuki Ishida
BACKGROUND: To the best of our knowledge, there has been no detailed study on bone-patellar tendon-bone (BTB) grafts for remnant-preserving, selective-bundle anterior cruciate ligament (ACL) augmentation. Therefore, we aimed to develop such a technique using a BTB graft. METHOD: A total of five patients underwent surgery using the presented procedure. These patients were young, male, and with high body mass index, and hence required very high durability of reconstructed ACL...
June 2016: Knee
Patrick A Smith, James P Stannard, Ferris M Pfeiffer, Keiichi Kuroki, Chantelle C Bozynski, James L Cook
PURPOSE: To compare all-inside cortical-button suspensory fixation in sockets versus interference screw fixation in tunnels with respect to clinical, histologic, and biomechanical assessments of all-soft tissue (AST) tendon autografts used for anterior cruciate ligament (ACL) reconstruction in a canine model. METHODS: By use of a validated "hybrid" double-bundle ACL reconstruction technique (reconstruction of the anteromedial bundle with preservation of the native posterolateral bundle), dogs were randomly assigned to undergo either suspensory fixation in sockets (n = 6) or interference screw fixation in tunnels (n = 6)...
June 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Shinichi Yoshiya
Anatomic all-inside anterior cruciate ligament reconstruction using the autogenous semitendinosus tendon graft can afford satisfactory outcomes, achieving significant postoperative improvement in all clinical parameters.
February 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Ana Ma Martin-Fuentes, Cristina Ojeda-Thies, Jesus Vila-Rico
INTRODUCTION: The purpose of this study is to analyze the clinical results of meniscal tears repaired with an all-inside suture with special attention to the results in stable versus anterior cruciate ligament (ACL)-deficient knees. METHODS: We studied 45 meniscal tears (32 medial, 13 lateral) repaired in 43 patients using a single all-inside suture system. The patients were divided in two groups and followed-up for at least 12 months. Group A (stable knees with isolated meniscal tears) consisted of 19 patients treated with all-inside sutures...
December 2015: Acta Orthopaedica Belgica
Mark Schurz, Thomas M Tiefenboeck, Markus Winnisch, Stefanie Syre, Fabian Plachel, Gernot Steiner, Stefan Hajdu, Marcus Hofbauer
PURPOSE: To evaluate the clinical and functional outcomes for anatomic anterior cruciate ligament (ACL) reconstruction using the all-inside technique with a minimum follow-up of 24 months. METHODS: Patients undergoing anatomic ACL reconstruction via the all-inside technique between January 2011 and October 2012 were reviewed for inclusion in this study. Functional outcome measures, including the Lysholm score, International Knee Documentation Committee score, visual analog scale score, and Tegner Activity Scale, were used to evaluate outcomes before surgery and at 3, 6, 12, and > 24 months...
February 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
James O Smith, Sam K Yasen, Breck Lord, Adrian J Wilson
Although anatomic anterior cruciate ligament (ACL) reconstruction is established for the surgical treatment of anterolateral knee instability, there remains a significant cohort of patients who continue to experience post-operative instability. Recent advances in our understanding of the anatomic, biomechanical and radiological characteristics of the native anterolateral ligament (ALL) of the knee have led to a resurgent interest in reconstruction of this structure as part of the management of knee instability...
November 2015: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Hong Je Kang, Churl Hong Chun, Kwang Mee Kim, Hang Hwan Cho, Johnsel C Espinosa
BACKGROUND: Meniscus tears are commonly associated with anterior cruciate ligament (ACL) ruptures. It is essential to repair meniscal tears as much as possible to prevent early osteoarthritis and to gain additional stability in the knee joint. We evaluated the results of arthroscopic all-inside repair using the Meniscal Viper Repair System (Arthrex) on meniscus tears simultaneously with ACL reconstruction. METHODS: Nineteen out of 22 patients who were treated with arthroscopic all-inside repair using the Meniscal Viper Repair System for meniscus tear associated with ACL rupture were evaluated...
June 2015: Clinics in Orthopedic Surgery
J Richard Steadman, Lauren M Matheny, Steven B Singleton, Nicholas S Johnson, William G Rodkey, Bernardo Crespo, Karen K Briggs
BACKGROUND: Few studies have compared outcomes after meniscus suture repair in patients younger than 40 years versus patients 40 years and older. PURPOSE: To document failure rates and long-term outcomes after meniscus suture repair by a single surgeon, using the inside-out technique, at a minimum 10-year follow-up in patients younger than 40 years versus those 40 years and older. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: This study included all patients 18 years or older who underwent meniscus suture repair with the inside-out technique by a single surgeon between January 1992 and December 2003...
September 2015: American Journal of Sports Medicine
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