scholarly journals Reconstruction of anterior cruciate ligament by using two different techniques

2010 ◽  
Vol 63 (11-12) ◽  
pp. 845-850 ◽  
Author(s):  
Vladimir Ristic ◽  
Srdjan Ninkovic ◽  
Vladimir Harhaji ◽  
Milan Stankovic ◽  
Dragan Savic ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Bone Graft ◽  
Scoring System ◽  
Cruciate Ligament ◽  
Group Versus ◽  
International Knee Documentation Committee ◽  
Rigid Fixation ◽  
Postoperative Results ◽  
Significant Difference ◽  
Anterior Cruciate

Introduction. Modern literature concerning reconstructions of Anterior Cruciate Ligament is mostly focused on the choice of graft (hamstring or bone-tendon-bone), its placing, tensioning and fixation. The bone-hamstring-bone graft consists of compressed cancellous bone on its ends and it has been developed to achieve a more rigid fixation of the graft. The aim of this study was to compare the postoperative results in surgically treated patients two years after the reconstruction of anterior cruciate ligament. Material and methods. The study included 55 patients divided into two groups according to the implanted graft: bone-tendon-bone and bone-hamstring-bone graft. The results were assessed by Tegner and Lysholm scoring systems, arthrometric measurements, functional tests and International Knee Documentation Committee standard. Results. The average postoperative results did not show a statistically significant difference (p<0.05) between the two groups (94 in the bone-tendon-bone group versus 93 in the bone-hamstring-bone group) according to Lysholm scoring system, nor in the arthrometric measurements obtained by Lachman test (2.0:2.1). According to the International Knee Documentation Committee standard, the bone-hamstring-bone group had more excellent results, but also three unsatisfactory ones; so, the bone-tendon-bone group was found to have uniform and better results (100% of excellent and good results vs. 91% in the bone-hamstring-bone group). Better results were also recorded by Tegner scoring system in the bone-tendon-bone group (8.6 vs. 7.1) due to the fact that there were more active athletes and greater preoperative level of activities in this group (3.1 vs.7.l in the bone-hamstring group). Conclusions. The choice of graft is a less important factor in the reconstruction of anterior cruciate ligament than its placing, tensioning and fixation, because a significant difference between groups was recorded only by the International Knee Documentation Committee standard.

scholarly journals A comparative study of anterior cruciate ligament reconstruction with double, single, or selective bundle techniques

2018 ◽  
Vol 26 (2) ◽  
pp. 230949901877312 ◽  
Author(s):  
Zi-Yang Chia ◽  
Jade N Chee ◽  
Hamid Rahmatullah Bin-Abd-Razak ◽  
Denny TT Lie ◽  
Paul CC Chang
Keyword(s):  
Anterior Cruciate Ligament ◽  
Comparative Study ◽  
Cruciate Ligament ◽  
International Knee Documentation Committee ◽  
Rotational Stability ◽  
Single Bundle ◽  
Stress Tests ◽  
Significant Difference ◽  
Anterior Cruciate

Purpose: Reconstruction of the anterior cruciate ligament (ACL) is the most frequently performed reconstructive surgery in the knee. Biomechanical studies have shown that double bundle (DB) reconstruction is better than single bundle (SB) reconstruction with regard to rotational stability. It is postulated that resection of ACL fibres that remain in continuity may be counterproductive for the knee as these fibres have the capacity to produce collagen. In this study, we aimed to evaluate the efficacy among selective bundle, DB and SB ACL reconstructions over a 2-year post-operative follow-up period. Methods: A retrospective comparative study was conducted for comparison between selective bundle, DB and SB reconstructions. Between 2012 and 2014, 291 ACL reconstructions were performed. Of these, 68 patients had selective ACL reconstructions (group SLB), 147 had DB ACL reconstructions (group DB) and 76 had SB ACL reconstructions (group SB). Institutional Review Board approval was obtained, and all patients provided informed consent. Clinical results were assessed with the International Knee Documentation Committee (IKDC), Lysholm and Tegner scores. Stability was measured using Lachman, pivot shift and anterior drawer stress tests using the KT1000 at 30° of knee flexion. Results: There was no significant difference in ligament grade, function grade, IKDC grade, as well as Tegner and Lysholm means among all three groups after a 2-year follow-up period. Conclusion: Selective bundle reconstruction provides comparable results to DB and SB reconstruction techniques. It is a viable alternative for patients with partial tears.

scholarly journals Manual Khalifa Therapy Improves Functional and Morphological Outcome of Patients with Anterior Cruciate Ligament Rupture in the Knee: A Randomized Controlled Trial

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Michael Ofner ◽  
Andreas Kastner ◽  
Engelbert Wallenboeck ◽  
Robert Pehn ◽  
Frank Schneider ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Common Knowledge ◽  
Controlled Trial ◽  
Cruciate Ligament ◽  
International Knee Documentation Committee ◽  
Specific Pressure ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Ikdc Score ◽  
Anterior Cruciate

Rupture of the anterior cruciate ligament (ACL) is a high incidence injury usually treated surgically. According to common knowledge, it does not heal spontaneously, although some claim the opposite. Regeneration therapy by Khalifa was developed for injuries of the musculoskeletal system by using specific pressure to the skin. This randomized, controlled, observer-blinded, multicentre study was performed to validate this assumption. Thirty patients with complete ACL rupture, magnetic resonance imaging (MRI) verified, were included. Study examinations (e.g., international knee documentation committee (IKDC) score) were performed at inclusion (t0). Patients were randomized to receive either standardised physiotherapy (ST) or additionally 1 hour of Khalifa therapy at the first session (STK). Twenty-four hours later, study examinations were performed again (t1). Three months later control MRI and follow-up examinations were performed (t2). Initial status was comparable between both groups. There was a highly significant difference of mean IKDC score results att1andt2. After 3 months, 47% of the STK patients, but no ST patient, demonstrated an end-to-end homogeneous ACL in MRI. Clinical and physical examinations were significantly different int1andt2. ACL healing can be improved with manual therapy. Physical activity can be performed without pain and nearly normal range of motion after one treatment of specific pressure.

scholarly journals Clinical Comparison of Transfix and Tightrope Fixations in Patients with Arthroscopic Anterior Cruciate Ligament Reconstruction

2021 ◽  
Author(s):  
Faik Turkmen ◽  
Veysel Basbug ◽  
Mustafa Ozer ◽  
Kayhan Kesik ◽  
Burkay Kutluhan Kacıra
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
International Knee Documentation Committee ◽  
Clinical Results ◽  
Registry System ◽  
Significant Difference ◽  
Anterior Cruciate ◽  
Hospital Registry ◽  
Femoral Graft

Backgraound: Transfix and Tightrope are widely used devices for femoral graft fixation in arthroscopic anterior cruciate ligament (ACL) reconstruction. The purpose of the study is to reveal differences between Transfix and Tightrope fixation technique by evaluating clinical results of cases. Materials and Methods: 87 patients who underwent arthroscopic ACL reconstruction for ACL rupture between January 2013 and June 2017 by the same senior surgeon and in whom the fixation methods evaluated in this study had been employed were retrospectively reviewed. Transfix was used in 45 (52%) patients and ACL Tightrope was used in 42 (48%) patients. In the first group (Transfix) mean age was 26,3± 5.8 (18-45) second group (Tightrope) mean age was 26,7± 6.1 (17-46). Patients in both groups were retrospectively screened for anamnesis and physical examination records in the hospital registry system. In addition, IKDC(International Knee Documentation Committee) and Lysholm scores were calculated in the preoperative and postoperative follow-up period, and all findings were evaluated over a mean period of 42.5 ± 7.4 (24-54) months. Results: Clinical evaluation and stability tests indicated that statistically no significant difference found between two groups. For the first group preoperative Lysholm scores was 47,3 and postoperatively 93 and second group scores were respectivly 47,6 and 94 (P<0.05). IKDC scoring system for first group preoperatively there were 13 poor, 26 good and 6 fair knees ; postoperatively 2 fair, 27 good and 16 excellent .In the second group preoperatively 11 poor, 25 fair and 6 good knees and postoperatively 2 fair, 26 good and 14 excellent knees evaluated. Conclucions: In ACL reconstruction for fixation femoral graft, Transfix and Tightrope are frequently used implants. Therefore, both femoral fixation implants can be safely used in arthroscopic ACL reconstruction based on the experience and preference of the surgeon, provided that they are properly applied.

scholarly journals Tibial fixation in anterior cruciate ligament reconstruction

2017 ◽  
Vol 25 (1) ◽  
pp. 230949901769974 ◽  
Author(s):  
Wei Wen Timothy Teo ◽  
Ching Sing Nicholas Yeoh ◽  
Teck Huat Andy Wee
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
International Knee Documentation Committee ◽  
Graft Fixation ◽  
Tibial Fixation ◽  
Significant Difference ◽  
Anterior Cruciate ◽  
Removal Of Hardware ◽  
Staple Fixation ◽  
Screw Group

Objective: To determine whether supplementary tibial graft fixation with a staple is routinely necessary for anterior cruciate ligament (ACL) reconstructions. Methods: We retrospectively reviewed a series of consecutive patients who underwent ACL reconstruction at our institution from April 2012 to July 2013. Patients who fulfilled the inclusion and exclusion criteria were divided into two groups, of which one with tibial fixation of the graft with a biointerference screw alone (biointerference screw group) and the other with tibial fixation of the graft with a biointerference screw and supplementary extra tunnel staple fixation (biointerference screw and staple group). All the surgeries were performed by a single fellowship-trained sports surgeon, using a standardized transportal technique and rehabilitation protocol. Both well-matched groups were evaluated at 1-year follow-up objectively for ligament laxity using instrumented testing with KT-2000 arthrometer and clinical tests as well as subjectively with the validated International Knee Documentation Committee 2000 (IKDC) and Lysholm knee score. All complications were reported. Results: A total of 64 patients (31 in the only biointerference screw group and 33 in the biointerference screw and staple group) were included in the study. At 1 year, there was no significant difference in the objective and subjective outcome assessments between the two groups. However, four patients from the group with supplementary staple experienced symptomatic hardware on kneeling of which two necessitated removal of hardware. Conclusion: Our study showed that supplementary tibial graft fixation with a staple is not routinely necessary for ACL reconstructions. It confers no additional benefits when compared with the use of biointerference screw alone for tibial graft fixation but may increase the risks of symptomatic hardware.

scholarly journals Clinical Outcomes of Arthroscopic Notchplasty and Partial Resection for Mucoid Degeneration of the Anterior Cruciate Ligament

2021 ◽  
Vol 10 (2) ◽  
pp. 315
Author(s):  
Joong Won Lee ◽  
Jung Tae Ahn ◽  
Hyun Gon Gwak ◽  
Sang Hak Lee
Keyword(s):  
Anterior Cruciate Ligament ◽  
Clinical Outcomes ◽  
Cruciate Ligament ◽  
Arthroscopic Surgery ◽  
Partial Resection ◽  
Knee Score ◽  
Mucoid Degeneration ◽  
Duration Of Symptoms ◽  
Significant Difference ◽  
Anterior Cruciate

Background: Mucoid degeneration of the anterior cruciate ligament (MD-ACL) is a chronic degenerative process involving a hypertrophied ACL, which may lead to notch impingement syndrome. As a treatment method, there is consensus regarding arthroscopic resection for MD-ACL resulting in good clinical outcomes; however, additional notchplasty remains controversial. The purpose of this study was to investigate clinical outcomes after arthroscopic partial resection of the ACL and additional notchplasty performed to minimize volume reduction of the ACL. Study Design: Level IIIb retrospective cohort study. Methods: Of 1810 individuals who underwent knee arthroscopic surgery performed by the same surgeon between July 2011 and October 2020, 52 were included, while 10 were excluded due to a follow-up period of <1 year. Clinical data including pain location, terminal flexion or extension pain, range of motion (ROM), Lysholm knee score, and Hospital for Special Surgery (HSS) knee score were assessed pre- and postoperatively. Additionally, according to the resected volume of the ACL, patients were classified into two groups: <25% (Group 1), and 25–50% (Group 2). Clinical outcomes were compared between the two groups. Results: There were 17 (40.5%) men and 25 (59.5%) women with a mean age of 53.9 years (range, 16–81 years) at the time of surgery. The mean duration of symptoms before surgery was 14.4 months (range, 3–66 months). Arthroscopic partial resection of the MD-ACL was performed in all patients, and concomitant notchplasty was performed in 36 (81.8%). All clinical scores improved postoperatively, and were statistically significant (p < 0.01). However, there was no significant difference in clinical outcomes between groups 1 and 2 classified according to the resected ACL volume. Recurrence of MD-ACL was recorded in only one patient, 11 months after arthroscopic treatment. No patients underwent ACL reconstruction because of symptoms of anterior instability. Conclusion: Arthroscopic partial resection of the ACL and concomitant notchplasty yielded satisfactory outcomes for the treatment of MD-ACL. Notchplasty may be an alternative procedure to avoid total ACL resection and postoperative instability.

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