Outcome of anterior cruciate ligament reconstruction using bone-patellar tendon-bone auto graft

Introductions: A rupture of the Anterior Cruciate Ligament (ACL) is the most common ligament injury resulting in instability of the knee which can cause secondary articular injury and early osteoarthritis (OA). Aim of this study was to evaluate the short term outcomes of ACL reconstruction using Bone Patellar Tendon Bone Auto Graft (BPTB) auto graft and factors that might contribute to poor results. Methods: Patients with Anterior Cruciate Ligament injury during the period of July 2013 to May 2014 were enrolled to observe the outcome of the ACL reconstruction using BPTB without arthroscopy. Lysholm Knee Scoring Scale was used to determine the clinical outcome. Outcome parameters were evaluated using Statistical Package for Social Science Version 20 (SPSS). Results: Total 30 normal or near normal function outcome of knee was reported in 29 (97%) patients after ACL reconstruction using BPTB without arthroscopy. There was no failure of grafts. Good static knee stability achieved with increased patient’s satisfaction. Lysholm Score was excellent in 27 (90%) and good in 3 (10 %) cases. Anterior knee pain persisted in 6 cases (20%). Conclusions: Excellent functional outcome with BPTB auto graft in Anterior Cruciate Ligament injury was achieved.

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Controversies in ACL Reconstruction: Bone-patellar Tendon-bone Anterior Cruciate Ligament Reconstruction Remains the Gold Standard

Sports Medicine and Arthroscopy Review ◽

10.1097/jsa.0b013e3181c14841 ◽

2009 ◽

Vol 17 (4) ◽

pp. 242-246 ◽

Cited By ~ 52

Author(s):

Maj Steven J. Hospodar ◽

Mark D. Miller

Keyword(s):

Anterior Cruciate Ligament ◽

Anterior Cruciate Ligament Reconstruction ◽

Acl Reconstruction ◽

Patellar Tendon ◽

Gold Standard ◽

Ligament Reconstruction ◽

Cruciate Ligament ◽

Cruciate Ligament Reconstruction ◽

Anterior Cruciate ◽

Bone Patellar Tendon

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Chronological Changes in Anterior Knee Stability after Anatomical Anterior Cruciate Ligament Reconstruction Using Bone–Patellar Tendon–Bone and Hamstring Grafts

The Journal of Knee Surgery ◽

10.1055/s-0039-1700809 ◽

2019 ◽

Author(s):

Kohei Kawaguchi ◽

Shuji Taketomi ◽

Hiroshi Inui ◽

Ryota Yamagami ◽

Keiu Nakazato ◽

...

Keyword(s):

Anterior Cruciate Ligament ◽

Acl Reconstruction ◽

Patellar Tendon ◽

Cruciate Ligament ◽

Knee Stability ◽

Bptb Graft ◽

Anterior Cruciate ◽

Double Bundle Acl Reconstruction ◽

Anterior Knee ◽

Bone Patellar Tendon

AbstractThe clinical outcomes of anterior cruciate ligament (ACL) reconstruction are typically evaluated at specific time points only. This study aimed to characterize the chronological changes in anterior knee stability after anatomical ACL reconstruction and to compare the anterior knee stability achieved with bone–patellar tendon–bone (BPTB) and hamstring tendon (HT) grafts. A total of 59 patients underwent anatomical rectangular tunnel ACL reconstruction using the BPTB graft and 23 patients underwent anatomical double-bundle ACL reconstruction using the HT graft. Anterior knee stability was quantitatively assessed using the KneeLax 3 arthrometer at 6 months, 1 year, and 2 years after surgery using side-to-side differences. The values for anterior knee stability using the BPTB graft were 0.3 mm after 6 months, 0.2 mm after 1 year, and 0.2 mm after 2 years, and no significant differences were observed during the postoperative study period. Meanwhile, the values for anterior knee stability using the HT graft were −0.3 mm after 6 months, 0.5 mm after 1 year, and 1.2 mm after 2 years, and anterior knee stability decreased chronologically from 6 months up to 2 years. Regarding anterior stability, the HT graft showed significant laxity compared with the BPTB graft only after 2 years. No chronological changes in anterior stability were observed from 6 months up to 2 years after ACL reconstruction using the BPTB graft, whereas anterior laxity developed during the same period after ACL reconstruction using the HT graft. This is a Level IV, therapeutic case series study.

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Prevalence and clinical implications of nerve injury during bone patellar tendon bone harvesting for anterior cruciate ligament reconstruction

Journal of Orthopaedic Surgery ◽

10.1177/2309499016684988 ◽

2017 ◽

Vol 25 (1) ◽

pp. 230949901668498 ◽

Cited By ~ 1

Author(s):

Barak Haviv ◽

Mustafa Yassin ◽

Ehud Rath ◽

Shlomo Bronak

Keyword(s):

Anterior Cruciate Ligament ◽

Acl Reconstruction ◽

Patellar Tendon ◽

Cruciate Ligament ◽

Sensory Nerve ◽

Sensory Loss ◽

Anterior Cruciate ◽

Bone Patellar Tendon ◽

Sensation Loss

Purpose: Tendon harvesting for anterior cruciate ligament (ACL) reconstruction often injure sensory branches of the saphenous nerve (SN). Our purpose was to estimate the prevalence and postoperative course of sensory nerve injuries in bone patellar tendon bone (BPTB) autograft harvesting for ACL reconstruction. Methods: Between 2012 and 2014, patients who had primary ACL with BPTB autograft were included ( n = 60) and interviewed specifically for sensory loss and its recovery. The surface area of sensory loss was documented. Evaluation also included demographic details, level of activity, and description of postoperative sensation disturbances. Results: The mean postoperative follow-up time was 24 ± 14 months. At the last follow-up, 46 (77%) patients reported on postoperative reduced sensation; however, only 35 (58%) remained with sensation loss. The most involved region of reduced sensation was of the infrapatellar branch of the SN. Three patients claimed they regret to have had the surgery specifically because of sensation loss and kneeling difficulties, while all others did not. Conclusion: Primary ACL reconstruction using the midline incision for harvesting the middle third of the patellar tendon autograft has a high prevalence of sensory nerve injury with a minor possibility for complete recovery within the first year. However, sensory loss secondary to this injury does not impair normal daily activities in these patients.

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Functional outcome of anterior cruciate ligament reconstruction using bone-patellar tendon-bone graft: a descriptive observational study from Telangana

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20211442 ◽

2021 ◽

Author(s):

K. Jaya Krishna Singh ◽

V. K. V. Prasad ◽

T. Ashita Singh ◽

Anant A. Takalkar

Keyword(s):

Anterior Cruciate Ligament ◽

Observational Study ◽

Functional Outcome ◽

Acl Reconstruction ◽

Patellar Tendon ◽

Cruciate Ligament ◽

Simple Random Sampling ◽

Anterior Cruciate ◽

Bone Autograft ◽

Bone Patellar Tendon

Background: The knee joint is the most commonly injured of all joints and the anterior cruciate ligament is the most commonly injured ligament. The bone-patellar tendon-bone (BPTB) autograft is the most commonly used autograft for reconstruction. The bone-patellar tendon-bone autograft has been widely accepted as the gold standard for ACL reconstruction with a high success rate. Objectives of the study were to study the functional outcome of ACL reconstruction using BPTB graft.Methods: The present descriptive observational study was carried out at department of orthopedics, Mediciti institute of medical sciences, Hyderabad involving 30 patients of ACL tear by simple random sampling method. Patients were then evaluated by both subjectively and objectively. They were evaluated by using Lysholm and Gilquist knee scoring scale. Data was analyzed by using SPSS 24.0 version IBM USA.Results: Majority of the patients i.e., 13 (43.3%) were from 26-35 years age group with right sided involvement in 60%. The result was found to be good in 16 i.e., 53.3%, excellent in 10 i.e., 33.3% and fair in 4 i.e., 13.3% patients. Prevalence of complications was reported as 23.3% in our study.Conclusions: Our study of ACL repair using BPTP gives good to excellent results within a span of one year.

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Advanced Patellar Tendinopathy Is Associated With Increased Rates of Bone–Patellar Tendon–Bone Autograft Failure at Early Follow-up After Anterior Cruciate Ligament Reconstruction

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967118807710 ◽

2018 ◽

Vol 6 (11) ◽

pp. 232596711880771 ◽

Cited By ~ 1

Author(s):

Alexander L. Lazarides ◽

Eduard Alentorn-Geli ◽

Emily N. Vinson ◽

Thomas W. Hash ◽

Kristian Samuelsson ◽

...

Keyword(s):

Anterior Cruciate Ligament ◽

Acl Reconstruction ◽

Patellar Tendon ◽

Graft Failure ◽

Cruciate Ligament ◽

Patellar Tendinopathy ◽

Anterior Cruciate ◽

Primary Acl Reconstruction ◽

Bone Patellar Tendon

Background: Revision anterior cruciate ligament (ACL) reconstruction can be potentially devastating for a patient. As such, it is important to identify prognostic factors that place patients at an increased risk for graft failure. There are no data on the effects of patellar tendinopathy on failure of ACL reconstruction when using a bone–patellar tendon–bone (BPTB) autograft. Purpose/Hypothesis: The purpose of this study was to investigate the association of patellar tendinopathy with the risk of graft failure in primary ACL reconstruction when using a BPTB autograft. The hypothesis was that patellar tendinopathy would result in higher rates of graft failure when using a BPTB autograft for primary ACL reconstruction. Study Design: Cohort study; Level of evidence, 3. Methods: All patients undergoing ACL reconstruction at a single institution from 2005 to 2015 were examined. A total of 168 patients undergoing primary ACL reconstruction with a BPTB autograft were identified. Patients’ magnetic resonance imaging scans were reviewed for the presence and grade of patellar tendinopathy by 2 musculoskeletal fellowship–trained radiologists; both were blinded to the aim of the study, patient demographics, surgical details, and outcomes. Patients were divided into 2 groups: failure (defined as presence of symptomatic laxity or graft insufficiency) and success of the ACL graft. Statistical analyses were run to examine the association of patellar tendinopathy with failure of ACL reconstruction using a BPTB autograft. Results: At a mean follow-up of 18 months, there were 7 (4.2%) patients with graft failure. Moderate or severe patellar tendinopathy was associated with ACL graft failure ( P = .011). Age, sex, and side of reconstruction were not associated with the risk of graft failure, although the majority of patients who failed were younger than 20 years. The use of patellar tendons with moderate to severe tendinopathy was associated with a relative risk of ruptures of 6.1 (95% CI, 1.37-27.34) as compared with autograft tendons without tendinopathy. Conclusion: Moderate or severe patellar tendinopathy significantly increases the risk of graft failure when using a BPTB autograft for primary ACL reconstruction. Patellar tendinopathy should be considered when determining the optimal graft choice for patients undergoing primary ACL reconstruction with autograft tendons.

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A novel technique of treating anterior cruciate ligament injury: combining the ACL reconstruction and repair.

10.21203/rs.3.rs-24772/v1 ◽

2020 ◽

Author(s):

Yuan Yang ◽

Kang Chen ◽

Wenzhe Feng ◽

Weimin Zhu ◽

Yuxiao Lai

Keyword(s):

Anterior Cruciate Ligament ◽

Acl Reconstruction ◽

Anterior Cruciate Ligament Injury ◽

Cruciate Ligament ◽

Donor Site ◽

Ligament Injury ◽

Knee Biomechanics ◽

Knee Stability ◽

Novel Technique ◽

Anterior Cruciate

Abstract Background To illustrate a novel technique of treating anterior cruciate ligament injury. Methods If the ACL stump is strong enough and of good quality, we combine the ACL reconstruction and repair together. Results It is assumed that this will be better for the knee biomechanics in contrast to the simple reconstruction. This technique may also save the graft. That means we can only harvest one tendon gracilis or semitendinosus to satisfy the need of the knee stability. Conclusions This technique of combining the reconstruction and repair protects the knee proprioceptive feelings, accelerate the revascularization and strengthen the reconstructed ACL. This technique may also save the ligament graft and avoid the complications of the donor site. We are looking forward to comparing the outcomes of this technique to the outcomes of simple ACL reconstruction.

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What Is The Best Graft To Use For Anterior Cruciate Ligament (ACL) Reconstruction In Adult, Male Football Players; Bone-Patellar Tendon-Bone Autograft Versus Hamstring Tendon Autograft?

The Internet Journal of Orthopedic Surgery ◽

10.5580/d09 ◽

2010 ◽

Vol 17 (1) ◽

Keyword(s):

Anterior Cruciate Ligament ◽

Acl Reconstruction ◽

Patellar Tendon ◽

Cruciate Ligament ◽

Hamstring Tendon ◽

Football Players ◽

Anterior Cruciate ◽

Bone Autograft ◽

Tendon Autograft ◽

Bone Patellar Tendon

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A novel technique of treating anterior cruciate ligament injury: combining the ACL reconstruction and repair.

10.21203/rs.3.rs-15969/v1 ◽

2020 ◽

Author(s):

Yuan Yang ◽

Weimin Zhu ◽

Yuxiao Lai ◽

Kang Chen ◽

Wenzhe Feng

Keyword(s):

Anterior Cruciate Ligament ◽

Acl Reconstruction ◽

Anterior Cruciate Ligament Injury ◽

Cruciate Ligament ◽

Ligament Injury ◽

Knee Biomechanics ◽

Knee Stability ◽

Novel Technique ◽

Anterior Cruciate

Abstract If the ACL stump is strong enough and of good quality, we combine the ACL reconstruction and repair together. The main aim of this technique is to retain the autologous ACL stump to protect the proprioception and accelerate the revascularization and may even promote the healing of the bone to tendon. It is assumed that this will be better for the knee biomechanics in contrast to the simple reconstruction. This technique may also save the graft. That means we can only harvest one tendon gracilis or semitendinosus to satisfy the need of the knee stability.

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