ACL Reconstruction: Is There A Difference In Graft Motion For Bone-patellar Tendon-bone Vs Hamstring Autograft At 6 Weeks Post-operatively?

Abstract Background ACL reconstruction surgeries is a common surgery that aim to provide stability and return functionality post ACL injury. Commonly, bone patellar tendon-bone (BPTB) and hamstring tendon autografts are used for the reconstruction. The choice of optimal autograft remains debatable to achieve satisfactory outcomes for various activities after reconstruction, including kneeling as widely needed, especially in prayers among Muslims. Kneeling with considerable ranges of motion and the minimum level of pain is still under rigorous investigations to choose proper autograft. Purpose Hereby, we compare kneeling outcomes post-operatively using bone-patellar tendon-bone autografts with hamstring autografts for ACL reconstruction. Methods A retrospective cohort study; Level of evidence (III) has enrolled. Adult patients underwent primary ACL reconstruction using either BPTB or HS autografts after they consented at a single institution with a minimum of 1-year as follow-up post-operatively were reviewed for assessment of the surgery’s outcomes in regards of kneeling pain and subjective assessment measures using International Knee Documentation Committee (IKDC) evaluation system. Results A total of Thirty-two males were met our inclusion criteria. Analysis of data provided that 12 patients were in the BTB group and 20 patients in the HS group. In all patients of our study, ACL rupture was sustained during participation in athletic activity regardless the type of sport with 60.8% patients were affected of left knee. After follow-up of 1-year, clinical evaluation of anterior drawer test postoperatively resulted with Two patients in HS group were positive. There was no statistically significant difference between scores of two groups when comparing patient-reported outcome measures, with mean IKDC scores of 68.5 and 62.55 in the BTB and HS groups, respectively. Interestingly, insignificant statistical difference observed in both groups in regard of kneeling pain in the BTB group when compared with the HS group. Conclusion The findings of our study have shown that Arthroscopic ACL reconstruction using either hamstring autograft or bone patellar tendon autograft ends with equally reasonable satisfactory outcomes, with an insignificant difference in kneeling pain between both groups.

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Kneeling Assessment After Anterior Cruciate Ligament Reconstruction Using Bone-Patellar Tendon-Bone Autograft Versus Hamstring Autograft

10.21203/rs.3.rs-26629/v1 ◽

2020 ◽

Author(s):

Fahad Al Hulaibi ◽

Zainab Al Eid ◽

Saad Al Taher ◽

Abdulaziz Albarrak ◽

Zaid Alzaid

Keyword(s):

Acl Reconstruction ◽

Patellar Tendon ◽

Evaluation System ◽

Cruciate Ligament ◽

Hamstring Autograft ◽

Level Of Evidence ◽

Significant Difference ◽

Patient Reported ◽

Bone Patellar Tendon

Abstract Background: ACL reconstruction surgeries is a common surgery that aim to provide stability and return functionality post ACL injury. Commonly, bone patellar tendon-bone (BPTB) and hamstring tendon autografts are used for the reconstruction. The choice of optimal autograft remains debatable to achieve satisfactory outcomes for various activities after reconstruction, including kneeling as widely needed, especially in prayers among Muslims. Kneeling with considerable ranges of motion and the minimum level of pain is still under rigorous investigations to choose proper autograft.Purpose: Hereby, we compare kneeling outcomes post-operatively using bone-patellar tendon-bone autografts with hamstring autografts for ACL reconstruction.Methods: A retrospective cohort study; Level of evidence (III) has enrolled. Adult patients underwent primary ACL reconstruction using either BPTB or HS autografts after they consented at a single institution with a minimum of 1-year as follow-up post-operatively were reviewed for assessment of the surgery’s outcomes in regards of kneeling pain and subjective assessment measures using International Knee Documentation Committee (IKDC) evaluation system.Results: A total of Thirty-two males were met our inclusion criteria. Analysis of data provided that 12 patients were in the BPTB group and 20 patients in the HS group. All patients show ACL rupture was sustained during participation in the athletic activity. After a follow-up of 1-year, there was no statistically significant difference between scores of two groups when comparing patient-reported outcome measures, with mean IKDC scores of 68.5 and 62.55 in the BPTB and HS groups, respectively. Interestingly, insignificant statistical differences observed in both groups regarding kneeling pain in the BPTB group when compared with the HS group.Conclusion: The findings of our study have shown that Arthroscopic ACL reconstruction using either hamstring autograft or bone patellar tendon autograft ends with equally reasonable satisfactory outcomes, with an insignificant difference in kneeling pain between both groups.

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Functional Outcome Comparison of Implant-Free Bone-Patellar Tendon Autograft in Arthroscopic ACL Reconstruction

Case Medical Research ◽

10.31525/ct1-nct04123834 ◽

2019 ◽

Author(s):

Keyword(s):

Functional Outcome ◽

Acl Reconstruction ◽

Patellar Tendon ◽

Patellar Tendon Autograft ◽

Outcome Comparison ◽

Tendon Autograft ◽

Bone Patellar Tendon

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Intra-articular Morphine and Ropivacaine Injection Provides Efficacious Analgesia As Compared With Femoral Nerve Block in the First 24 Hours After ACL Reconstruction: Results From a Bone–Patellar Tendon–Bone Graft in an Adolescent Population

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120985902 ◽

2021 ◽

Vol 9 (3) ◽

pp. 232596712098590

Author(s):

Brendon C. Mitchell ◽

Matthew Y. Siow ◽

Andrew T. Pennock ◽

Eric W. Edmonds ◽

Tracey P. Bastrom ◽

...

Keyword(s):

Pain Management ◽

Acl Reconstruction ◽

Patellar Tendon ◽

Nerve Block ◽

Femoral Nerve Block ◽

Femoral Nerve ◽

Single Shot ◽

Pain Scores ◽

Peripheral Block ◽

Bone Patellar Tendon

Background: Opioid consumption and patient satisfaction are influenced by a surgeon’s pain-management protocol as well as the use of adjunctive pain mediators. Two commonly utilized adjunctive pain modifiers for anterior cruciate ligament (ACL) reconstruction are femoral nerve blockade and intra-articular injection; however, debate remains regarding the more efficacious methodology. Hypothesis: We hypothesized that intra-articular injection with ropivacaine and morphine would be found to be as efficacious as a femoral nerve block for postoperative pain management in the first 24 hours after bone–patellar tendon–bone (BTB) ACL reconstruction. Study Design: Cohort study; Level of evidence, 3. Methods: Charts were retrospectively reviewed for BTB ACL reconstructions performed by a single pediatric orthopaedic surgeon from 2013 to 2019. Overall, 116 patients were identified: 58 received intra-articular injection, and 58 received single-shot femoral nerve block. All patients were admitted for 24 hours. Pain scores were assessed every 4 hours. Morphine milligram equivalents (MMEs) consumed were tabulated for each patient. Results: Opioid use was 24.3 MMEs in patients treated with intra-articular injection versus 28.5 MMEs in those with peripheral block ( P = .108). Consumption of MMEs was greater in the intra-articular group in the 0- to 4-hour period (7.1 vs 4.6 MMEs; P = .008). There was significantly less MME consumption in patients receiving intra-articular injection versus peripheral block at 16 to 20 hours (3.2 vs 5.6 MMEs; P = .01) and 20 to 24 hours (3.8 vs 6.5 MMEs; P < .001). Mean pain scores were not significantly different over the 24-hour period (peripheral block, 2.7; intra-articular injection, 3.0; P = .19). Conclusion: Within the limitations of this study, we could identify no significant difference in MME consumption between the single-shot femoral nerve block group and intra-articular injection group in the first 24 hours postoperatively. While peripheral block is associated with lower opioid consumption in the first 4 hours after surgery, patients receiving intra-articular block require fewer opioids 16 to 24 hours postoperatively. Given these findings, we propose that intra-articular injection is a viable alternative for analgesia in adolescent patients undergoing BTB ACL reconstruction.

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