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ACL graft maturity

Felix Fischer, Christian Fink, Elmar Herbst, Christian Hoser, Caroline Hepperger, Cornelia Blank, Peter Gföller
PURPOSE: The aim of this study was to compare isokinetic quadriceps and hamstring muscle strength in patients following anterior cruciate ligament (ACL) reconstruction who received either hamstring (HT) or quadriceps (QT) tendon autografts at two time intervals within the first year after surgery. METHODS: One hundred twenty-four patients, 81 males (age 22.0 ± 6.2 years) and 43 females (age 20.9 ± 8.7 years), participated in this study. ACL reconstruction was performed with either quadriceps tendon autografts (QT; n = 61) or hamstring tendon autografts (HT; n = 63)...
March 21, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Takuya Naraoka, Yuka Kimura, Eiichi Tsuda, Yuji Yamamoto, Yasuyuki Ishibashi
BACKGROUND: Remnant-preserved anterior cruciate ligament (ACL) reconstruction was introduced to improve clinical outcomes and biological healing. However, the effects of remnant preservation and the influence of the delay from injury until reconstruction on the outcomes of this technique are still uncertain. Purpose/Hypothesis: The purposes of this study were to evaluate whether remnant preservation improved the clinical outcomes and graft incorporation of ACL reconstruction and to examine the influence of the delay between ACL injury and reconstruction on the usefulness of remnant preservation...
April 2017: American Journal of Sports Medicine
Jin Hwan Ahn, Yong Seuk Lee, Hwa Jae Jeong, Jai Hyung Park, Yohan Cho, Kwang-Jeong Kim, Taeg Su Ko
INTRODUCTION: This study was performed to compare ACL graft maturation and morphologies using MRI between trans-tibial (TT) and retrograde outside-in (OI) techniques, and to compare clinical outcomes between the two groups. MATERIALS AND METHODS: Patients underwent single-tunnel ACL reconstruction using quadrupled hamstring autografts, with the TT technique used on 42 patients (TT group) and the retrograde OI technique used on 39 patients (OI group). All patients were examined with 3 T MRI at 6 months (between 5 and 7 months) after surgery...
January 28, 2017: Archives of Orthopaedic and Trauma Surgery
Emily Meike, S M Howell, M L Hull
PURPOSE: After reconstructing a torn ACL with a soft tissue allograft, the long-term healing process of graft maturation following the short-term healing process of graft incorporation into the bone tunnels might lead to recurring instability and concomitant decreases in the activity level, function, and patient satisfaction. Relying on roentgen stereophotogrammetric analysis (RSA), the primary purpose was to determine whether anterior laxity increased and whether patient-reported outcomes declined between 1 and 7 years for a particular graft construct, surgical technique, and rehabilitation programme...
October 20, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Berardo Di Matteo, Markus Loibl, Luca Andriolo, Giuseppe Filardo, Johannes Zellner, Matthias Koch, Peter Angele
AIM: To systematically review the currently available literature concerning the application of biologic agents such as platelet-rich plasma (PRP) and stem cells to promote anterior cruciate ligament (ACL) healing. METHODS: A systematic review of the literature was performed on the use of biologic agents (i.e., PRP or stem cells) to favor ACL healing during reconstruction or repair. The following inclusion criteria for relevant articles were used: Clinical reports of any level of evidence, written in English language, on the use of PRP or stem cells during ACL reconstruction/repair...
September 18, 2016: World Journal of Orthopedics
D Figueroa, R Martínez, R Calvo, M Scheu, M Gallegos, A Vaisman, C Martínez, A González
INTRODUCTION: For successful anterior cruciate ligament (ACL) reconstruction, revascularisation and histological maturation are necessary, as their failure can cause graft rupture. PURPOSE: The purpose of this study was to describe differences in the histological maturation of early failed plasty (less than 12 months after surgery) and late failed plasty (more than 12 months after surgery) in patients with re-rupture after ACL reconstruction with hamstring tendons...
November 2016: Revista Española de Cirugía Ortopédica y Traumatología
Simeon J S Ruiter, Reinoud W Brouwer, Tim W G M Meys, Cornelis H Slump, Jos J A M van Raay
BACKGROUND: There are two primary surgical techniques to reconstruct the anterior cruciate ligament (ACL), transtibial (TT) technique and anteromedial portal (AMP) technique. Currently, there is no consensus which surgical technique elicits the best clinical and functional outcomes. MRI-derived measures of the signal intensity (SI) of the ACL graft have been described as an independent predictor of graft properties. The purpose of this study is to compare the MRI derived SI measurements of the ACL graft one year after ACL reconstruction, in order to compare the outcomes of both the AMP and TT ACL reconstruction technique...
August 10, 2016: BMC Musculoskeletal Disorders
Hong Li, Jiwu Chen, Hongyun Li, Ziying Wu, Shiyi Chen
PURPOSE: To determine whether magnetic resonance image (MRI)-based graft maturity predicts clinical and functional scores during the first year after ACL reconstruction. METHODS: Patients with unilateral ACL reconstruction were prospectively invited to participate in this study, and they were examined using a 3.0-T MRI scan at 3, 6, and 12 months after the operation. Clinical examinations were performed on the same day, including subjective functional examinations, physical examinations and the KT-1000 test...
August 2, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
T Schmidt, D Grabau, J H Grotewohl, U Gohs, A Pruß, M Smith, S Scheffler, A Hoburg
PURPOSE: Allografts are frequently used for anterior cruciate ligament (ACL) reconstruction. However, due to the inherent risk of infection, a method that achieves complete sterilization of grafts is warranted without impairing their biomechanical properties. Fractionation of electron beam (FEbeam) irradiation has been shown to maintain similar biomechanical properties compared to fresh-frozen allografts (FFA) in vitro. Therefore, aim of this study was to evaluate the biomechanical properties and early remodelling of grafts that were sterilized with fractionated high-dose electron beam irradiation in an in vivo sheep model...
July 20, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Brian Ho, Eric W Edmonds, Henry G Chambers, Tracey P Bastrom, Andrew T Pennock
BACKGROUND: Anterior cruciate ligament (ACL) reconstruction failure is relatively common in young high-risk athletes. The purpose of this study was to examine a single center's 10-year experience with ACL reconstructions in pediatric and adolescent patients to better define short-term failure rates and risk factors for revision ACL surgery. METHODS: This institutional review board-approved retrospective study included all patients who underwent a primary ACL reconstruction between 2002 and 2013...
July 2, 2016: Journal of Pediatric Orthopedics
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
Brian M Grawe, Phillip N Williams, Alissa Burge, Marcia Voigt, David W Altchek, Jo A Hannafin, Answorth A Allen
BACKGROUND: Recent clinical investigations have identified inadequate autograft hamstring graft diameter (<8 mm) to be predictive of failure after reconstruction of the anterior cruciate ligament (ACL). PURPOSE/HYPOTHESIS: The objective of this study was to determine the utility of preoperative magnetic resonance imaging (MRI) variables of the hamstring tendons for the prediction of graft diameter at the time of surgery. The hypothesis was that cross-sectional area (CSA) of the hamstring tendon measured on MRI could accurately predict graft diameter, and threshold measurements could be established to predict graft diameter at the time of surgery...
May 2016: Orthopaedic Journal of Sports Medicine
Jin Hwan Ahn, Hwa Jae Jeong, Yong Seuk Lee, Jai Hyung Park, Jin Ho Lee, Taeg Su Ko
BACKGROUND: The purposes of this study were as follows: 1) to determine the correlation between the bending angle of the anterior cruciate ligament (ACL) graft at the femoral tunnel and the magnetic resonance imaging (MRI) signal intensity of the ACL graft and 2) to analyze the difference in the MRI signal intensity of the reconstructed ACL graft in different areas of the graft after single-bundle hamstring autograft ACL (SB ACL) reconstruction using an outside-in (OI) technique with bone-sparing retro-reaming...
August 2016: Knee
Mohammed T Al-Bluwi, Md Q Azam, Mir Sadat-Ali
BACKGROUND: Reconstruction of the anterior cruciate ligament (ACL) involves use of semintendinosis and gracilis tendons graft that is transplanted into bone tunnels at the femoral and tibial insertion sites and the sites and the bone tendon interface is a weak link in the early healing period due to slow rate of healing. We hypothesized that an addition of bone growth factor like Sadat-Habdan mesenchymal stimulating peptide (SHMSP) could enhance bone tendon healing rate so that re-rupture of the tendon does not take place...
January 2016: International Journal of Applied and Basic Medical Research
Achilleas Boutsiadis, Christos Karampalis, Anastasios Tzavelas, Vasileios Vraggalas, Pavlos Christodoulou, Ilias Bisbinas
Anterior cruciate ligament (ACL) rupture predisposes to altered kinematics and possible knee joint degeneration. Graft fiber maturation and ligamentization may eliminate this risk during ACL reconstruction procedures. ACL remnant-sparing techniques support the theory that the preserved tissue enhances revascularization, preserves the mechanoreceptors, and leads to anatomic remodeling. The purpose of this article is to present a simple and reproducible technique of tensioning the preserved ACL remnant over the femur...
December 2015: Arthroscopy Techniques
Stefano Zaffagnini, Alberto Grassi, Giulio Maria Marcheggiani Muccioli, Tommaso Roberti Di Sarsina, Federico Raggi, Andrea Benzi, Maurilio Marcacci
At the current state of the art in anterior cruciate ligament (ACL) reconstruction, multiple techniques have been presented but none has given clearly defined and improved results. One of the main issues concerns the choice of graft. The concept of using xenograft tissue, defined as a graft tissue from one species and destined for implantation in an unlike species, was introduced in order to try to overcome the mechanical and biological concerns associated with synthetic materials and the safety and quality concerns and availability problems of allograft tissue...
April 2015: Joints
M Komzák, R Hart, P Šmíd, M Puskeiler, P Jajtner
PURPOSE OF THE STUDY Growth factors produced by platelets enhance tissue healing. The aim of this study was to confirm or disprove the hypothesis that, in anterior cruciate ligament (ACL) reconstruction, the application of platelet-rich plasma (PRP) into the tibial and femoral tunnels and in the graft enhances graft maturation and graft-bone interface healing and thus improves knee function at 3 and 12 months post-operatively in comparison with the control group. MATERIAL AND METHODS A total of 40 patient had the surgery; 20 underwent single-bundle hamstring reconstruction with PRP application (PRP group) and 20 had the same surgery without PRP addition (control group)...
2015: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
Christopher A Verioti, Matthew C Sardelli, Tony Nguyen
We conducted a study to biomechanically evaluate 3 methods of tibial-sided fixation for anterior cruciate ligament reconstruction: fully threaded interference screw only, interference screw backed with 4.75-mm SwiveLock anchor, and fully threaded bio-interference screw backed with 4.5-mm bicortical screw (all Arthrex). Thirty skeletally mature porcine tibiae were used. The first group was prepared by graft fixation within the tibial tunnel using only an interference screw. The second and third groups included an interference screw with 2 types of secondary fixation: 4...
July 2015: American Journal of Orthopedics
Ji Hyun Ahn, Jong Dae Kim, Ho Won Kang
PURPOSE: To compare maturation of reconstructed graft on second-look arthroscopy and clinical outcomes between 2 groups: the provisional anatomic (PA) group, with both the anteromedial (AM) and posterolateral (PL) femoral tunnels in their anatomic location, and the nonanatomic (NA) group, with either 1 of the 2 femoral tunnels beyond its anatomic location after double-bundle anterior cruciate ligament reconstruction. METHODS: We enrolled 154 patients who underwent 3-dimensional computed tomography scanning and second-look arthroscopy after double-bundle anterior cruciate ligament reconstruction...
November 2015: Arthroscopy: the Journal of Arthroscopic & related Surgery
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
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