scholarly journals Skeletally immature patient showed lower graft maturity than skeletally mature patient after ACL reconstruction with a rounded rectangular femoral tunnel

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kazuki Asai ◽  
Junsuke Nakase ◽  
Kengo Shimozaki ◽  
Rikuto Yoshimizu ◽  
Mitsuhiro Kimura ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Signal Intensity ◽  
Cruciate Ligament ◽  
Pivot Shift Test ◽  
Control Group ◽  
Skeletally Immature ◽  
Group 2 ◽  
Anterior Cruciate ◽  
Immature Group ◽  
Group 1

AbstractTo compare the clinical results and ligamentization of anterior cruciate ligament reconstruction (ACLR) between skeletally immature and mature patients. Two-hundred-and-two patients who underwent primary ACLR were evaluated retrospectively. The clinical outcomes were compared between skeletally immature (immature group 1, n = 27) and mature (control group 1, n = 175) groups. Graft ligamentization of the reconstructed anterior cruciate ligament (ACL) using magnetic resonance imaging (MRI) signal intensity at 6 months postoperatively was compared between immature group 2 (n = 16), which included participants from immature group 1, and control group 2 (n = 32), created by recruiting data-matched controls from control group 1. Immature group 1 had significantly higher revision (14.8%) and pivot shift test positive (22.2%) rates than control group 1 (2.9% and 4.0%, respectively) (P = 0.020 and 0.003, respectively). The signal intensity in immature group 2 were significantly higher at the mid-substance and distal site of the reconstructed ACL than those in control group 2 (P = 0.003 and 0.034, respectively). Skeletally immature patients had higher graft revision and residual rotational laxity rates. Reconstructed ACL in skeletally immature patients showed higher signal intensity on MRI at 6 months postoperatively.

scholarly journals Does the Application of Platelet-Rich Fibrin in Anterior Cruciate Ligament Reconstruction Enhance Graft Healing and Maturation? A Comparative MRI Study of 44 Cases

2020 ◽  
Vol 8 (2) ◽  
pp. 232596712090201 ◽  
Author(s):  
Tahsin Beyzadeoglu ◽  
Tuna Pehlivanoglu ◽  
Kerem Yildirim ◽  
Halil Buldu ◽  
Reha Tandogan ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Synovial Fluid ◽  
Acl Reconstruction ◽  
Signal Intensity ◽  
Cruciate Ligament ◽  
Postoperative Blood Loss ◽  
Platelet Rich Fibrin ◽  
Group 2 ◽  
Anterior Cruciate ◽  
Group 1

Background: Anterior cruciate ligament (ACL) reconstruction performed with growth factors and activated platelets has been suggested to accelerate tendon ligamentization, leading to earlier return to daily activities and sports. Hypotheses: Platelet-rich fibrin (PRF) will result in improved graft maturation and healing as evaluated by magnetic resonance imaging (MRI) in patients undergoing hamstring ACL reconstruction. Hemostatic and analgesic properties of PRF will lead to less postoperative blood loss and pain. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 44 patients with isolated ACL injuries who underwent arthroscopic all-inside anatomic single-bundle ACL reconstruction with semitendinosus tendon graft were enrolled. Group 1 included 23 patients who had PRF sprayed to the surface of the graft; group 2 included 21 patients for whom no PRF was used. Patients were discharged after 24 hours and examined for hemarthrosis that needed to be aspirated. MRI was performed at the fifth postoperative month. A blinded radiologist evaluated graft maturation according to its signal intensity and the presence of synovial fluid at the tunnel-graft interface. Results: PRF-treated grafts demonstrated lower MRI signal intensity and less fluid in the graft-tunnel interface as compared with controls for the entire length of the graft. The mean full-length MRI signal intensities were 9.19 versus 16.59 ( P = .047) for groups 1 and 2, respectively. Subgroup analysis of the semitendinosus grafts demonstrated a signal intensity of 11.57 versus 23.98 ( P = .044) for the proximal third, 9.53 versus 13.83 ( P = .237) for the midbody, and 6.48 versus 11.98 ( P = .087) for the distal third. Synovial fluid at the graft-tunnel interface was detected in 1 patient in group 1 (4.3%) and 3 patients in group 2 (14.3%; P < .001). Patients in group 1 had significantly less hemarthrosis that needed to be aspirated ( P = .003), while postoperative analgesia requirements were similar in both groups ( P = .08). No clinical benefit of PRF could be demonstrated in clinical outcomes. Conclusion: Application of PRF led to superior graft integration and maturation in the proximal third of the ACL graft. There was no significant difference in MRI signal intensity in the midbody or distal tibial graft. Application of PRF also resulted in significantly lower rates of postoperative hemarthrosis that needed to be aspirated.

scholarly journals Comparison of Clinical and Radiological Parameters with Two Different Surgical Methods for Anterior Cruciate Ligament Reconstruction

2014 ◽  
Vol 2 (11_suppl3) ◽  
pp. 2325967114S0027
Author(s):  
Osman Çiloğlu ◽  
Hakan Çiçek ◽  
Ahmet Yılmaz ◽  
Metin Özalay ◽  
Gökhan Söker ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Muscle Strength ◽  
Surgical Technique ◽  
Femoral Tunnel ◽  
Cruciate Ligament ◽  
Tunnel Widening ◽  
Isokinetic Muscle Strength ◽  
Group 2 ◽  
Anterior Cruciate ◽  
Group 1

Objectives: We investigated the effects anatomic or nonanatomic femoral tunnel positions and tunnel fixation methods obtained using two different surgery methods on tunnel widening and clinical results in anterior cruciate ligament (ACL) reconstructions. Methods: Patients with isolated anterior cruciate ligament rupture are included to study who don’t have intra-and extra-articular additional pathology of the knee, without previously a history of operations of both knees. 2 groups were created. Group 1 Aperfix implant were used which can be able to perform non anatomical femoral tunnel and intra tunnel fixation with transtibial technique. In Group 2 Endobutton CL implant were used which can make fixation from outside the cortex with anatomic femoral tunnel in use of anteromedial portal techniques. 27 patients (average age 29,33, range 18 to 55 years) in group 1 and 27 patients (average age 27,51, range 16 to 45 years) in group 2 totally 54 patients were performed surgery. All patients were assessed using the IKDC (International knee documentation committee), Tegner Activity Scala and Lysholm II Functional Scores. Muscle strength measurements in both groups compared to intact knee was measured with an isokinetic dynamometer Biodex System 3 Pro. The location of the femoral tunnel aperture and tunnel widening were imaged with 3D reconstructive computed tomography. All measurements were performed using the same software application by the same radiologist. Results: The two groups were similar with respect to age and sex distribution, operated side, the size of the tunnel created, and follow-up period (p>0.05). After surgery in both groups, the clinical scores showed significant improvement compared to preoperative (p=0,0001). However, postoperative clinical outcomes in the two groups did not show a difference significantly (p>0,005). Isokinetic muscle strength study showed significant differences between the two groups (p=0,0001). Location of femoral tunnel aperture on the medial wall of the lateral femoral condyle showed a significant differences in the two groups (p=0,0001). The expansion of proximal and distal femoral tunnel in two groups showed significant differences (p=0,0001). There was relationship between distal femoral tunnel widening and location of femoral tunnel aperture. Conclusion: Although there is no statistically significant difference between the two groups clinically, difference noticed in terms of isokinetic muscle strength may be due to differences in the degree of shift as a result of multiple loading depending on the biomechanical properties of materials. We thought that the difference seen in the widening of tunnel in the proximal or distal may be due to, the technique of graft fixation, the distance between the fixation point and the joint, and to the location of the femoral tunnel aperture on medial wall of lateral condyle from anatomical or non anatomical region. There is no golden standard in neither surgical technique nor material of fixation. Proper theoretical knowledge and extensive clinical experience are important in the light of an accurate surgical technique applied. We thought that information we have reached in our study should be supported by biomechanical studies

Septic Arthritis After Anterior Cruciate Ligament Reconstruction: How Important Is Graft Salvage?

2018 ◽  
Vol 46 (10) ◽  
pp. 2376-2383 ◽  
Author(s):  
Jonas Pogorzelski ◽  
Alexander Themessl ◽  
Andrea Achtnich ◽  
Erik M. Fritz ◽  
Klaus Wörtler ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Resonance Imaging ◽  
Kt 1000 ◽  
Graft Removal ◽  
Group 2 ◽  
Anterior Cruciate ◽  
Group 1

Background: Septic arthritis (SA) of the knee after anterior cruciate ligament reconstruction (ACLR) is a rare but potentially devastating condition. In certain cases, graft removal becomes necessary. Purpose: To evaluate clinical, subjective, and radiologic outcomes of patients with SA after ACLR and assess whether graft retention has superior clinical results as compared with graft removal. Study Design: Cohort study; Level of evidence, 3. Methods: All patients who were at least 12 months out from arthroscopic treatment of SA after isolated ACLR at our institution were eligible for inclusion. Patients were categorized into 2 groups: group 1, patients with initial graft retention; group 2, patients with initial graft removal. Group 2 was subdivided into 2 groups: group 2a, patients with graft reimplantation; group 2b, patients without graft reimplantation. Objective and subjective assessments were obtained at follow-up, including the International Knee Documentation Committee (IKDC) knee examination form, KT-1000 arthrometer measurements, WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) score, Lysholm score, and IKDC subjective evaluation. Radiologic assessment was performed with pre- and postoperative magnetic resonance imaging. Results: Of the 41 patients included, 33 (81%) were available for follow-up at a mean ± SD 54.7 ± 24.4 months at an age of 28.4 ± 9.3 years. When compared with patients from group 2 (n = 12), patients from group 1 (n = 21) obtained significantly better results on the objective IKDC score (normal or nearly normal: group 1, 66.6%; group 2, 36.4%; P = .047) and KT-1000 measurements (group 1, 1.3 ± 1.0 mm; group 2, 2.9 ± 1.5 mm; P = .005). Group 1 also scored better than group 2 on the Lysholm ( P = .007), IKDC subjective ( P = .011), and WOMAC ( P = .069) measures. Between groups 2a (n = 4) and 2b (n = 8), no significant differences in outcomes could be detected ( P values, .307-.705), although patients with anterior cruciate ligament graft reimplantation showed a clear tendency toward better results in objective and not subjective parameters. Magnetic resonance imaging evaluation showed higher rates of cartilage damage and meniscal tears among patients with graft resection versus graft retention. Conclusion: Patients with graft retention showed superior postoperative results when compared with patients who underwent initial graft resection, although subanalysis showed comparable outcomes between graft retention and reimplantation. Thus, while graft-retaining protocols should have the highest priority in the treatment of SA after ACLR, graft reimplantation should be performed in cases where graft resection becomes necessary, to avoid future cartilage and meniscal lesions. Finally, further studies with larger numbers of patients are needed to gain a better understanding of the outcomes of patients with SA after ACLR.

scholarly journals Does anterolateral ligament injury change the treatment option in patients with partial ACL tears?

2021 ◽  
Vol 87 (2) ◽  
pp. 366-373
Author(s):  
Burak Gunaydin ◽  
Tugba Ilkem Kurtoglu Ozcaglayan ◽  
Mehmet Umit Cetin ◽  
Abdulkadir Sari ◽  
Yasar Mahsut Dincel ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Surgical Planning ◽  
Cruciate Ligament ◽  
Anterolateral Ligament ◽  
Ligament Injury ◽  
Choice Of Treatment ◽  
Group 2 ◽  
Anterior Cruciate ◽  
Group 1

Patients with ACL tears with ALL injury have more clinical complaints (instability, feeling of the pop on the knee or knee sliding). patients have ALL injury with partial ACL tears, It is unclear whether the choice of treatment will be conservative or surgical. This study aimed to determine the effect of anterolateral ligament (ALL) status, whether intact or ruptured, on the choice of conservative or surgical treatment in patients with partial anterior cruciate ligament (ACL) tears. Between 2015 and 2019, patients with suspected partial ACL tears were identified on both physical examination and MR imaging. 122 patients who had partial ACL tears and also status of patient’s ALL could be evaluated by radiologist were included in the study, retrospectively. Sixty-two patients who underwent ACL reconstruction were determined as group 1, and 60 patients who did not undergo ACL reconstruction were defined as group 2. In patients with partial ACL rupture with or without ACL reconstruction, it was evaluated whether a ruptured or non- ruptured ALL was effective in this decision of conservative or surgically. The MRIs of patients with partial ACL tears were evaluated by a radiologist and it was concluded that the ALLs of 50 patients were ruptured, and 72 were intact. The ALLs of 36 patients in group 1 were ruptured, and 26 patients were intact. Fourteen patients in group 2 had ruptured ALLs, 46 patient’s ALLs were intact. Seventy-two percent of the patients with partial ACL tears who had ruptured ALLs in MRI underwent ACL reconstruction. It was found that ACL reconstruction was performed more frequently in patients with partial ACL tears with ALL rupture. Therefore, we believe that preoperative evaluations of ALLs using MRI in patients with partial ACL tears are essential for surgical planning.

MRI Signal Intensity of Quadriceps Tendon Autograft and Hamstring Tendon Autograft 1 Year After Anterior Cruciate Ligament Reconstruction in Adolescent Athletes

2021 ◽  
pp. 036354652110404
Author(s):  
Alexandra H. Aitchison ◽  
David Alcoloumbre ◽  
Douglas N. Mintz ◽  
Sofia Hidalgo Perea ◽  
Joseph T. Nguyen ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Signal Intensity ◽  
Cruciate Ligament ◽  
Quadriceps Tendon ◽  
Hamstring Tendon ◽  
Skeletally Immature ◽  
Hamstring Tendon Autograft ◽  
Significant Difference ◽  
Anterior Cruciate ◽  
Tendon Autograft

Background: Hamstring tendon autograft (HTA) is a common graft choice for anterior cruciate ligament (ACL) reconstruction (ACLR) in skeletally immature patients. Recently, the use of quadriceps tendon autograft (QTA) has shown superior preliminary outcomes in this population. Purpose: To evaluate graft maturity by comparing magnetic resonance imaging (MRI) signal intensity of HTA versus QTA used in primary ACLR. Study Design: Cohort study; Level of evidence, 3. Methods: All patients under the age of 18 years who underwent a primary ACLR by the senior authors using either an HTA or a QTA were retrospectively reviewed. A total of 70 skeletally immature patients (37 in the HTA group and 33 in the QTA group) with an available MRI at 6 and 12 months postoperatively were included. Signal intensity ratio (SIR) was measured on sagittal MRI by averaging the signal at 3 regions of interest along the ACL graft and dividing by the signal of the tibial footprint of the posterior cruciate ligament. Statistical analysis was performed to determine interrater reliability and differences between time points and groups. Results: Age, sex, and type of surgery were not associated with any differences in SIR. There was no significant difference in SIR between groups on the 6-month MRI. However, the SIR of the QTA group was significantly less than in the HTA group on the 12-month MRI (2.33 vs 2.72, respectively; P = .028). Within the HTA group, there was no significant difference in SIR at either MRI time point. In the QTA group, there was a significant decrease in SIR between the 6-month and 12-month postoperative MRI (2.70 vs 2.33, respectively; P = .045). Conclusion: These findings suggest improved graft maturation, remodeling, and structural integrity of the QTA compared with the HTA between 6 and 12 months postoperatively. This provides evidence that, at 1 year postoperatively, QTA may have a superior rate of incorporation and synovialization as compared with the HTA.

Comparison of Clinical and Radiological Parameters with Two Different Surgical Methods for Anterior Cruciate Ligament Reconstruction

2020 ◽  
Vol 33 (09) ◽  
pp. 938-946
Author(s):  
Osman Çiloğlu ◽  
Hakan Çiçek ◽  
Ahmet Yılmaz ◽  
Metin Özalay ◽  
Gökhan Söker ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Peak Torque ◽  
Tunnel Enlargement ◽  
Clinical Scores ◽  
Significant Difference ◽  
The Mean ◽  
Group 2 ◽  
Anterior Cruciate ◽  
Group 1

AbstractThis study compared the clinical and radiological findings of nonanatomic transtibial (TT) technique with intraspongious fixation and anatomical anteromedial portal (AMP) technique with extracortical button implant in anterior cruciate ligament (ACL) reconstruction. A total of 54 patients with isolated ACL rupture were included in this prospective study. The patients who had the intraspongious fixation by nonanatomical TT technique were allocated to Group 1 (n = 27). The patients with extracortical fixation by anatomical AMP technique were placed in Group 2 (n = 27). The clinical scores of the patients were evaluated with the International Knee Documentation Committee Evaluation Form, Tegner activity score, and Lysholm II Functional Scoring. The tibial and femoral tunnels were evaluated with three-dimensional computed tomography. The kinematic examinations were performed with a Biodex System 3 Pro isokinetic dynamometer. There was no significant difference between the groups in terms of demographic data (p > 0.05). The postoperative clinical scores improved significantly in both the groups compared with the preoperative levels (p = 0.001), but there was no significant difference in the postoperative clinical scores between the groups (p > 0.05). In the extension and flexion of 60 to 180 degrees/s, the peak torque and the peak torque/body weight values of the repaired knee to intact knee ratios showed significant differences in favor of Group 2 (p = 0.001). In both the groups, no significant difference was found between the mean extent of the tunnel enlargement (p > 0.05). The mean tunnel height was significantly greater in Group 1 (45% ± 9.86 vs. 34.11% ± 10.0%) (p = 0.001). When the localization of the tunnel enlargements (proximal-middle-distal) was examined, a significant difference was found between the groups (p = 0.001). Although the AMP technique, which is a more anatomic reconstruction, had an advantage with regard to tunnel enlargement and the isokinetic muscle studies, there was no difference between the two techniques in terms of the clinical results.

scholarly journals Comparative analysis of arthroscopic techniques of anterior cruciate ligament reconstruction in adolescents

2020 ◽  
Vol 8 (3) ◽  
pp. 259-268
Author(s):  
Marsel R. Salikhov ◽  
Vladislav V. Avramenko
Keyword(s):  
Anterior Cruciate Ligament ◽  
Comparative Analysis ◽  
Cruciate Ligament ◽  
Rotational Stability ◽  
Femoral Canal ◽  
Group 3 ◽  
Group 2 ◽  
Anterior Cruciate ◽  
Anterior Posterior ◽  
Group 1

Background. According to the considerably contradictory information across the international literature, both the anatomical and transtibial reconstruction of the anterior cruciate ligament (ACL), under similar conditions, yield good functional results from treatment. Therefore, it is important to evaluate the comparative effectiveness and the prospects of certain methods of ACL reconstruction. The purpose of this study was to analyze the possibilities and advantages of anatomical technologies for the reconstruction intervention. Aim. To compare the outcomes of ACL reconstructions among adolescent children using different methods. Materials and methods. The outcomes of 94 arthroscopic reconstructions of the ACL in adolescents were analyzed. The patients were categorized into 3 groups: Group 1 included 32 patients (34%) who underwent isometric plastic surgery of the ACL, wherein the femoral canal was formed using the transtibial technique. Group 2 included 30 patients (32%) who underwent anatomical plastic surgery of the ACL, with the formation of the femoral canal through additional anteromedial arthroscopic access. Group 3 included 32 patients (34%) who underwent the all-inside anatomical reconstruction of the ACL. Results. A comparative analysis of the outcomes of reconstruction of the ACL among adolescents revealed that the anterior-posterior and rotational stability of the knee joint was better in group 3 patients than in groups 1 and 2 patients. In fact, the group 3 patients showed a significantly less positive pivot-shift (0 degree to 87.5%; I+ the extent of 12.5%) than the group 1 patients (0 degree 46.8%; I+ degree 25%; II+ degree and 21.9%; III+ degree and 6.3%), followed by the group 2 patients (0 degree to 86.6%; I+ degree 6.7%; II+ degree of 6.7%). Conclusion. Considering the safety aspects of intra-articular structures and for the better anatomical orientation of the femoral canal, the all-inside method of ACL reconstruction yielded better outcomes of postoperative anterior-posterior and rotational stability of the knee joint.

scholarly journals Anatomical anterograde plasty of the anterior cruciate ligament with lateral extraarticular tenodesis from semitendinosus tendon

2018 ◽  
Vol 25 (3-4) ◽  
pp. 12-18
Author(s):  
V. V Zayats ◽  
N. V Zagorodniy ◽  
A. K Dulaev ◽  
A. V Dydykin
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Sport Activity ◽  
Scientific Basis ◽  
Semitendinosus Tendon ◽  
Pivot Shift Test ◽  
Additional Element ◽  
Rotational Joint ◽  
Group 2 ◽  
Anterior Cruciate

Purpose of the study: to provide a scientific basis for the recommendations on clinical use of lateral extraarticular tenodesis (LEAT) from semitendinosus tendon (ST) graft as an additional element for knee stability in anterior cruciate ligament (ACL) anatomical anterograde reconstruction. Patients and methods. Treatment results were evaluated for 162 patients (mean age 27.2±2.8) with marked rotational joint instability (Pivot shift test 3+) after arthroscopic anterior cruciate ligament reconstruction (ACL-R). In 44 (27.2%) observations ACL-R was supplemented by LEAT from ST (group 1), in 118 (72.8%) the isolated anatomical anterograde plasty of ACL was performed (group 2). Lysholm Knee Scoring Scale, KOOS and 2000 IKDC were used for the assessment of the results. Results. Follow up period made up at least 2 years. Statistically significant differences between the groups were recorded in 21 months after intervention and later. In 43 (97.7%) patients from the 1group and 111 (94.1%) patients from the 2group excellent and good results (A and B by 2000 IKDC) were achieved. In 1 (2.3%) and 7 (5.9%) patients the results were assessed as satisfactory (C by 2000 IKDC), respectively. No statistically significant differences between the groups were recorded by Lysholm Knee Scoring Scale and 2000 IKDC (p>0.05). The average scores by KOOS that indicated the presence of pathological processes in the knee joint and characterized patient’s sport activity were statistically (p

scholarly journals Functional results of surgical reconstruction of the anterior cruciate ligament of the knee joint in combination with lateral stabilization

2019 ◽  
Vol 178 (1) ◽  
pp. 39-44 ◽  
Author(s):  
V. V. Zayats ◽  
A. K. Dulaev ◽  
N. V. Zagorodnii ◽  
A. V. Dydykin ◽  
I. N. Ulianchenko
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Joint ◽  
Cruciate Ligament ◽  
Functional Results ◽  
Surgical Reconstruction ◽  
Pivot Shift Test ◽  
Sports Activity ◽  
Group 2 ◽  
Anterior Cruciate ◽  
Bone Autograft

Theobjectivewas to compare the effectiveness of isolated anatomical antegrade reconstruction of the anterior cruciate ligament (ACL) with bonetendon-bone autograft (BTB autograft) and in combination with lateral extra-articular tenodesis (LEAT) graft from the iliotibial tract (ITT).Material and methods. We analyzed 187 arthroscopic ACL reconstructions in patients with a Pivot shift test – 3+ degree. We performed an isolated ACL-R in 118 (63.1 %) patients in group 1 and added the LEAT from ITB to it in group 2.Results. According to IKDC-2000: 176 (94.1 %) patients were included in categories A and B, 11 (5.9 %) – in C. Significant differences in these groups appeared 15 months after the operation. According to KOSS: in group 2, the anterior and rotational knee stability, as well as the level of sports activity were higher, and pathological symptoms were less common.Conclusion. LEAT from ITB increases stability and functionality of the knee joint in patients with anatomical antegrade ACL reconstructions with BTB-autograft for terms over 15 months after the operation, and is an economically procedure.

The Relationship Between Intercondylar Notch Width of the Femur and the Incidence of Anterior Cruciate Ligament Tears

1998 ◽  
Vol 26 (3) ◽  
pp. 402-408 ◽  
Author(s):  
K. Donald Shelbourne ◽  
Thorp J. Davis ◽  
Thomas E. Klootwyk
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Intercondylar Notch ◽  
Men And Women ◽  
Notch Width ◽  
Significant Difference ◽  
Group 2 ◽  
Anterior Cruciate ◽  
Intercondylar Notch Width ◽  
Group 1

For 714 consecutive patients who underwent autogenous patellar tendon graft anterior cruciate ligament reconstructions we intraoperatively measured intercondylar notch width. We prospectively recorded height, weight, sex, and which patients subsequently tore their contralateral anterior cruciate ligament or the 10-mm autograft. The patients were divided into two groups based on notch width (group 1, 15 mm; group 2, 16 mm). The mean notch width was 13.9 2.2 mm for women and 15.9 2.5 mm for men. There was no statistically significant difference in notch width between height groups for women or men. Analysis showed that, with height and weight as covariates, women had statistically significantly narrower notches than men. Twenty-three of 388 patients in group 1 and 4 of 326 patients in group 2 tore their contralateral anterior cruciate ligaments. Within groups, no statistically significant differences in contralateral tear rates existed between men and women. Once the men and women had reconstructions with equally sized 10-mm autografts, there was no difference in graft tear rate between groups or between men and women. Our results show that patients with narrower notches have a higher incidence of tearing their contralateral anterior cruciate ligament. After reconstruction with a 10-mm autograft, the incidence of graft rupture is the same for men and women.

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