A Randomized Clinical Trial Comparing Patellar Tendon, Hamstring Tendon, and Double-Bundle ACL Reconstructions

2019 ◽  
Vol 101 (11) ◽  
pp. 949-960 ◽  
Author(s):  
Nicholas G. Mohtadi ◽  
Denise S. Chan
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Patellar Tendon ◽  
Hamstring Tendon ◽  
Double Bundle

A Randomized Clinical Trial Comparing Patellar Tendon, Hamstring Tendon, and Double-Bundle ACL Reconstructions

2015 ◽  
Vol 25 (4) ◽  
pp. 321-331 ◽  
Author(s):  
Nicholas Mohtadi ◽  
Denise Chan ◽  
Rhamona Barber ◽  
Elizabeth Oddone Paolucci
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Patellar Tendon ◽  
Hamstring Tendon ◽  
Double Bundle

scholarly journals Comparison of Clinical Outcomes Following Anatomic Single vs. Double-Bundle ACL Reconstruction: A Randomized Clinical Trial

2017 ◽  
Vol 5 (7_suppl6) ◽  
pp. 2325967117S0024
Author(s):  
James J. Irrgang ◽  
Scott Tashman ◽  
Charity Moore ◽  
Volker Musahl ◽  
Robin Vereeke West ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Clinical Outcomes ◽  
Acl Reconstruction ◽  
Double Bundle ◽  
Double Bundle Acl Reconstruction

scholarly journals Knee Kinematics Following Anatomic Single vs. Double Bundle ACL Reconstruction: A Randomized Clinical Trial

2017 ◽  
Vol 5 (7_suppl6) ◽  
pp. 2325967117S0031
Author(s):  
Scott Tashman ◽  
James J. Irrgang ◽  
Charity Moore ◽  
Volker Musahl ◽  
Robin Vereeke West ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Acl Reconstruction ◽  
Knee Kinematics ◽  
Double Bundle ◽  
Double Bundle Acl Reconstruction

Intraoperative Biomechanical Evaluation of Anatomic Anterior Cruciate Ligament Reconstruction Using a Navigation System

2008 ◽  
Vol 36 (10) ◽  
pp. 1903-1912 ◽  
Author(s):  
Yasuyuki Ishibashi ◽  
Eiichi Tsuda ◽  
Akira Fukuda ◽  
Harehiko Tsukada ◽  
Satoshi Toh
Keyword(s):  
Patellar Tendon ◽  
Cruciate Ligament ◽  
Knee Laxity ◽  
Hamstring Tendon ◽  
Tendon Graft ◽  
Double Bundle ◽  
Posterolateral Bundle ◽  
Anteromedial Bundle ◽  
Double Bundle Reconstruction ◽  
Anterior Cruciate

Background Recently, more anatomic anterior cruciate ligament reconstructions have been developed to improve knee laxity. Purpose The objective of this study is to assess knee kinematics after double-bundle reconstruction with hamstring tendon and after anatomically oriented reconstruction with a patellar tendon using navigation during surgery. Study Design Cross-sectional study; Level of evidence, 3. Methods Eighty knees received double-bundle reconstruction with a hamstring tendon graft, and 45 knees received anatomically oriented reconstruction with a patellar tendon graft. Before reconstruction, knee laxity was measured using a navigation system. After the posterolateral bundle or anteromedial bundle was temporarily fixed during double-bundle reconstruction, knee laxity was measured to assess the function of each bundle. After double-bundle reconstruction or anatomically oriented reconstruction with patellar tendon, knee laxity was measured in the same manner. Results Both double-bundle reconstruction and anatomically oriented reconstruction similarly improved knee laxity compared With before reconstruction in all knee flexion angles. Regarding the function of the anteromedial and posterolateral bundles in double-bundle reconstruction, the 2 grafts showed contrasting behavior. The posterolateral bundle restrained tibial displacement mainly in knee extension, whereas the anteromedial bundle restrained it more in the knee flexion position. The posterolateral bundle has a more important role in controlling rotation of the tibia than the anteromedial bundle. Conclusion Although the posterolateral bundle has an important role in the extension position, the anteromedial bundle is more important in the flexion position. Therefore, both bundles should be reconstructed to improve knee laxity throughout knee range of motion. Even with single-bundle reconstruction using a patellar tendon, anatomic reconstruction might improve knee laxity similar to double-bundle reconstruction.

scholarly journals Lateral Extra-Articular Tenodesis Reduces Failure of Hamstring Tendon Autograft ACL Reconstruction -Two Year Outcomes from the STABILITY Study Randomized Clinical Trial

2019 ◽  
Vol 7 (7_suppl5) ◽  
pp. 2325967119S0028 ◽  
Author(s):  
Alan M. Getgood ◽  
Dianne Bryant ◽  
Robert B. Litchfield ◽  
Robert Gordon McCormack ◽  
Mark Heard ◽  
...  
Keyword(s):  
Clinical Trial ◽  
High Risk ◽  
Randomized Clinical Trial ◽  
Graft Failure ◽  
Primary Outcome ◽  
Pivot Shift ◽  
Hamstring Tendon ◽  
Rotatory Laxity ◽  
Ligamentous Laxity

Objectives: Persistent anterolateral rotatory laxity following anterior cruciate ligament reconstruction (ACLR) has been correlated with poor outcome and graft failure. We hypothesized that anterolateral complex reconstruction by way of a Lateral Extra-articular Tenodesis (LET) in combination with single bundle ACLR would reduce the risk of persistent rotatory laxity in young individuals who are deemed as being at high risk of failure. Methods: This is a pragmatic, multicenter, randomized clinical trial comparing standard hamstring tendon ACLR with combined ACLR and LET, utilizing a strip of iliotibial band (Modified Lemaire). Patients aged 25 years or less with an ACL deficient knee were included. They also had to have two of the following three criteria: 1) Grade 2 pivot shift or greater; 2) Returning to high risk/pivoting sports; 3) Generalized ligamentous laxity. The primary outcome was graft failure defined as either the need for revision ACLR or symptomatic instability associated with a positive asymmetric pivot shift, indicating persistent rotational laxity. Secondary outcome measures included the P4 pain scale, KOOS, IKDC. Patients were followed for two years with visits at 3, 6, 12 and 24 months postoperatively. A sample size of 300 per group was calculated based on a relative reduction in graft failure by 40%, with type 1 error of 5%, 80% power and 15% loss to follow-up rate. Results: 624 patients were randomized with a mean age of 18.9 (range: 14-25), 293 male. 436 (87.9%) patients presented pre-operatively with high-grade rotatory laxity (grade 2 pivot or greater) and 215 (42.1%) were diagnosed as having generalized ligamentous laxity (Beighton Score of 4 or greater). 523 of the 624 patients are at least 2 years postoperative; 29 lost to follow-up (˜5%). In the ACLR group 104/252 (41%) of patients suffered the primary outcome compared to 61/242 (25%) of the ACLR+LET patients (RR=0.61, 95%CI 0.47 to 0.79), p<0.0001. 39 patients suffered graft rupture, 28/252 (11%) in the ACLR group compared to 11/242 (4.5%) in the ACL+LET group (RR=0.41, 95%CI 0.21 to 0.80, p<0.001). At 3 months postoperative, patients in the ACLR group had less pain (p=0.004); at 3 and 6 months all KOOS subdomains, the IKDC favored the ACLR alone group (p=0.03). At 12 and 24 months, no important between-group differences were observed in any patient reported outcome. Conclusion: The addition of LET to a hamstring autograft ACLR in young active patients significantly reduces graft failure and persistent anterolateral rotatory laxity at 2 years post operatively.

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