Chronological Changes in Anterior Knee Stability after Anatomical Anterior Cruciate Ligament Reconstruction Using Bone–Patellar Tendon–Bone and Hamstring Grafts

2019 ◽  
Author(s):  
Kohei Kawaguchi ◽  
Shuji Taketomi ◽  
Hiroshi Inui ◽  
Ryota Yamagami ◽  
Keiu Nakazato ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Patellar Tendon ◽  
Cruciate Ligament ◽  
Knee Stability ◽  
Bptb Graft ◽  
Anterior Cruciate ◽  
Double Bundle Acl Reconstruction ◽  
Anterior Knee ◽  
Bone Patellar Tendon

AbstractThe clinical outcomes of anterior cruciate ligament (ACL) reconstruction are typically evaluated at specific time points only. This study aimed to characterize the chronological changes in anterior knee stability after anatomical ACL reconstruction and to compare the anterior knee stability achieved with bone–patellar tendon–bone (BPTB) and hamstring tendon (HT) grafts. A total of 59 patients underwent anatomical rectangular tunnel ACL reconstruction using the BPTB graft and 23 patients underwent anatomical double-bundle ACL reconstruction using the HT graft. Anterior knee stability was quantitatively assessed using the KneeLax 3 arthrometer at 6 months, 1 year, and 2 years after surgery using side-to-side differences. The values for anterior knee stability using the BPTB graft were 0.3 mm after 6 months, 0.2 mm after 1 year, and 0.2 mm after 2 years, and no significant differences were observed during the postoperative study period. Meanwhile, the values for anterior knee stability using the HT graft were −0.3 mm after 6 months, 0.5 mm after 1 year, and 1.2 mm after 2 years, and anterior knee stability decreased chronologically from 6 months up to 2 years. Regarding anterior stability, the HT graft showed significant laxity compared with the BPTB graft only after 2 years. No chronological changes in anterior stability were observed from 6 months up to 2 years after ACL reconstruction using the BPTB graft, whereas anterior laxity developed during the same period after ACL reconstruction using the HT graft. This is a Level IV, therapeutic case series study.

scholarly journals Correlation between radiological and clinical findings after anterior cruciate ligament reconstruction

2006 ◽  
Vol 59 (9-10) ◽  
pp. 421-425 ◽  
Author(s):  
Srdjan Ninkovic ◽  
Aleksandar Milicic ◽  
Dragan Savic ◽  
Milan Stankovic ◽  
Srdjan Radic ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Clinical Outcome ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Patellar Tendon ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Knee Stability ◽  
Cruciate Ligament Reconstruction ◽  
Anterior Cruciate ◽  
Bone Patellar Tendon

Introduction. In the last two decades, the gold standard for anterior cruciate ligament reconstruction is the bone-patellar tendon-bone graft procedure. Correct position of the bone-patellar tendon-bone graft significantly affects the postoperative knee stability. The aim of this study was to establish if and how clinically measured knee stability is associated with radiographic position of bone-patellar tendon-bone graft in the femoral and tibial bones. Material and methods. The prospective study included 39 patients, 30 men and 9 women. We analyzed and compared results of clinical and radiographic examinations prior to and 2 years following surgery. Results. The mean arthrometric difference between the anterior tibial movement prior to surgery was 11,2mm and 2,4mm (p<0,05) after surgery. The preoperative Tegner and Lysholm score was 1,49, and postoperative 8,23 (p<0,05). The preoperative Lysholm-Gillquist scale was 51,56 and postoperative 97,74 (p<0,05). The International Knee Documentation Committee (IKDC) scores were as follows: grade A in 32 patients (84.6%), grade B in 5 patients (12.8%), and grade C in 1 patient (2.6%). By comparison of IKDC scores and radiographic parameters (M1 - M10) of anterior-posterior and profile views, a statistical significance was found only between IKDC and M9 index (sagittal femoral index OR?/RR? x 100). Discussion. By using bone-patellar tendon-bone grafts, it is not possible to entirely achieve anatomical positions. Correct graft position within the bone tunnels is of great significance concerning knee stability after anterior cruciate ligament reconstruction. Conclusion. Correlation between radiological and clinical findings after anterior cruciate ligament reconstruction in our 39 patients shows that only the position of the graft affects the clinical outcome. Posterior graft location provides better clinical outcome and knee stability. On the other hand, anterior location is associated with worse postoperative IKDC scores, unstable knee and worse clinical outcome. .

scholarly journals Prevalence and clinical implications of nerve injury during bone patellar tendon bone harvesting for anterior cruciate ligament reconstruction

2017 ◽  
Vol 25 (1) ◽  
pp. 230949901668498 ◽  
Author(s):  
Barak Haviv ◽  
Mustafa Yassin ◽  
Ehud Rath ◽  
Shlomo Bronak
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Patellar Tendon ◽  
Cruciate Ligament ◽  
Sensory Nerve ◽  
Sensory Loss ◽  
Anterior Cruciate ◽  
Bone Patellar Tendon ◽  
Sensation Loss

Purpose: Tendon harvesting for anterior cruciate ligament (ACL) reconstruction often injure sensory branches of the saphenous nerve (SN). Our purpose was to estimate the prevalence and postoperative course of sensory nerve injuries in bone patellar tendon bone (BPTB) autograft harvesting for ACL reconstruction. Methods: Between 2012 and 2014, patients who had primary ACL with BPTB autograft were included ( n = 60) and interviewed specifically for sensory loss and its recovery. The surface area of sensory loss was documented. Evaluation also included demographic details, level of activity, and description of postoperative sensation disturbances. Results: The mean postoperative follow-up time was 24 ± 14 months. At the last follow-up, 46 (77%) patients reported on postoperative reduced sensation; however, only 35 (58%) remained with sensation loss. The most involved region of reduced sensation was of the infrapatellar branch of the SN. Three patients claimed they regret to have had the surgery specifically because of sensation loss and kneeling difficulties, while all others did not. Conclusion: Primary ACL reconstruction using the midline incision for harvesting the middle third of the patellar tendon autograft has a high prevalence of sensory nerve injury with a minor possibility for complete recovery within the first year. However, sensory loss secondary to this injury does not impair normal daily activities in these patients.

scholarly journals Functional outcome of anterior cruciate ligament reconstruction using bone-patellar tendon-bone graft: a descriptive observational study from Telangana

2021 ◽  
Author(s):  
K. Jaya Krishna Singh ◽  
V. K. V. Prasad ◽  
T. Ashita Singh ◽  
Anant A. Takalkar
Keyword(s):  
Anterior Cruciate Ligament ◽  
Observational Study ◽  
Functional Outcome ◽  
Acl Reconstruction ◽  
Patellar Tendon ◽  
Cruciate Ligament ◽  
Simple Random Sampling ◽  
Anterior Cruciate ◽  
Bone Autograft ◽  
Bone Patellar Tendon

<p><strong>Background: </strong>The knee joint is the most commonly injured of all joints and the anterior cruciate ligament is the most commonly injured ligament. The bone-patellar tendon-bone (BPTB) autograft is the most commonly used autograft for reconstruction. The bone-patellar tendon-bone autograft has been widely accepted as the gold standard for ACL reconstruction with a high success rate. Objectives of the study were to study the functional outcome of ACL reconstruction using BPTB graft.</p><p><strong>Methods: </strong>The present descriptive observational study was carried out at department of orthopedics, Mediciti institute of medical sciences, Hyderabad involving 30 patients of ACL tear by simple random sampling method. Patients were then evaluated by both subjectively and objectively. They were evaluated by using Lysholm and Gilquist knee scoring scale. Data was analyzed by using SPSS 24.0 version IBM USA.</p><p><strong>Results: </strong>Majority of the patients i.e., 13 (43.3%) were from 26-35 years age group with right sided involvement in 60%. The result was found to be good in 16 i.e., 53.3%, excellent in 10 i.e., 33.3% and fair in 4 i.e., 13.3% patients. Prevalence of complications was reported as 23.3% in our study.</p><p><strong>Conclusions: </strong>Our study of ACL repair using BPTP gives good to excellent results within a span of one year.</p>

scholarly journals Advanced Patellar Tendinopathy Is Associated With Increased Rates of Bone–Patellar Tendon–Bone Autograft Failure at Early Follow-up After Anterior Cruciate Ligament Reconstruction

2018 ◽  
Vol 6 (11) ◽  
pp. 232596711880771 ◽  
Author(s):  
Alexander L. Lazarides ◽  
Eduard Alentorn-Geli ◽  
Emily N. Vinson ◽  
Thomas W. Hash ◽  
Kristian Samuelsson ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Patellar Tendon ◽  
Graft Failure ◽  
Cruciate Ligament ◽  
Patellar Tendinopathy ◽  
Anterior Cruciate ◽  
Primary Acl Reconstruction ◽  
Bone Patellar Tendon

Background: Revision anterior cruciate ligament (ACL) reconstruction can be potentially devastating for a patient. As such, it is important to identify prognostic factors that place patients at an increased risk for graft failure. There are no data on the effects of patellar tendinopathy on failure of ACL reconstruction when using a bone–patellar tendon–bone (BPTB) autograft. Purpose/Hypothesis: The purpose of this study was to investigate the association of patellar tendinopathy with the risk of graft failure in primary ACL reconstruction when using a BPTB autograft. The hypothesis was that patellar tendinopathy would result in higher rates of graft failure when using a BPTB autograft for primary ACL reconstruction. Study Design: Cohort study; Level of evidence, 3. Methods: All patients undergoing ACL reconstruction at a single institution from 2005 to 2015 were examined. A total of 168 patients undergoing primary ACL reconstruction with a BPTB autograft were identified. Patients’ magnetic resonance imaging scans were reviewed for the presence and grade of patellar tendinopathy by 2 musculoskeletal fellowship–trained radiologists; both were blinded to the aim of the study, patient demographics, surgical details, and outcomes. Patients were divided into 2 groups: failure (defined as presence of symptomatic laxity or graft insufficiency) and success of the ACL graft. Statistical analyses were run to examine the association of patellar tendinopathy with failure of ACL reconstruction using a BPTB autograft. Results: At a mean follow-up of 18 months, there were 7 (4.2%) patients with graft failure. Moderate or severe patellar tendinopathy was associated with ACL graft failure ( P = .011). Age, sex, and side of reconstruction were not associated with the risk of graft failure, although the majority of patients who failed were younger than 20 years. The use of patellar tendons with moderate to severe tendinopathy was associated with a relative risk of ruptures of 6.1 (95% CI, 1.37-27.34) as compared with autograft tendons without tendinopathy. Conclusion: Moderate or severe patellar tendinopathy significantly increases the risk of graft failure when using a BPTB autograft for primary ACL reconstruction. Patellar tendinopathy should be considered when determining the optimal graft choice for patients undergoing primary ACL reconstruction with autograft tendons.

scholarly journals Outcome of anterior cruciate ligament reconstruction using bone-patellar tendon-bone auto graft

2018 ◽  
Vol 5 (1) ◽  
pp. 22-25
Author(s):  
Gajendra Mani Shah ◽  
Nabees Man Singh Pradhan ◽  
Rojan Tamrakar ◽  
Bidur Gyawali ◽  
Toya Raj Bhatta ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Patellar Tendon ◽  
Anterior Cruciate Ligament Injury ◽  
Cruciate Ligament ◽  
Normal Function ◽  
Ligament Injury ◽  
Patient’S Satisfaction ◽  
Anterior Cruciate ◽  
Bone Patellar Tendon

Introductions: A rupture of the Anterior Cruciate Ligament (ACL) is the most common ligament injury resulting in instability of the knee which can cause secondary articular injury and early osteoarthritis (OA). Aim of this study was to evaluate the short term outcomes of ACL reconstruction using Bone Patellar Tendon Bone Auto Graft (BPTB) auto graft and factors that might contribute to poor results. Methods: Patients with Anterior Cruciate Ligament injury during the period of July 2013 to May 2014 were enrolled to observe the outcome of the ACL reconstruction using BPTB without arthroscopy. Lysholm Knee Scoring Scale was used to determine the clinical outcome. Outcome parameters were evaluated using Statistical Package for Social Science Version 20 (SPSS). Results: Total 30 normal or near normal function outcome of knee was reported in 29 (97%) patients after ACL reconstruction using BPTB without arthroscopy. There was no failure of grafts. Good static knee stability achieved with increased patient’s satisfaction. Lysholm Score was excellent in 27 (90%) and good in 3 (10 %) cases. Anterior knee pain persisted in 6 cases (20%). Conclusions: Excellent functional outcome with BPTB auto graft in Anterior Cruciate Ligament injury was achieved.

scholarly journals Prospective and Randomized Clinical Evaluation of Hamstring Versus Patellar Tendon Autograft for Anterior Cruciate Ligament Reconstruction in Soccer Players

2021 ◽  
Vol 9 (9) ◽  
pp. 232596712110281
Author(s):  
Luiz Gabriel Betoni Guglielmetti ◽  
Victor Eduardo Roman Salas ◽  
Pedro Baches Jorge ◽  
Fabrício Roberto Severino ◽  
Aires Duarte ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Patellar Tendon ◽  
Knee Pain ◽  
Anterior Knee Pain ◽  
Cruciate Ligament ◽  
Soccer Players ◽  
Outcome Score ◽  
Anterior Cruciate ◽  
Anterior Knee

Background: Anterior cruciate ligament (ACL) reconstruction is usually performed with autologous bone–patellar tendon–bone (PT) or hamstring tendon (HT) graft. There has been only 1 randomized clinical trial examining ACL reconstruction with these grafts specifically in soccer players, and more studies comparing these graft types within a homogenous cohort such as soccer athletes may better highlight differences in outcomes. Purpose: To compare the results of ACL reconstruction with PT versus HT autograft in soccer players and to evaluate objective and subjective outcomes. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A total of 62 professional or semiprofessional soccer players (mean age, 25.1 years) with ACL injury were randomized to undergo reconstruction with PT or HT autograft by a single orthopaedic surgeon (n = 31 in each group). Outcome measures were recorded preoperatively and at 2 years postoperatively. The primary outcome was the modified Cincinnati Knee Rating System, and secondary outcomes were the objective and subjective International Knee Documentation Committee scores, Lachman test, pivot-shift test, anterior drawer test, and Lysholm score. The following variables were also evaluated postoperatively: return to soccer, level at return, graft rerupture, postoperative complications, anterior knee pain, patellar tendinitis, difficulty sprinting, and loss of kicking power. Results: The PT and HT groups were homogenous in terms of age, sex distribution, injured side, and time from injury to surgery, and there was no difference between them on any preoperative outcome score. At 2 years postoperatively, there were no differences between the groups on any outcome score; however, there were significantly fewer patients with anterior knee pain in the HT group compared with the PT group (7 [22.6%] vs 15 [48.4%], respectively; P = .03). Two patients from each group (2/31; 6.5%) sustained rerupture. Conclusion: There were no differences between soccer players who underwent different types of ACL reconstruction with the exception of anterior knee pain, which was more frequent in players who underwent reconstruction with PT graft. Registration: NCT02642692 ( ClinicalTrials.gov ).

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