scholarly journals Comparative study between aperture and suspensary fixation of hamstring autografts on femoral side in ACL reconstruction: clinical and radiological outcome assessment

2017 ◽  
Vol 3 (2) ◽  
pp. 298
Author(s):  
Manoj R. Kashid ◽  
Rahool S. ◽  
Amit Chaudhry ◽  
Rajshekhar . ◽  
Varunendra Bahadur Singh ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Acl Reconstruction ◽  
Femoral Condyle ◽  
Lysholm Score ◽  
Tunnel Widening ◽  
Knee Score ◽  
Hamstring Graft ◽  
Fixation Methods ◽  
Suspensory Fixation ◽  
Femoral Side

<p class="abstract"><strong>Background:</strong> Arthroscopically aided anterior cruciate ligament reconstruction using hamstring graft can be fixed to femoral condyle by suspensory and aperture fixation methods. The following study was undertaken to investigate whether there is any difference in functional outcomes with these fixation methods as measured by the Lysholm knee score and to determine tunnel widening post operatively with these two methods and does it affect the functional outcome.</p><p class="abstract"><strong>Methods:</strong> 50 patients of clinically and radiologic ally diagnosed ACL tear fulfilling the inclusion and exclusion criteria were randomized into two groups to undergo arthroscopic ACL reconstruction using quadrupled hamstring graft with  suspensory (n=25) and aperture (n=25) fixation methods on femoral side. They were compared post operatively with Lysholm score, clinical laxity tests and percentage of tunnel enlargement using computed tomograms at 01 year.<strong></strong></p><p class="abstract"><strong>Results:</strong> At the end of 6 months there was no much difference in Lysholm score between both the groups (P =0.663) and at the end of 01 year aperture group had slightly better outcome. However, the difference was not statistically significant (p =0.173). There was more tunnel widening in the suspensory group especially of the femoral tunnel in the coronal plane. However, the amount of tunnel widening in both the groups was not significant statistically (P =0.071 and P =0.963). Tunnel widening is not associated with inferior clinical outcomes or functional knee score.</p><p><strong>Conclusions:</strong> Aperture and Suspensory fixation methods of hamstring graft at femoral condyle in ACL reconstruction are comparable clinically and there is no advantage of one particular method over other. Although comparatively more tunnel widening is seen in suspensory fixation methods; it does not affect the final clinical outcomes or functional knee scores. </p>

scholarly journals Clinical comparison between femoral transfixation and bioscrew fixation using hamstring tendon graft for ACL reconstruction

2017 ◽  
Vol 3 (6) ◽  
pp. 1099
Author(s):  
Anil Kumar Mishra ◽  
Barun Datta ◽  
Varunendra Bahadur Singh ◽  
Biraj Gogoi ◽  
S. K. Rai ◽  
...  
Keyword(s):  
Acl Reconstruction ◽  
Femoral Condyle ◽  
Knee Laxity ◽  
Hamstring Tendon ◽  
Tendon Graft ◽  
Interference Screw ◽  
Fixation Technique ◽  
Significant Difference ◽  
Hamstrings Tendon ◽  
Femoral Side

<p class="abstract"><strong>Background:</strong> One of the popular graft choices for ACL reconstruction have been Hamstrings tendon autograft. There is no consensus on the ideal technique of fixation of hamstrings graft to femoral condyle. Theoretically we hypothesized that transfixation method of hamstrings graft fixation to femoral condyle should be superior to bio-interference screw fixation technique. Hence aim of our study is to compare this two fixation methods of hamstrings autografts clinically.</p><p class="abstract"><strong>Methods:</strong> 50 clinically and radiologically proven ACL deficient fighting soldiers are selected for the study. In group A; 25 patients underwent ACL reconstruction with Bioscrew using aperture technique on femoral side. Other 25 patients in group B underwent ACL reconstruction with transfixation screw using cortico-cancellous fixation technique on femoral side. In both groups quadrupled semitendinosus autograft is utilized. All the patients evaluated for functional outcome at the end of 6 weeks and at 6 months and at the end of 1 year following the procedure. The subjects are evaluated using the modified Lysholm knee score and knee laxity is measured by Rolimeter.<strong></strong></p><p class="abstract"><strong>Results:</strong> At 01 year post op. there was no statistically significant difference in both groups in terms of Manual laity tests,Rollimeter laity measurement and Lysholm knee score.The overall satisfactory result (Excellent + Good) in both the groups at 01 year follow up were 98% by Lysholm score.</p><p><strong>Conclusions:</strong> Transfixation and Bioscrew fixation showed comparable results in manual knee laxity tests, instrumental knee laxity tests using Rolimeter, Lyslohm scores and high patient satisfaction, with almost 96% of patients in both groups returned to their pre-injury levels. </p>

scholarly journals Influence of Graft Bending Angle on Femoral Tunnel Widening After Double-Bundle ACL Reconstruction: Comparison of Transportal and Outside-In Techniques

2021 ◽  
Vol 9 (10) ◽  
pp. 232596712110357
Author(s):  
Do Kyung Lee ◽  
Jun Ho Kim ◽  
Byung Hoon Lee ◽  
Hyeonsoo Kim ◽  
Min Jae Jang ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Acl Reconstruction ◽  
Femoral Tunnel ◽  
Pearson Correlation ◽  
Double Bundle ◽  
Tunnel Widening ◽  
Bending Angle ◽  
Graft Bending Angle ◽  
Significant Difference ◽  
Double Bundle Acl Reconstruction

Background: Previous studies have suggested that increased mechanical stress due to acute graft bending angle (GBA) is associated with tunnel widening and graft failure after anterior cruciate ligament (ACL) reconstruction. Few studies have compared the GBA between the outside-in (OI) and the transportal (TP) techniques. Purpose: To evaluate the influence of GBA on clinical outcomes and tunnel widening after ACL reconstruction with OI versus TP technique. Study Design: Cohort study; Level of evidence, 3. Methods: Included in the study were 56 patients who underwent double-bundle ACL reconstruction (n = 28 in the OI group and n = 28 in the TP group). Clinical outcomes (Lysholm, International Knee Documentation Committee, Tegner score, and knee laxity) 1 year postoperatively were evaluated. Computed tomography scans at 5 days and 1 year postoperatively were used for imaging measurements, and the femoral tunnel was divided into the proximal third, middle, and aperture sections. The GBA and cross-sectional area (CSA) were measured using image analysis software and were compared between groups. A correlation analysis was performed to determine if the GBA affected clinical outcomes or tunnel widening. Results: No significant difference was observed in clinical outcomes between the groups. The GBA of both the anteromedial (AM) and posterolateral bundles were more acute in the OI group compared with the TP group ( P < .05). The CSA at the AM tunnel aperture increased significantly in the OI group (84.2% ± 64.3%) compared with the TP group (51.4% ± 36.7%) ( P = .04). However, there were no differences in the other sections. In the Pearson correlation test, GBA was not correlated with tunnel widening or clinical outcomes. Conclusion: Regardless of technique, the GBA did not have a significant influence on tunnel widening or clinical outcomes. Considering a wider AM tunnel aperture, a more proximal and posterior AM tunnel position might be appropriate with the OI technique.

To Study the Functional Outcome of Arthroscopic ACL Reconstruction Using Hamstring Graft Fixed with Endobutton for Femur and Interference Screw and Suture Post for Tibial Fixation

2016 ◽  
Vol 5 (1) ◽  
pp. 978
Author(s):  
Pheiroijam Robindro ◽  
Narayanan Vijaykumar Latchumi ◽  
Kanthimathi B. D.
Keyword(s):  
Functional Outcome ◽  
Acl Reconstruction ◽  
Sports Medicine ◽  
Surgical Techniques ◽  
Interference Screw ◽  
Knee Score ◽  
Hamstring Graft ◽  
Tibial Fixation ◽  
Anterior Cruciate

<strong>Background:</strong>Arthroscopic anterior cruciate reconstruction has become one of the most successful surgical techniques in sports medicine however initial secure graft fixation is essential for the success of any ACL reconstruction.<p><strong>Objective:</strong> The study was done to evaluate the functional outcome of arthroscopic ACL reconstruction using hamstring graft fixed with endobutton for femur and interference screw and suture post for tibial fixation.</p><p><strong>Material and Methods:</strong> From 2009 to 2013, 30 patients underwent ACL reconstruction using hamstring graft fixed with endobutton for femur and interference screw with additional suture post for tibial fixation and the outcome was observed using IKDC knee score 2000.</p><p><strong>Results:</strong> The mean IKDC knee score at the follow up, 24 patients out of 30 patients had normal, 5 had nearly normal and 1 had abnormal outcome. The majority of patients had improved outcome by two grades.</p><p><strong>Conclusion:</strong> In our study, endobutton for femoral tunnel and hybrid fixation combination of suture post with interference screw provides secure fixation for ACL reconstruction with hamstring graft.</p>

Outcomes of Anterior Cruciate Ligament Reconstruction in Females Using Patellar–Tendon–Bone versus Hamstring Autografts: A Systematic Review and Meta-Analysis

2018 ◽  
Vol 32 (08) ◽  
pp. 770-787 ◽  
Author(s):  
Si Heng Sharon Tan ◽  
Bernard Puang Huh Lau ◽  
Lingaraj Krishna
Keyword(s):  
Anterior Cruciate Ligament ◽  
Clinical Outcomes ◽  
Acl Reconstruction ◽  
Patellar Tendon ◽  
Cruciate Ligament ◽  
Activity Level ◽  
Knee Score ◽  
Graft Rupture ◽  
Significant Difference ◽  
Anterior Cruciate

AbstractThe current review aims to compare the outcomes of anterior cruciate ligament (ACL) reconstruction in the female population after patellar–tendon–bone and hamstring grafts. The review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. All original randomized controlled trials and prospective cohort studies that compared clinical outcomes after female ACL reconstruction using hamstring versus patellar–tendon–bone grafts were included. All clinical outcomes reported by three or more studies were included. Fifteen publications, with 948 female patients, were included. Most outcomes were reported to have no significant graft differences by all studies that reported the outcome. These included all the outcomes for objective knee scores (International Knee Documentation Committee [IKDC] objective knee score), neuromuscular testing (quadriceps strength, hamstring strength, and single hop test), graft rupture or failure, and subjective knee scores (Lysholm score and IKDC subjective knee score). The pivot shift test, flexion deficit, and presence of crepitus were also reported to have no significant graft differences by all studies. Some studies reported a significant difference in anteroposterior laxity (Lachman's test and instrumented laxity), range of motion deficits (extension deficit), and sports and activity level (Tegner score). However, these statistically significant differences were noted to be clinically insignificant due to the normal population variation or standard error of measurement of these tools of evaluation. Patients reconstructed with patellar-tendon–bone grafts have a higher risk of kneeling pain. There was no significant difference in the incidence of crepitus. Most of the outcomes following female ACL reconstructions showed no clinically and statistically significant difference when either patellar–tendon–bone or hamstring autograft was used. These included outcomes for anteroposterior laxity, objective knee scores, neuromuscular testing, graft rupture or failure, subjective knee scores, sports and activity level, and crepitus. This a level II study.

scholarly journals CLINICAL COMPARISON BETWEEN FEMORAL TRANSFIXATION AND BIOSCREW FIXATION USING HAMSTRING TENDON GRAFT FOR ACL RECONSTRUCTION AT ORTHOPAEDICS DEPARTMENT OF JLNMCH, BHAGALPUR, BIHAR

2020 ◽  
pp. 65-67
Author(s):  
Rakesh Ramdayal Singh ◽  
Yogesh Kumar ◽  
Maseeh Azam ◽  
D. K. Singh ◽  
Debarshi Jana
Keyword(s):  
Acl Reconstruction ◽  
Femoral Condyle ◽  
Knee Laxity ◽  
Hamstring Tendon ◽  
Tendon Graft ◽  
Interference Screw ◽  
Fixation Technique ◽  
Significant Difference ◽  
Hamstrings Tendon ◽  
Femoral Side

Background: One of the popular graft choices for ACL reconstruction have been Hamstrings tendon autograft. Thereis no consensus on the ideal technique of fixation of hamstrings graft to femoral condyle. Theoretically we hypothesized that transfixation method of hamstrings graft fixation to femoral condyle should be superior to bio-interference screw fixation technique. Hence aim of our study is to compare this two fixation methods of hamstrings autografts clinically. Methods: 50 clinically and radiologically proven ACL deficient fighting soldiers are selected for the study. In groupA; 25 patients underwent ACL reconstruction with Bioscrew using aperture technique on femoral side. Other 25 patients in group B underwent ACL reconstruction with transfixation screw using cortico-cancellous fixation technique on femoral side. In both groups quadrupled semitendinosus autograft is utilized. All the patients evaluated for functional outcome at the end of 6 weeks and at 6 months and at the end of 1 year following the procedure. The subjects are evaluated using the modified Lysholm knee score and knee laxity is measured by Rolimeter. Results: At 01 year post op. there was no statistically significant difference in both groups in terms of Manual laitytests,Rollimeter laity measurement and Lysholm knee score.The overall satisfactory result (Excellent + Good) in both the groups at 01 year follow up were 98% by Lysholm score. Conclusions: Transfixation and Bioscrew fixation showed comparable results in manual knee laxity tests,instrumental knee laxity tests using Rolimeter, Lyslohm scores and high patient satisfaction, with almost 96% of patients in both groups returned to their pre-injury levels.

scholarly journals Functional outcome of anterior cruciate ligament (ACL) reconstruction: comparison of bone-patella tendon-bone (BPTB) vs. Hamstring graft

2016 ◽  
Vol 15 (1) ◽  
Author(s):  
Jeffrey Jaya Raj ◽  
Nik Mohd Fatmy Nik Mohd Najmi ◽  
Mohammad Amirrudin Hamdan ◽  
Aminudin Che Ahmad ◽  
Ahmad Hafiz Zulkifly
Keyword(s):  
Functional Outcome ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Cross Sectional Study ◽  
Lysholm Score ◽  
Hamstring Graft ◽  
Sports Activity ◽  
Cross Sectional ◽  
Sf 36 ◽  
One Year

Introduction: This is a cross-sectional study to evaluate the functional outcome of ACL Reconstruction between BPTB and hamstring graft who underwent ACL Reconstruction between January to June 2012 at our institution. Methods: Functional IKDC scoring was done pre-operatively, at 6 months and one year. Arthrometric measurements were taken using KT2000. Lysholm score and SF-36 were assessed at one year. Resuts: All patients are male, mean age is 29 (21 to 37 years old). 21.4% patients from patella BPTB group and 13% of hamstring group had anterior knee pain. 50% of patients from both groups complained of numbness over operative site. Average time return to pre-injury sports activity for BPTB group was 7.9 months, whereas for hamstring group was 8.3 months. KT-2000 measurements revealed an average side to side laxity difference average of 6.6mm in BPTB group and 7.9mm in hamstring group. Pivot shift were negative at 6 months in all patients. IKDC knee scoring significantly improved from grade C or D to grade B in 82% of BPTB group and 63% in hamstring group one year post operatively. There were no difference between both groups in terms of SF-36, Lysholm score and knee range of motion. Conclusions: There are no difference in functional outcome and lysholm knee score between the two groups although there is a discrepancy of IKDC score and arthrometric measurement at one year. Although both groups have moderate anterior laxity after one year, but they are asymptomatic and able to go back to preinjury sports activities.

scholarly journals Outcome of hamstring graft with preserved insertion: Prospective Study with 5 year Follow-up

2020 ◽  
Author(s):  
Ravi Gupta ◽  
Akash Singhal ◽  
Rohil Mehta ◽  
Gladson David
Keyword(s):  
Acl Reconstruction ◽  
Failure Rate ◽  
Graft Failure ◽  
Lysholm Score ◽  
Failure Rates ◽  
Free Graft ◽  
Hamstring Graft ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Abstract BackgroundAutologous hamstring graft remains to be a commonly used graft for Anterior Cruciate Ligament (ACL) in sportspersons. With less graft failure rates, better mechanical stability and proprioception with preserved insertion hamstring graft, we investigated long term outcomes of hamstring graft with preserved insertion. Methods: 441 sportspersons were enrolled in the study. They were divided into two groups by computerized randomization. In Group I, ACL reconstruction was done using hamstring free graft (STGF), and in Group II, ACL reconstruction was done using hamstring graft with preserved tibial insertion (STGPI). Postoperatively, patients were assessed for graft rupture, knee stability, Lysholm score, tegner activity and WOMAC score.ResultsThe average age of the patients was 24 ± 2 years in group 1 and 27 ± 8.5 years in group 2. At 5 years, the mean KT-1000 difference was 2.01 in group 1 and 1.96 in group 2 (P = 0.77); the mean Lysholm score was 97.80 and 98.60(p = 0.07), respectively; mean WOMAC score was 3.09 and 3.12(p = 0.89) respectively; mean difference between the pre-injury and post-surgery Tegner level of sports activity was 1.78 and 0.54(P < 0.05), respectively and graft failure rate was 4.1% and 7.7%.(p < 0.05), respectively.ConclusionWe report STGPI to be a more viable option than hamstring free graft in sportspersons for ACL reconstruction due to less graft failure rates and better tegner activity score postoperatively. Further, STGPI is an option with low graft failure rate like that of Bone Patellar Tendon Bone graft,with added advantage of not having significant donor site morbidity.Level of EvidenceLevel 1, Randomized Controlled Trial

scholarly journals Bone tunnel impaction reduced the tibial tunnel enlargement

Open Medicine ◽  
2017 ◽  
Vol 12 (1) ◽  
pp. 99-106 ◽  
Author(s):  
Huan Xu ◽  
Rongzong Zheng ◽  
Jinhe Ying
Keyword(s):  
Acl Reconstruction ◽  
Tibial Tunnel ◽  
Hamstring Tendon ◽  
Bone Tunnel ◽  
Tunnel Widening ◽  
Tunnel Enlargement ◽  
Fixation Devices ◽  
Suspensory Fixation ◽  
Group A ◽  
The Mean

AbstractThe purpose of this study was to investigate whether the bone tunnel impaction technique performed by dilators could dwindle the tibial tunnel enlargement after anterior cruciate ligament (ACL) reconstruction with hamstring tendon using both extracortical suspensory fixation devices at femoral and tibial site.Thirty-one consecutive patients undergoing primary ACL reconstruction with the hamstring autograft were enrolled in this research. Patients were randomly allotted to group A (bone tunnel impaction technique using dilators) or group B (regular extraction bone tunnel drilling).ResultsThe average follow-up was 16.2 months. The mean femoral tunnel widening was 1.05 mm and 1.02 mm respectively in group A and B. The mean tibial tunnel widening was 0.61 mm and 1.08 mm respectively in group A and B. There was no statistical difference for tunnel enlargement between the two groups at the femoral site (P = 0.62) but significant difference at the tibial site (P < 0.0001).ConclusionBone tunnel impaction technique leaded to a reduction of tibial bone tunnel enlargement after ACL reconstruction with hamstring tendon using both extracortical suspensory fixation devices at femoral and tibial site.

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