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acl graft selection

Brian R Waterman, William Arroyo, Eric J Cotter, Michael A Zacchilli, E'Stephan J Garcia, Brett D Owens
Background: There remains a debate over whether to retain the index anterior cruciate ligament (ACL) graft in the setting of septic arthritis. Purpose: To evaluate and compare clinical outcomes for the treatment of septic arthritis after ACL reconstruction (ACLR) in those with and without early graft retention. Study Design: Case series; Level of evidence, 4. Methods: The Military Health System was queried for all ACLR procedures performed between 2007 and 2013...
March 2018: Orthopaedic Journal of Sports Medicine
Sachin Ramchandra Tapasvi, Anshu Shekhar, Shantanu Sudhakar Patil
Anterior cruciate ligament (ACL) tears are usually managed by reconstruction with autograft or allograft, but primary repair in carefully selected patients is a reasonable option. Proximal avulsions presenting early with excellent tissue quality are amenable to repair and healing. Restoration of native ACL preserves its proprioceptive and kinematic functions. A repair is less invasive and avoids graft-related problems, and faster rehabilitation is possible. Protection for the repair in the early stages will allow better healing...
February 2018: Arthroscopy Techniques
M A Faisal, A Z Chowdhury, I K Kundu, K N Arifeen, A S Ullah, C I Mahmud, O M Dastagir, M A Islam, M S Paul
Graft selection for primary anterior cruciate ligament reconstruction is very important part of knee stability. The purpose of this Qasi experimental study was to compare the clinical outcomes after ACL reconstruction using either a BPTB graft or a four-strand hamstrings graft and conducted from January 2012 to December 2013. Patients presented with a symptomatic unilateral ACL rupture who were underwent ACL reconstruction by using either BPTB or Hamstrings graft, IPD of Department of Orthopedics at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka as well as in a private hospital in Dhaka, Bangladesh were selected as study population...
January 2018: Mymensingh Medical Journal: MMJ
Yoon-Ho Kwak, Sahnghoon Lee, Myung Chul Lee, Hyuk-Soo Han
BACKGROUND: Quadriceps tendon-patellar bone (QTPB) autograft is an excellent graft option with good clinical outcome. Use of QTPB autografts have increased because they minimize donor-site morbidity including anterior knee pain, while providing adequate mechanical strength. Although, there were many clinical results about allografts that used in anterior cruciate ligament (ACL) reconstruction, it have never been reported about the clinical outcome of ACL reconstruction with QTPB allograft...
February 9, 2018: BMC Musculoskeletal Disorders
Amit M Momaya, Clint Beicker, Paul Siffri, Michael J Kissenberth, Jeffrey Backes, Lane Bailey, Gabriel J Rulewicz, Jennifer M Mercuri, E Carlisle Shealy, John M Tokish, Charles A Thigpen
Background: Hamstring autograft size <8 mm has been shown to be a predictor for failure after anterior cruciate ligament (ACL) reconstruction. The ability to predict graft size preoperatively is helpful in counseling patients about the possible need for graft augmentation. Purpose: To determine whether preoperative ultrasound (US) measurements of hamstring tendons can predict intraoperative graft diameter during ACL reconstruction. Study Design: Cohort study (diagnosis); Level of evidence, 2...
January 2018: Orthopaedic Journal of Sports Medicine
Mark P Cote
In the past decade there has been a rapid expansion in the available evidence for outcomes after revision knee anterior cruciate ligament reconstructions including data from 2 large registries and a growing body of research. The advent of 2 large registries and a growing body of evidence have provided a refined view of failure after revision reconstruction. A careful review of this evidence indicates that failure rates are not as high as previously reported in the literature. Because the body of literature continues to grow, the true role of graft selection on failure rates will become clearer and a more precise estimate of failure will emerge...
January 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Martin Sauerschnig, Josef Stolberg-Stolberg, Carmen Schmidt, Valerie Wienerroither, Michael Plecko, Karin Schlichting, Carsten Perka, Christian Dynybil
BACKGROUND: Non-steroidal anti-inflammatory drugs are commonly used to reduce pain and inflammation in orthopaedic patients. Selective cyclooxygenase-2 (COX-2) inhibitors have been developed to minimize drug-specific side effects. However, they are suspected to impair both bone and tendon healing. The objective of this study is to evaluate the effect of COX-2 inhibitor administration on tendon-to-bone healing and prostaglandin E (PGE2) concentration. METHODS: Thirty-two New Zealand white rabbits underwent reconstructions of the anterior cruciate ligaments and were randomized into four groups: Two groups postoperatively received a selective COX-2 inhibitor (Celecoxib) on a daily basis for 3 weeks, the two other groups received no postoperative COX-2 inhibitors at all and were examined after three or 6 weeks...
January 5, 2018: European Journal of Medical Research
Fernando C Rezende, Vinícius Y Moraes, Carlos Es Franciozi, Pedro Debieux, Marcus V Luzo, João Carlos Belloti
BACKGROUND: Anterior cruciate ligament (ACL) tears are serious knee injuries that are frequently treated surgically in the form of arthroscopically assisted reconstruction with grafts from the patella or hamstrings tendons. We reviewed the evidence for the choice of arthroscopically assisted ACL reconstruction technique in terms of whether it should involve one incision (femoral tunnel drilled from inside the knee joint under arthroscopic visualisation) or two incisions (femoral tunnel drilled from outside to inside the knee joint)...
December 15, 2017: Cochrane Database of Systematic Reviews
Christopher J DeFrancesco, Eileen P Storey, Kevin G Shea, Mininder S Kocher, Theodore J Ganley
Although initially considered rare, anterior cruciate ligament (ACL) ruptures in pediatric patients recently have increased substantially as a result of greater awareness of the injury and increased participation in youth sports. Although pediatric patients with an ACL injury and a clinically stable joint may handle the injury well and return to sports activity without requiring surgical reconstruction, young, active patients with an ACL rupture and an unstable joint may be good candidates for ACL reconstruction to prevent ongoing instability and additional joint damage...
February 1, 2018: Journal of the American Academy of Orthopaedic Surgeons
Eric M Yung, Richard Brull, Eric Albrecht, Girish P Joshi, Faraj W Abdallah
BACKGROUND: Local infiltration analgesia offers effective postoperative analgesia after knee arthroplasty, but the role of its counterpart, local instillation analgesia (LIA), in anterior cruciate ligament reconstruction (ACLR) is unclear. This systematic review and meta-analysis evaluates the analgesic benefits of LIA for outpatient ACLR. METHODS: We sought randomized controlled trials investigating the analgesic effects of LIA versus control in adults having outpatient ACLR and receiving multimodal analgesia (excluding nerve blocks, which are examined in parts I and II of this project)...
November 30, 2017: Anesthesia and Analgesia
Hongtao Xu, Jiangtao Dong, Dongmei Xin, Jian Zhang, Kai Kang, Shijun Gao
BACKGROUND Graft choice is very controversial. This study compared the second-look evaluation and clinical outcomes of anatomic ACL-R using a thin autograft versus a thick hybrid graft. MATERIAL AND METHODS Sixty-eight patients who had received ACL-R with hamstring autograft or autograft-allograft hybrid graft accepted second-look arthroscopy were grouped (autograft: n=31, age: 32.8±8.9, Male/Female: 16/15, and hybrid graft: n=37, age: 33.9±8.4, Male/Female: 27/10). Patients were evaluated with the functional score and KT-1000 test before reconstruction...
November 23, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Nicholas Kusnezov, Emmanuel D Eisenstein, John C Dunn, Aaron J Wey, David R Peterson, Brian R Waterman
PURPOSE: To provide further guidance on the optimal decision between anterior cruciate ligament (ACL) graft removal versus retention in the setting of septic arthritis following reconstruction using an expected value decision analysis. METHODS: A systematic review and expected value decision analysis and sensitivity analyses were performed to quantify the clinical decision. A decision tree was created with 5 outcomes of interest: nonoperative complications, revision surgery, early reoperation, late reoperation, and "well...
November 6, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
Andrea Pasquini, Marco Jacopetti, Francesco Pogliacomi, Ileana Ramazzina, Cosimo Costantino
OBJECTIVE: Several different types of grafts have been used in ACL rupture. The purpose of the study was to compare the recovery of lower limbs muscle strength and proprioception in athletes, who underwent ACL reconstruction with Bone-Patellar-Tendon-Bone (BPTB) versus semitendinosus and gracilis (HS) autografts. METHODS: We enrolled 30 male amateur athletes. Each patient was evaluated by isokinetic test, triaxial accelerometer test and balance test with stabilometric platform...
October 18, 2017: Acta Bio-medica: Atenei Parmensis
Rahul Khare, Hitesh Lal, Kandarp Vidyarthi, Vivek Jangira, Deepak Mittal
OBJECTIVE: Pretensioning is usually done using two methods - manual cyclical loading and using tensioner with a tendon board. Both the methods are being used with little knowledge about the superiority of either method. This study was done with the objective of trying to find out the better method. METHODS: A total of 50 patients were selected for the above mentioned study who were randomised into each of the two groups using chit system - In group A patients, cyclical loading was done by twenty times full flexion -extension movements but in group B patients, the graft was placed on a tensioner with 15 pounds tension for 10 minutes...
July 2017: Journal of Clinical Orthopaedics and Trauma
Andrew J Riff, Timothy J Luchetti, Alexander E Weber, Jaskarndip Chahal, Bernard R Bach
BACKGROUND: During the preoperative discussion prior to anterior cruciate ligament reconstruction (ACLR), patients are often interested in data regarding rates of revision reconstruction, reoperation, concomitant pathologic changes, and future contralateral ACL injury. PURPOSE: To analyze a single surgeon's experience with primary and revision ACLR over a 30-year interval, focusing on incidence and risk factors for revision and reoperation. STUDY DESIGN: Case series; Level of evidence, 4...
August 2017: Orthopaedic Journal of Sports Medicine
M-L Louis, P D'ingrado, F P Ehkirch, S Bertiaux, P Colombet, B Sonnery-Cottet, B Schlatterer, R Pailhé, J C Panisset, C Steltzlen, S Lustig, C Lutz, F Dalmay, P Imbert, D Saragaglia
BACKGROUND: A careful analysis of the reasons for ACL reconstruction failure is essential to selection of the optimal surgical revision technique designed to ensure good rotational stability and to minimise the risk of re-rupture. OBJECTIVE: To evaluate anterolateral ligament (ALL) stabilisation during revision ACL reconstruction. HYPOTHESIS: ALL stabilisation during revision ACL reconstruction provides good rotational stability without increasing the risk of complications...
September 7, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
Thibaut Noailles, Philippe Boisrenoult, Matthieu Sanchez, Philippe Beaufils, Nicolas Pujol
PURPOSE: To investigate the effect of the anterior cruciate ligament (ACL) torsion in 90° knee flexion on the morphological appearance of the ACL. METHODS: Sixty knees from fresh frozen anatomical specimens were dissected. Eighteen knees were excluded according to selection criteria (torn ACL, mucoid degeneration of the ACL, arthritic lesions of the notch, or knees harboring synovial inflammatory pathologies). After the removal of the synovial membrane, the morphology of the ligamentous fibers of the ACL and the twist were analyzed...
September 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
Jae-Ang Sim, Jong-Min Kim, SahngHoon Lee, Eun-Kyoo Song, Jong-Keun Seon
PURPOSE: The purpose of this study was to compare femoral tunnel geometry including tunnel position, length, and graft bending angle between trans-portal and outside-in techniques in anterior cruciate ligament (ACL) reconstruction and discover whether such differences in tunnel geometry could influence graft healing or clinical outcome. METHODS: Sixty-four patients with anatomical single-bundle ACL reconstruction performed with either trans-portal technique (32 patients, one centre) or outside-in technique (32 patients, the other centre) were included in this retrospective study...
July 29, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Darby A Houck, Matthew J Kraeutler, Armando F Vidal, Eric C McCarty, Jonathan T Bravman, Michelle L Wolcott
No abstract text is available yet for this article.
July 12, 2017: Journal of Knee Surgery
Philippe M Tscholl, Virginie M Haldemann, Arne De Smet, Suzanne Gard, Ryan Burgan, Viken V Yerganyan, Jacques Ménétrey
Indication for anterior cruciate ligament reconstruction is a debated subject and needs to be discussed on an individual basis, depending on the patient's age and physical demands. Graft selection is a crucial step for successful outcome and needs to be adapted to the patient, to the concomitant lesions, preoperative knee and lower limb injuries, but also to the surgeon's experience and preference. The present article summarizes current concepts, the pros and cons of the most used autografts and allografts, and highlights the importance to adapt postoperative rehabilitation in function of the graft...
July 12, 2017: Revue Médicale Suisse
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