scholarly journals Anterior cruciate ligament reconstruction with quadriceps tendon-patellar bone allograft: matched case control study

2018 ◽  
Vol 19 (1) ◽  
Author(s):  
Yoon-Ho Kwak ◽  
Sahnghoon Lee ◽  
Myung Chul Lee ◽  
Hyuk-Soo Han
Keyword(s):  
Ligament Reconstruction ◽  
Case Control Study ◽  
Cruciate Ligament ◽  
Bone Allograft ◽  
Quadriceps Tendon ◽  
Case Control ◽  
Matched Case ◽  
Anterior Cruciate ◽  
Matched Case Control Study ◽  
Control Study

The Association Between Tibial Slope and Revision Anterior Cruciate Ligament Reconstruction in Patients ≤21 Years Old: A Matched Case-Control Study Including 317 Revisions

2019 ◽  
Vol 47 (14) ◽  
pp. 3330-3338 ◽  
Author(s):  
Joseph D. Cooper ◽  
Wei Wang ◽  
Heather A. Prentice ◽  
Tadashi T. Funahashi ◽  
Gregory B. Maletis
Keyword(s):  
Ligament Reconstruction ◽  
Case Control Study ◽  
Cruciate Ligament ◽  
Tibial Slope ◽  
Case Control ◽  
Matched Case ◽  
Slope Difference ◽  
Anterior Cruciate ◽  
Matched Case Control Study ◽  
Control Study

Background: There is evidence that tibial slope may play a role in revision risk after anterior cruciate ligament reconstruction (ACLR); however, prior studies are inconsistent. Purpose: To determine (1) whether there is a difference in lateral tibial posterior slope (LTPS) or medial tibial posterior slope (MTPS) between patients undergoing revised ACLR and those not requiring revision and (2) whether the medial-to-lateral slope difference is different between these 2 groups. Study Design: Case-control study; Level of evidence, 3. Methods: We conducted a matched case-control study (2006-2015). Cases were patients aged ≤21 years who underwent revision surgery after primary unilateral ACLR; controls were patients aged ≤21 years without revision who were identified from the same source population. Controls were matched to cases by age, sex, body mass index, race, graft type, femoral fixation device, and post-ACLR follow-up time. Tibial slope measurements were made by a single blinded reviewer using magnetic resonance imaging. The Wilcoxon signed rank test and McNemar test were used for continuous and categorical variables, respectively. Results: No difference was observed between revised and nonrevised ACLR groups for LTPS (median: 6° vs 6°, P = .973) or MTPS (median: 4° vs 5°, P = .281). Furthermore, no difference was found for medial-to-lateral slope difference (median: −1 vs −1, P = .289). A greater proportion of patients with revised ACLR had an LTPS ≥12° (7.6% vs 3.8%) and ≥13° (4.7% vs 1.3%); however, this was not statistically significant after accounting for multiple testing. Conclusion: We failed to observe an association between revision ACLR surgery and LTPS, MTPS, or medial-to-lateral slope difference. However, there was a greater proportion of patients in the revision ACLR group with an LTPS ≥12°, suggesting that a minority of patients who have more extreme values of LTPS have a higher revision risk after primary ACLR. A future cohort study evaluating the angle that best differentiates patients at highest risk for revision is needed.

scholarly journals Ultrasonographic Assessment of Femoral Cartilage in Individuals With Anterior Cruciate Ligament Reconstruction: A Case-Control Study

2018 ◽  
Vol 53 (11) ◽  
pp. 1082-1088 ◽  
Author(s):  
Matthew S. Harkey ◽  
J. Troy Blackburn ◽  
Daniel Nissman ◽  
Hope Davis ◽  
Isaac Durrington ◽  
...  
Keyword(s):  
Ligament Reconstruction ◽  
Case Control Study ◽  
Cruciate Ligament ◽  
Case Control ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Cross Sectional ◽  
Femoral Cartilage ◽  
Anterior Cruciate ◽  
Control Study

Context Developing osteoarthritis is common after anterior cruciate ligament reconstruction (ACLR). Monitoring changes in femoral cartilage size after ACLR may be a way to detect the earliest structural alterations before the radiographic onset of osteoarthritis. Diagnostic ultrasonography (US) offers a clinically accessible and valid method for evaluating anterior femoral cartilage size. Objective To compare the US measurements of anterior femoral cross-sectional area and cartilage thickness between limbs in individuals with a unilateral ACLR and between the ACLR limbs of these individuals and the limbs of uninjured control participants. Design Case-control study. Setting Research laboratory. Patients or Other Participants A total of 20 volunteers with an ACLR (37.0 ± 26.6 months after surgery) and 28 uninjured volunteers. Main Outcome Measure(s) We used US to assess anterior femoral cartilage cross-sectional area and thickness (ie, medial, lateral, and intercondylar) in the ACLR and contralateral limbs of participants with ACLR and unilaterally in the reference limbs of uninjured participants. Results The ACLR limb presented with greater anterior femoral cartilage cross-sectional area (96.68 ± 22.68 mm2) than both the contralateral (85.69 ± 17.57 mm2, t19 = 4.47; P < .001) and uninjured (84.62 ± 15.89 mm2, t46 = 2.17; P = .04) limbs. The ACLR limb presented with greater medial condyle thickness (2.61 ± 0.61 mm) than both the contralateral (2.36 ± 0.47 mm, t19 = 2.78; P = .01) and uninjured limbs (2.22 ± 0.40 mm, t46 = 2.69; P = .01) and greater lateral condyle thickness (2.46 ± 0.65 mm) than the uninjured limb (2.12 ± 0.41 mm, t46 = 2.20; P = .03). Conclusions Anterior femoral cartilage cross-sectional area and thickness assessed via US were greater in the ACLR limb than in the contralateral and uninjured limbs. Greater thickness and cross-sectional area may have been due to cartilage swelling or hypertrophy after ACLR, which may affect the long-term health of the joint.

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