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>

Miniplate Suture Button Augmentation for Soft Tissue Graft Tibial Fixation in Anterior Cruciate Ligament Reconstruction

2021 ◽  
Vol 104 (2) ◽  
pp. 277-285
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Interference Screw ◽  
Tibial Fixation ◽  
Suture Button ◽  
Soft Tissue Graft ◽  
Anterior Cruciate ◽  
Supplemental Fixation

Background: Anterior cruciate ligament (ACL) reconstruction requires reliable and rigid graft fixation. Tibial-sided fixation is frequently cited as the “weak point” of the femur-graft-tibia construct. Some authors have recommended supplemental fixation with a staple or screw suture to post improve the strength and stiffness of the fixation. However, with these fixations, there is a risk for symptomatic hardware. Miniplate is flatter than screw or staple and does not penetrate the bone when attached. It is used as a button for suspensory fixation to enhance interference screw tibial fixation. Objective: To evaluate the clinical outcomes of the miniplate suture button for supplemental soft tissue graft tibial fixation in ACL reconstruction. Materials and Methods: A retrospective study was carried out between August 2016 and December 2019. A total of 40 patients had undergone primary ACL reconstruction, performed with hamstring tendon grafts that were secured using a miniplate suture button for supplemental interference screw tibial fixation. A total of 18 patients were excluded, leaving 22 patients at 1-year follow-up. Results: At least 1-year follow-up, the remaining 22 patients had significant difference between preoperative and postoperative outcome of anterior drawer test, Lachman test and pivot shift test (p<0.05). Lysholm knee scores improved significantly from 54.0±12.53 to 90.04±5.38. However, 3 patients (13.6%) experienced symptomatic hardware pain and 3 patients (13.6%) tendered around the miniplate site. There were no radiographic changes in miniplate displacement, deformed or broken plate, and bony reaction around miniplate. Conclusion: The use of a miniplate suture button as a supplemental fixation showed adequate fixation strength and showed good results in postoperative manual ligament laxity test and functional scores at minimum 1-year follow-up. However, there is still symptomatic pain at the hardware site. Keywords: Anterior cruciate ligament reconstruction, Supplemental fixation, Suture button

FUNCTIONAL OUTCOME OF ARTHROSCOPIC ACL RECONSTRUCTION WITH HAMSTRING GRAFT

2021 ◽  
pp. 36-37
Author(s):  
Sai Bharath Kanugula ◽  
Atchuta Rao Ampolu ◽  
Ashok Kumar Patnala
Keyword(s):  
Anterior Cruciate Ligament ◽  
Functional Outcome ◽  
Cruciate Ligament ◽  
Common Mechanism ◽  
Associated Injuries ◽  
Hamstring Graft ◽  
Sports Activity ◽  
Anterior Drawer Test ◽  
Anterior Cruciate

Background: The most common joint to be injured in our body is knee joint, and the commonest ligament to be injured is anterior cruciate ligament in the knee.Etiology includes road trafc accidents and sport injuries. The ACL, along with other ligaments, the capsule are the stabilizers of the knee and prevents anterior translation, and limits valgus and rotational stress. The articular cartilage injuries in acute ACL tears constitutes from 16 – 46%, and in chronic tears, the incidence increases further2. For prevention of further worsening of the existing lesions and also to prevent formation of new lesions, stablity of the knee should be achieved.The present study is to assess the functional outcome of arthroscopic anterior cruciate ligament reconstruction using hamstring tendon (gracilis and semitendinosus) autograft in patients with ACL tears. Methods: Study design: Hospital Based Observational study. Study period: September 2019 to August 2021. Sample size: 30 30 consecutive patients who underwent arthroscopic ACL reconstructions with hamstring graft were taken for this study. Results: Out of these, 27 patients were male and 3 were female. Right side affected in 18 patients and left side in 12 patients. The most common mechanism of the injury was sports activity in 17 patients, RTA injuries in 10 patients and other job related injuries in 3 patients. Isolated ACL tears in thirteen patients in our study and rest had associated injuries to menisci in same knee.Better postoperative functional scores are seen with patients with isolated ACL injuries compared to those patients with associated injuries of the knee like meniscal tears. Observations include anterior drawer test was negative in 83.33% of patients at 3 months, 86.67% of patients at 6 months and at 1 year 96.15% of patients had a negative anterior drawer test. Full range of motion attained in 86.67% of patients at 3 months, 93.33% of patients at 6 months and at 1 year 96.15% of patients.Pivot shift test was negative postoperatively for all the patients at any follow-up. Postoperatively at 3 months 25 (83.33%) patients had 5/5 quadriceps power (MRC grading) 92.3% of them had 5/5 power at latest follow up. Complications include Supercial infection and Deep infection in our study. Conclusion: Anterior cruciate ligament tears are most common at a mean age of 28 years with preponderance to male gender. The most common mechanism of the injury was sports activity. Isolated ACL injury is more common than along with associated meniscal injuries.Anatomic single bundle reconstruction with quadrupled hamstring graft gives good functional results.Hamstring graft xation with endobutton and interference screw gives better functional outcome.

scholarly journals Comparing 2-Year Outcomes of Anterior Cruciate Ligament Reconstruction Using Either Patella-Tendon or Semitendinosus-Tendon Autografts: A Non-Randomised Prospective Study

2005 ◽  
Vol 13 (2) ◽  
pp. 139-146 ◽  
Author(s):  
BPB Tow ◽  
PCC Chang ◽  
AK Mitra ◽  
BK Tay ◽  
MC Wong
Keyword(s):  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Semitendinosus Tendon ◽  
Knee Score ◽  
Patella Tendon ◽  
Anterior Translation ◽  
Anterior Cruciate ◽  
Tendon Autograft

Purpose. To compare the results of anterior cruciate ligament (ACL) reconstructions using either a patella-tendon autograft or a semitendinosus-tendon autograft. Methods. Based on surgeon experience and preference, 68 patients underwent ACL reconstruction using either a quadruple-strand semitendinosus autograft (n=34) or a central one-third bone-patella tendon-bone autograft (n=34). Each patient was assessed preoperatively and postoperatively at 3, 6, and 24 months using the International Knee Documentation Committee (IKDC) knee score, Biodex muscle strength and endurance testing, and the KT1000 instrumented arthrometer test of knee laxity to anterior translation. All assessments at the 2-year follow-up were performed by the same physician and physiotherapist. Results. While ACL reconstruction improved knee stability and IKDC knee scores significantly, there was no statistically significant difference between semitendinosus- and patella-tendon autograft reconstructions in terms of long-term knee score or laxity to anterior translation. Semitendinosus graft reconstruction was associated with less donor-site morbidity and hamstring weakness. Meniscectomy was associated with poorer long-term knee scores. Conclusion. ACL reconstruction is associated with a significantly better IKDC knee score and laxity measurement at 2-year follow-up. However, we were unable to demonstrate a significantly better long-term outcome in knee score or laxity to anterior translation with either a patella-tendon autograft or a semitendinosus-tendon autograft.

Five-Strand Hamstring Autograft in Primary Anterior Cruciate Ligament Reconstruction

2018 ◽  
Vol 32 (04) ◽  
pp. 366-371
Author(s):  
Lingaraj Krishna ◽  
Xin Yang Tan ◽  
Acksen Thangaraja ◽  
Francis Wong
Keyword(s):  
Acl Reconstruction ◽  
Screw Fixation ◽  
Cruciate Ligament ◽  
Interference Screw ◽  
Hamstring Graft ◽  
Hamstring Autograft ◽  
Interference Screw Fixation ◽  
Anterior Cruciate ◽  
Graft Diameter ◽  
Primary Acl Reconstruction

AbstractThe purpose of this study was to describe our surgical technique of using five-strand hamstring autograft with interference screw fixation in primary anterior cruciate ligament (ACL) reconstruction and to report the early postoperative outcomes of this technique. Patients who underwent primary ACL reconstruction using five-strand hamstring autografts with interference screw fixation between December 2014 and June 2016 were included in this study. The five-strand configuration was used in these patients because the four-strand configuration produced a graft diameter of less than 8 mm. Subjective questionnaires, including the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the Lysholm Score, were administered preoperatively, as well as at 1- and 2-year follow-ups. Paired t-test was used to compare the pre- and postoperative outcome scores. The study group comprised 25 patients. There were no intraoperative complications. The mean follow-up period was 17.8 months (12–24). There were 19 males and 6 females. The median age was 24 years (16–41), and median body mass index was 23.9 (18.5–30.2). The median diameter of the five-strand graft was 9 mm (8–10 mm), with a mean of 9.06 ± 0.60 mm. This was associated with a median graft length of 90 mm (80–100 mm). The postoperative Lysholm, KOOS symptoms, KOOS Pain, KOOS daily function, KOOS sports function, KOOS quality of life, and Short Form-36 Physical Component Summary scores improved significantly compared with the preoperative scores. The use of the five-strand hamstring graft with interference screw fixation in primary ACL reconstruction is associated with significant improvements in patient-reported outcomes in the early postoperative period. The five-strand graft technique is a useful means of increasing graft diameter when faced with an undersized hamstring graft.

scholarly journals Pediatric Anterior Cruciate Ligament Reruptures Are Related to Lower Functional Scores at the Time of Return to Activity: A Prospective, Midterm Follow-up Study

2019 ◽  
Vol 7 (12) ◽  
pp. 232596711988888 ◽  
Author(s):  
Diego Costa Astur ◽  
João Victor Novaretti ◽  
Elton Luiz Borges Cavalcante ◽  
Adilson Goes ◽  
Camila Cohen Kaleka ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Surgical Techniques ◽  
Study Patient ◽  
Skeletally Immature ◽  
Functional Scores ◽  
Anterior Cruciate ◽  
Return To Activity

Background: Skeletally immature patients show a higher rate of anterior cruciate ligament (ACL) reruptures. A better understanding of the risk factors for an ACL rerupture in this population is critical. Purpose/Hypothesis: The objective of this study was to analyze preoperative, intraoperative, and postoperative characteristics of pediatric patients undergoing ACL reconstruction and determine the relationship of these factors with an ACL rerupture. It was hypothesized that patients with worse activity scores and knee function at the time of return to activity would have a higher rate of ACL reruptures at midterm follow-up. Additionally, it was hypothesized that most ACL reruptures would occur before age 20 years in the study population. Study Design: Case-control study; Level of evidence, 3. Methods: A total of 65 skeletally immature patients (age <16 years) with ACL ruptures underwent reconstruction with a quadruple hamstring tendon graft between 2002 and 2016. Of these patients, 52 were available for the study. Patient characteristics, surgical details, Tegner and Lysholm scores, and ACL reconstruction outcomes were recorded. Patients were analyzed and compared according to ACL rerupture occurrence. Results: Of the 52 patients, 18 (34.6%) experienced an ACL rerupture after reconstruction. The majority of reruptures (77.8%) occurred before age 20 years. There were 2 patients who sustained ACL reruptures during the rehabilitation period before they returned to activity. The majority of reruptures occurred after 12 months (83.2%), with 66.6% occurring after 24 months. Upon returning to activity between 6 and 9 months postoperatively, patients who ended up with intact ACL grafts reported 69% higher mean Tegner scores ( P = .006) and 64% higher mean Lysholm scores than patients who sustained ACL reruptures ( P < .001). Within the limits of this study, we could identify no statistical relationship between the rate of ACL reruptures and different sport types, surgical techniques, or associated injuries ( P > .05). Conclusion: Skeletally immature patients who underwent ACL reconstruction and sustained ACL reruptures had lower Tegner and Lysholm scores upon returning to activity than patients without ACL reruptures. In addition, most ACL reruptures occurred in patients younger than 20 years (77.8%) and after 24 months postoperatively (66.6%).

scholarly journals Comparison of Clinical Results of Anteromedial and Transtibial Femoral Tunnel Drilling in ACL Reconstruction

2020 ◽  
Author(s):  
Leena Metso ◽  
Kirsi-Maaria Nyrhinen ◽  
Ville Bister ◽  
Jerker Sandelin ◽  
Arsi Harilainen
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Femoral Tunnel ◽  
Cruciate Ligament ◽  
Clinical Results ◽  
Rotational Stability ◽  
Tibial Fixation ◽  
Ikdc Score ◽  
Anterior Cruciate

Abstract Background: This study compares long term results of two femoral bone tunnels in anterior cruciate ligament (ACL) reconstruction. The femoral tunnel can be drilled transtibially (TT) or through an anteromedial portal (AM). Methods: 300 patients with ACL reconstructions were chosen for this study. They were divided into two groups: 150 patients with anteromedial drilling (AM) and 150 with transtibial (TT) drilling. In the AM group the reconstructions were performed using semitendinosus graft with Tape Locking Screw (TLS™) technique (n=87) or Retrobutton™ femoral and BioScrew™ tibial fixation with a semitendinosus-gracilis graft (n=63). In the TT group the fixation method used was Rigidfix™ femoral and Intrafix tibial fixation. The evaluation methods were clinical examination, knee scores (Lysholm, Tegner, IKDC) and instrumented laxity measurements (KT-2000™). Our aim was to evaluate if there is a better rotational stability and therefore better clinical results when using AM drilling. Results: In the AM group there were 18 and in the TT group 17 revision procedures which were excluded from the study, leaving 132 patients in the AM group and 133 in the TT group for evaluation. In the one year follow-up there were 90 patients (68,2 %) in the AM group and 86 patients (64,7 %) in the TT group. In the two year follow-up there were 60 (45,5 %) and 58 (43,6 %) patients, respectively. The Tegner activity level was consistently higher in the TT group from preoperatively to two year follow-up postoperatively (p < 0.05). The IKDC score was better at two year follow-up in the TT group (p < 0.05). Statistical analysis was done using the BMDP Statistical Package (Statistical Solutions Ltd, Cork, Ireland). Conclusion: There was a statistically significant difference in IKDC score at two year follow-up, in favor of the TT drilling group compared with the AM group (p < 0.05). No other differences were found between these groups. Both drilling techniques resulted in improved patient performance and patient satisfaction. Also, we found no data supporting the hypothesis that AM drilling technique provides better rotational stability to the knee. Trial registration: ISRCTN16407730 Keywords: Anterior cruciate ligament reconstruction; clinical outcome; anteromedial; transtibial

scholarly journals Functional Outcomes and Hop Tests Results in Anterior Cruciate Ligament Reconstruction Patients with Adjustable Loop Fixation: 2-Years Follow-up

2020 ◽  
Vol 8 (A) ◽  
pp. 892-897
Author(s):  
Sholahuddin Rhatomy ◽  
Chairul Wahjudi ◽  
Thomas Edison Prasetyo ◽  
Riky Setyawan ◽  
Nicolaas C. Budhiparama
Keyword(s):  
Anterior Cruciate Ligament ◽  
Functional Outcome ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Lysholm Score ◽  
Functional Score ◽  
Peroneus Longus ◽  
Hop Test ◽  
Anterior Cruciate

BACKGROUND: Grafts are ultimately integrated into the bone tunnels by either screws, cross-pins, or cortical suspension devices in anterior cruciate ligament (ACL) reconstruction. Investigation the usage of adjustable loop button is inadequate. AIM: The aim of this study was to identify knee functional outcome and serial hop test in ACL reconstruction with adjustable loop button in 2-years follow-up. METHODS: Chronic isolated ACL ruptured patients were reconstructed with adjustable loop button using peroneus longus autograft. We recorded knee functional outcome score using Tegner-Lysholm score, Modified Cincinnati score, and International Knee Documentation Committee (IKDC) at pre-operative and 2-years follow-up. Serial hop test was assessed at 6 months after surgery. RESULTS: Forty-seven patients fulfilled inclusion criteria with median age 22.0. Evaluation of functional outcome of Tegner-Lysholm score, Modified Cincinnati score, and IKDC showed significant improvement at 2-years follow-up compared to pre-operative. Serial hop test showed excellent result at 6 months after surgery. CONCLUSION: The result of knee functional score (Tegner-Lysholm score, Modified Cincinnati score, and IKDC) and serial hop test in ACL reconstruction with adjustable loop using peroneus longus autograft was excellent at 2-years follow-up. LEVEL OF EVIDENCE: Level 2, Retrospective Cohort Study.

scholarly journals Return to Play after Anterior Cruciate Ligament Reconstruction among Amateur Soccer Players

2019 ◽  
Vol 60 (02) ◽  
pp. 035-038
Author(s):  
Julián Alonso ◽  
Samuel Malig ◽  
Cristián Fontboté ◽  
Camilo Azar ◽  
Francisco Vergara ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Sports Medicine ◽  
Cruciate Ligament ◽  
Return To Play ◽  
Current Status ◽  
Soccer Teams ◽  
Anterior Cruciate ◽  
Sedentary Life Style

Abstract Objective The aim of the present study is to assess the return to play among amateur soccer league players after anterior cruciate ligament (ACL) reconstruction. Materials and Method The surgical protocols of ACL reconstruction surgeries performed in a sports medicine clinic from July 1st, 2013, to June 30th, 2014, were included in the study. Only the charts of amateur soccer league players who played once or twice a week were selected. The follow-up time was calculated as the number of months between surgery and the telephone survey. At the follow-up, the current status of the soccer playing was recorded. Those patients who were no longer playing in a team were asked what kind of sport they were currently practicing, as well as the main reason for not returning to team playing. Results A total of 61 (25.6%) patients met the inclusion criteria. The mean follow-up time was of 22.4 ± 3.4 months. At the follow-up, 30 (49.1%) patients were playing in amateur soccer teams. Among the patients who were no longer playing in a team, 19 (61.2%) were playing soccer occasionally, 11 (35.4%) were practicing other sports, and 1 developed a sedentary life style. The reasons for not returning to team playing were: fear of reinjury in 26%; knee symptoms in 26%; lack of confidence in the knee in 23%, family or job commitments in 23%; and not being eligible to participate in competitive sports in 2%. Conclusion After an average of two years of ACL reconstruction, only half of the amateur soccer league players return to play.

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