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Allograft ligament

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https://www.readbyqxmd.com/read/28211291/a-biomechanical-analysis-of-tibial-acl-reconstruction-with-graft-length-mismatch
#1
Evan B Gaines, Diana Lau, Qais Naziri, Westley Hayes, Julio J Jauregui, Bhaveen H Kapadia, William P Urban, Bashir A Zikria
INTRODUCTION: The incidence of graft length mismatch (GLM) during anterior cruciate ligament (ACL) reconstruction is reported to be up to 13%, with a rate of 20% when using bone-patellar tendon-bone (BPTB) allografts. Multiple techniques have been described to accommodate for the longer BPTB graft. As no study has compared the biomechanical properties of these methods (with cyclic loading), we evaluated the strength of four different surgical techniques used to accommodate for GLM during ACL reconstruction...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28195744/-proprietary-processed-allografts
#2
Troy A Roberson, Jeffrey T Abildgaard, Douglas J Wyland, Paul C Siffri, Stephen P Geary, Richard J Hawkins, John M Tokish
BACKGROUND: The processing of allograft tissues in anterior cruciate ligament (ACL) reconstruction continues to be controversial. While high-dose irradiation of grafts has received scrutiny for high failure rates, lower dose irradiation and "proprietary-based" nonirradiated sterilization techniques have become increasingly popular, with little in the literature to evaluate their outcomes. Recent studies have suggested that the specifics of allograft processing techniques may be a risk factor for higher failure rates...
February 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28178094/reconstruction-of-symptomatic-congenital-anterior-cruciate-ligament-insufficiency
#3
Brant C Sachleben, Adam Y Nasreddine, Jeffrey J Nepple, Frances A Tepolt, James R Kasser, Mininder S Kocher
BACKGROUND: Hypoplasia or congenital absence of the anterior cruciate ligament (ACL) is a rare disorder occurring in ∼1 in every 6000 births. Although some patients with hypoplasia or agenesis of the ACL may not complain of instability, others desire to participate in more demanding activities that require the stability of a competent ACL. There are limited reports of surgical treatment of this patient population. The purpose of this study was to report ACL reconstruction in a case series of patients with symptomatic congenital ACL deficiency...
February 7, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28159425/magnetic-resonance-imaging-evaluation-of-physeal-violation-in-adolescents-after-transphyseal-anterior-cruciate-ligament-reconstruction
#4
Joon-Ho Wang, Kang-Min Son, Dae-Hee Lee
PURPOSE: To quantify and compare the amount and location of physis violation of the distal femur and proximal tibia after transphyseal anterior cruciate ligament (ACL) reconstruction in skeletally immature patients. METHODS: This study included 19 patients with open physes of the distal femur and proximal tibia who underwent ACL reconstruction with tibialis anterior allografts. Physeal tunnel volume and location on the growth plate, as well as obliquity to the growth plate, were measured by 3-dimensional postoperative magnetic resonance imaging of the distal femur and proximal tibia...
January 31, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28109536/biomechanical-properties-of-bovine-tendon-xenografts-treated-with-a-modern-processing-method
#5
Henry B Colaço, Breck R Lord, Diane L Back, Andrew J Davies, Andrew A Amis, Adil Ajuied
Xenograft tendons have been used in few human studies, with variable results. With the advent of novel tissue processing techniques, which may mitigate against an immune-mediated rejection response without adversely affecting mechanical properties, there may now be a clinical role for xenograft tendons, particularly in knee ligament reconstruction. We hypothesize that 'BioCleanse®' processed bovine extensor digitorum medialis (EDM) tendons exhibit favorable time-zero pre-implantation biomechanical characteristics when compared to both unprocessed bovine EDM tendons and BioCleanse® processed human cadaveric allograft tibialis anterior tendons...
January 13, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/28028569/functional-testing-and-return-to-sport-following-stabilization-surgery-for-recurrent-lateral-patellar-instability-in-competitive-athletes
#6
Aaron J Krych, Michael P O'Malley, Nick R Johnson, Rohith Mohan, Timothy E Hewett, Michael J Stuart, Diane L Dahm
PURPOSE: Medial patellofemoral ligament (MPFL) reconstruction and tibial tubercle osteotomy are commonly used to treat recurrent lateral patellar instability, yet there are limited available data on return to sport (RTS) following these procedures. The purpose of this study is to evaluate patient factors associated with excellent functional outcomes, including successful RTS, following surgical stabilization including MPFL reconstruction in competitive athletes with recurrent lateral patellar instability...
December 27, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28024306/a-canine-arthroscopic-anterior-cruciate-ligament-reconstruction-model-for-study-of-synthetic-augmentation-of-tendon-allografts
#7
James L Cook, Pat Smith, James P Stannard, Ferris Pfeiffer, Keiichi Kuroki, Chantelle C Bozynski, Cristi Cook
Novel graft types, fixation methods, and means for augmenting anterior cruciate ligament (ACL) reconstructions require preclinical validation prior to safe and effective clinical application. The objective of this study was to describe and validate a translational canine model for all-inside arthroscopic complete ACL reconstruction using a quadriceps tendon allograft with internal brace (QTIB). With institutional approval, adult research hounds underwent complete transection of the native ACL followed by all-inside ACL reconstruction using the novel QTIB construct with suspensory fixation (n = 10)...
December 26, 2016: Journal of Knee Surgery
https://www.readbyqxmd.com/read/28018069/bilateral-sequential-knee-dislocation-in-a-patient-with-connective-tissue-disorder-report-of-an-unusual-case-and-lessons-learnt
#8
Waheeb Al-Azzani, Konrad Wronka, James Lewis, Adel Ghandour, Angus Robertson
Tibiofemoral knee dislocation is a rare but serious limb-threatening injury. Without prompt recognition and management, amputation or long-term functional impairment may result. The authors present a case of bilateral sequential knee dislocation, secondary to low-energy trauma, in a patient with Systemic Lupus Erythematosus and antiphospholipid syndrome. Adequate stability was achieved on both occasions by reconstruction of the postero-lateral corner and MCL. During the first reconstruction, ipsi-lateral autograft, as well as hamstring tendons from the contra-lateral side, were used to strengthen the graft...
October 2016: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28005400/does-allograft-augmentation-of-small-diameter-hamstring-autograft-acl-grafts-reduce-the-incidence-of-graft-retear
#9
Andrew T Pennock, Brian Ho, Kristina Parvanta, Eric W Edmonds, Henry G Chambers, Joanna H Roocroft, Tracey P Bastrom
BACKGROUND: Small-diameter hamstring tendons are frequently encountered during anterior cruciate ligament (ACL) reconstructions in patients with short stature or those who are skeletally immature. The role of augmenting these small-diameter autografts with allograft is unclear. PURPOSE: To assess clinical outcomes and failure rates in adolescent patients with small hamstring tendon autografts (<7 mm) that were either augmented with soft tissue allograft or accepted "as is" and not augmented...
February 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28005102/tibial-tubercle-fracture-after-bone-patellar-tendon-bone-autograft
#10
Matthew J Brown, Leslie J Bisson, Mark J Anders
Fractures occurring with anterior cruciate ligament (ACL) reconstruction are rare and those that do occur take place on the patellar side of a bone-patellar tendon-bone (BPTB) autograft. Here we discuss a far more infrequent occurrence, fracture of the tibial tubercle aspect of the BPTB autograft. This fracture type occurs even more infrequently than tibial plateau fractures after ACL reconstruction based on the published literature. In this article we discuss the third published episode of a tibial tubercle fracture after BPTB allograft...
November 2016: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28005098/allografts-for-ligament-reconstruction-where-are-we-now
#11
REVIEW
Frank B Wydra, Philip J York, Christopher R Johnson, Lorenzo Silvestri
The use of musculoskeletal allografts by orthopedic surgeons continues to rise. The process of procuring and sterilizing allografts is evolving with much consideration to limiting the spread of infectious diseases and preserving tissue integrity. Research involving the application of allografts, particularly for ligament repair, is quite active, necessitating an update for the practicing orthopedist. Avoiding donor site morbidities is one of the most commonly cited advantages of allografts over autografts. There is controversy amongst studies for allografts in terms of their biological incorporation and clinical outcomes compared to autografts...
November 2016: American Journal of Orthopedics
https://www.readbyqxmd.com/read/27999505/osteochondral-allograft-transplantation-for-femoral-trochlear-dysplasia
#12
Dharmpal V Vansadia, James R Heltsley, Scott Montgomery, Misty Suri, Deryk G Jones
BACKGROUND: The risk factors for patellofemoral joint instability include laxity of medial patellar restraints, abnormal limb geometry, femoral and tibial malrotation, patella alta, and trochlear dysplasia. Femoral trochlear dysplasia is characterized by a hypoplastic or shallow trochlear groove. CASE REPORT: We report the case of a 31-year-old female with trochlear dysplasia and recurrent patella dislocations, laxity of the medial patellofemoral ligament (MPFL), and high-grade chondromalacia of the trochlea and the patella...
2016: Ochsner Journal
https://www.readbyqxmd.com/read/27896290/do-clinical-results-and-return-to-sport-rates-after-ulnar-collateral-ligament-reconstruction-differ-based-on-graft-choice-and-surgical-technique
#13
Brandon J Erickson, Gregory L Cvetanovich, Rachel M Frank, Bernard R Bach, Mark S Cohen, Charles A Bush-Joseph, Brian J Cole, Anthony A Romeo
BACKGROUND: Ulnar collateral ligament reconstruction (UCLR) has become a common procedure performed in overhead-throwing athletes of many athletic levels. PURPOSE/HYPOTHESIS: The purpose of this study was to determine whether clinical outcomes and return-to-sport (RTS) rates differ among patients undergoing UCLR based on graft choice, surgical technique, athletic competition level, handedness, and treatment of the ulnar nerve. We hypothesized that no differences would exist in clinical outcomes or RTS rates between technique, graft choice, or other variables...
November 2016: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/27894180/causes-of-failure-of-anterior-cruciate-ligament-reconstruction-and-revision-surgical-strategies
#14
Paolo Di Benedetto, Enrico Di Benedetto, Andrea Fiocchi, Alessandro Beltrame, Araldo Causero
Purpose: Long-term outcomes of anterior cruciate ligament (ACL) reconstruction are good or excellent; however, 0.7%-20% of patients suffer from recurrent instability due to graft failure. The purpose of this paper was to analyse failure aetiology and the possibilities of revision surgical strategies, with a description of our experience. We obtained optimal and good results in most of our patients. Materials and Methods: We retrospectively reviewed 42 patients who underwent revision surgery (43 revisions) due to relapsing instability after ACL reconstruction between 2006 and 2015...
December 1, 2016: Knee Surgery & related Research
https://www.readbyqxmd.com/read/27876265/a-prospective-randomized-comparison-of-two-distinct-allogenic-tissue-constructs-for-anterior-cruciate-ligament-reconstruction
#15
Michael B Rose, Christopher Domes, Mehwish Farooqi, Dennis C Crawford
BACKGROUND: Conduct a prospective randomized study to compare clinical outcomes of anterior cruciate ligament (ACL) reconstruction using quadrupled hamstring tendon (HT) allograft or doubled tibialis anterior (TA) allograft. Limited level 1 data exist comparing outcomes of different soft tissue allograft constructs for ACL reconstruction. We hypothesized no difference would exist in the patient reported outcomes (PRO), arthrometric testing, or rate of re-rupture between the two constructs...
December 2016: Knee
https://www.readbyqxmd.com/read/27871659/graft-selection-in-anterior-cruciate-ligament-surgery-who-gets-what-and-why
#16
REVIEW
Kyle R Duchman, T Sean Lynch, Kurt P Spindler
Anterior cruciate ligament (ACL) injuries are common and affect a young, active patient population. Despite much research, ACL reconstruction graft choice remains a topic of debate. Based on the best available evidence, autograft seems to be superior to allograft for ACL reconstruction in young, active patients. Future high-level studies are required in order to better define the role of allograft in ACL reconstruction. As graft choice is often influenced by surgeon preference, it is important that surgeons understand the current literature as well as the goals of their patients...
January 2017: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/27866794/treatment-of-symptomatic-acromioclavicular-joint-instability-by-a-docking-technique-clinical-indications-surgical-technique-and-outcomes
#17
W Ben Kibler, Aaron D Sciascia, Brent J Morris, David C Dome
PURPOSE: To report functional and objective outcomes resulting from surgical treatment of patients with symptomatic type III through V acromioclavicular (AC) joint injury by use of a modification of the anatomic AC joint reconstruction developed by Carofino and Mazzocca. METHODS: The study included all patients treated in 2009-2014 who presented with a history of direct trauma to the shoulder; deformity of the AC joint on clinical examination; radiographic findings that would classify the injury as a Rockwood type III, IV, or V injury; AC joint instability on clinical examination; and self-reported deficits of arm function on initial presentation, in whom a comprehensive and directed nonoperative program failed...
November 17, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/27828983/sacrotuberous-ligament-healing-following-surgical-division-during-transgluteal-pudendal-nerve-decompression-a-3-tesla-mr-neurography-study
#18
Jan Fritz, Benjamin Fritz, A Lee Dellon
Pelvic pain due to chronic pudendal nerve (PN) compression, when treated surgically, is approached with a transgluteal division of the sacrotuberous ligament (STL). Controversy exists as to whether the STL heals spontaneously or requires grafting. Therefore, the aim of this study was to determine how surgically divided and unrepaired STL heal. A retrospective evaluation of 10 patients who had high spatial resolution 3-Tesla magnetic resonance imaging (3T MRI) exams of the pelvis was done using an IRB-approved protocol...
2016: PloS One
https://www.readbyqxmd.com/read/27816100/editorial-commentary-the-jury-remains-out-on-hybrid-autograft-plus-allograft-for-diminutive-hamstring-anterior-cruciate-ligament-autografts
#19
EDITORIAL
Aman Dhawan
In a Level III, single center, retrospective, nonrandomized observational study, anterior cruciate ligament reconstruction revision rates and patient-reported outcomes were found to be similar at 2-year follow-up when using autograft hamstrings versus a hybrid graft (autograft and nonirradiated allograft), with both groups reporting low levels of revisions and excellent outcomes. Despite previous published data that were cause for concern, a study in this issue provides support for use of a hybrid graft technique when encountering the challenging situation of a diminutive hamstring autograft when performing anterior cruciate ligament reconstruction...
November 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/27803939/mechanoreceptor-reinnervation-of-autografts-versus-allografts-after-anterior-cruciate-ligament-reconstruction
#20
Simon W Young, Roberto D Valladares, Florence Loi, Jason L Dragoo
BACKGROUND: Loss of proprioceptive function occurs after anterior cruciate ligament (ACL) rupture. Clinical, motor, and proprioceptive function is known to improve after ACL reconstruction but does not return to normal. While histological studies of human ACL allografts have been unable to demonstrate mechanoreceptor reinnervation, animal data suggest that reinnervation may occur when an autograft is used. PURPOSE: To compare the presence or absence of mechanoreceptors between allograft versus autograft after ACL reconstruction in humans...
October 2016: Orthopaedic Journal of Sports Medicine
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