Early Outcomes in Anterior Cruciate Ligament Reconstruction: Full Tibial tunnel technique compared to all-inside technique

The all-inside technique for ACL reconstruction uses the semitendinous muscle tendon as a graft, and postoperative pain is slightly reduced. Through the full tibial tunnel technique, better anatomical graft placement is obtained with promising results, yet there are only few scientific articles comparing the two techniques. The main objective is evaluation of results after ACL reconstruction by comparing the clinical results of the two surgical techniques. A prospective study was conducted that included 63 eligible patients according to pre-established criteria. The technique used was randomly indicated to each patient. Demographics and clinical examination results were collected and subsequently stored. The assessment tools used were the International Knee Documentation Committee (IKDC), Knee injury and Osteoarthritis Outcome Score (KOOS) and the Visual Analogue Scale (VAS) with a 6-month follow-up period. The statistical analysis was performed for preoperative follow-up scores, at 3 and 6 months. All patients were operated by the same surgical team under spinal anesthesia with nerve block and tourniquet applied.In regards to IKDC and KOOS scores, the difference between the two interventions was not statistically significant (p = .579 and p = .710). Postoperative pain was slightly reduced in patients in the all-inside\ group but without any statistical significance compared to full-tibial tunnel technique(p = .259). There were no graft ruptures or late postoperative complications. Regarding IKDC, KOOS and VAS evaluating tools, there is no statistically significant difference between the two evaluated methods for ACL reconstruction, all-inside and full tibial tunnel at 3 months and 6 months after surgery.

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Anterior Cruciate Ligament Reconstruction Using an Achilles Tendon Allograft Graft

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967114s00134 ◽

2014 ◽

Vol 2 (11_suppl3) ◽

pp. 2325967114S0013

Author(s):

Musa Uğur Mermerkaya ◽

Ahmet Özgür Atay ◽

Şenol Bekmez ◽

Fatih Karaaslan ◽

Erkan Alkan ◽

...

Keyword(s):

Anterior Cruciate Ligament ◽

Achilles Tendon ◽

Acl Reconstruction ◽

Cruciate Ligament ◽

Tibial Tunnel ◽

Tunnel Widening ◽

Significant Difference ◽

Anterior Cruciate ◽

Femoral Side

Objectives: To compare femoral and tibial tunnel widening (TW) in patients undergoing anterior cruciate ligament (ACL) reconstruction using an interference screw (IS), or an EndoButton-Continuous Loop (EndoButton-CL®) on the femoral side, and an IS/staple on the tibial side. Methods: We retrospectively reviewed data on 46 patients who underwent arthroscopic ACL reconstruction with Achilles tendon allografting. Fixation was performed with a bioabsorbable IS (the IS group) in 24 patients (mean age 26.5 years), and with the EndoButton-CL device (the EB group) in 22 patients (mean age 28.1 years) on the femoral side. Evaluation included standardized anteroposterior (AP) and lateral radiography. The diameters of tunnels at the last follow-up visit (at a median time of 17 months postoperatively) were compared to those noted on radiographs taken 1 day postoperatively. Results: The two groups were similar in terms of age and gender distribution, the operated side, the size of the tunnel created, and the follow-up period (p>0.05). Femoral TW at the proximal and middle levels (on both anteroposterior and lateral views) in the IS group was significantly greater than in the EB group (p<0.050 for all comparisons). No significant difference in femoral TW at the distal level was evident between the groups, and tibial TW at all levels was similar in both groups (p>0.050). Conclusion: Femoral ACL graft fixation using an EndoButton-CL reduced femoral TW compared to use of an IS.

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Tear Rates of the Ipsilateral ACL Graft and the Contralateral Native ACL Are Similar following ACL Reconstruction

The Journal of Knee Surgery ◽

10.1055/s-0040-1713861 ◽

2020 ◽

Author(s):

Nadia Nastassia Ifran ◽

Ying Ren Mok ◽

Lingaraj Krishna

Keyword(s):

Acl Reconstruction ◽

Medical Records ◽

Cruciate Ligament ◽

Acl Graft ◽

Increased Risk ◽

Significant Difference ◽

The Mean ◽

Anterior Cruciate ◽

Mean Time

AbstractThe aim of the study is to compare the tear rates of ipsilateral anterior cruciate ligament (ACL) grafts and the contralateral native ACL as well as to investigate the correlation of gender, age at time of surgery, and body mass index (BMI) with the occurrence of these injuries. The medical records of 751 patients who underwent ACL reconstruction surgery with follow-up periods of 2 to 7 years were retrospectively analyzed. Survival analyses of ipsilateral ACL grafts and contralateral native ACL were performed. Univariate and multivariate logistic regression analyses were performed to identify risk factors that were associated with these injuries. The tear rates of the ipsilateral ACL graft and contralateral ACL were 5.86 and 6.66%, respectively with no significant difference between groups (p = 0.998). The mean time of tears of the ipsilateral ACL and contralateral ACL was also similar (p = 0.977) at 2.64 and 2.78 years, respectively after surgery. Both the odds of sustaining an ipsilateral ACL graft and contralateral ACL tear were also significantly decreased by 0.10 (p = 0.003) and 0.14 (p = 0.000), respectively, for every 1-year increase in age at which the reconstruction was performed. However, graft type, gender, and BMI were not associated with an increased risk of these injuries. There was no difference between tear rates of ipsilateral ACL graft and contralateral ACL following ACL reconstruction. Patients who undergo ACL reconstruction at a young age are at an increased risk of both ipsilateral graft and contralateral ACL rupture after an ACL reconstruction. Patients who are young and more likely to return to competitive sports should be counselled of the risks and advised to not neglect the rehabilitation of the contralateral knee during the immediate and back to sports period of recovery. This is a Level III, retrospective cohort study.

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Accessory Anteromedial Portal may not Provide Clinically Superior Results Compared with the Anteromedial Portal in Anterior Cruciate Ligament Reconstruction

The Journal of Knee Surgery ◽

10.1055/s-0037-1607074 ◽

2017 ◽

Vol 31 (08) ◽

pp. 716-722

Author(s):

Shu-Ming Ye ◽

Jue-Hua Jing ◽

Hao Lv ◽

Ji-Sen Zhang ◽

Xin-Zhong Xu ◽

...

Keyword(s):

Acl Reconstruction ◽

Femoral Tunnel ◽

Pivot Shift ◽

Cruciate Ligament ◽

Tibial Tunnel ◽

Pivot Shift Test ◽

Single Bundle ◽

Anteromedial Portal ◽

Anterior Cruciate

AbstractTechniques using the anteromedial portal (AMP) and accessory anteromedial portal (AAMP) are commonly used in anterior cruciate ligament (ACL) reconstruction. The aim of this study was to investigate the radiological and clinical outcomes of arthroscopic single-bundle ACL reconstruction using the AMP or AAMP technique to drill the femoral tunnel. The records of 157 patients who underwent single-bundle ACL reconstruction using the AMP or AAMP technique between 2011 and 2015 were reviewed. The femoral tunnel clock-face position and femoral tunnel and tibial tunnel anterior–posterior (AP) inclination angles were assessed on axial or AP magnetic resonance images. At last follow-up, the Lachman test and pivot-shift test were used to evaluate AP and rotational stability, respectively. The Lysholm knee scoring scale and the International Knee Documentation Committee (IKDC) form were used to evaluate clinical and functional results. No statistically significant differences were found between the groups in patient age, sex, follow-up period, or affected side distribution. The mean femoral tunnel inclination angle was 31.13 ± 8.06 degrees in the AMP group and 30.17 ± 9.02 degrees in the AAMP group (p = 0.513). The tibial tunnel inclination angle in the AMP group (16.28 ± 7.89 degrees) was not different from that in the AAMP group (13.70 ± 6.08 degrees). No significant differences were observed between the two groups in the Lachman test, pivot-shift test, Lysholm knee scoring scale, or IKDC scores. The AAMP technique was not clinically superior to the AMP technique in ACL reconstruction. This is a retrospective comparative study and its level of evidence is III.

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Evaluation of Single-Bundle versus Double-Bundle PCL Reconstructions with More Than 10-Year Follow-Up

The Scientific World JOURNAL ◽

10.1155/2015/751465 ◽

2015 ◽

Vol 2015 ◽

pp. 1-5 ◽

Cited By ~ 6

Author(s):

Masataka Deie ◽

Nobuo Adachi ◽

Atsuo Nakamae ◽

Kobun Takazawa ◽

Mitsuo Ochi

Keyword(s):

Evaluation Method ◽

Cruciate Ligament ◽

Knee Injuries ◽

Surgical Techniques ◽

Double Bundle ◽

Single Bundle ◽

Bundle Versus ◽

Significant Difference ◽

The Mean

Background. Posterior cruciate ligament (PCL) injuries are not rare in acute knee injuries, and several recent anatomical studies of the PCL and reconstructive surgical techniques have generated improved patient results. Now, we have evaluated PCL reconstructions performed by either the single-bundle or double-bundle technique in a patient group followed up retrospectively for more than 10 years.Methods. PCL reconstructions were conducted using the single-bundle (27 cases) or double-bundle (13 cases) method from 1999 to 2002. The mean age at surgery was 34 years in the single-bundle group and 32 years in the double-bundle group. The mean follow-up period was 12.5 years. Patients were evaluated by Lysholm scoring, the gravity sag view, and knee arthrometry.Results. The Lysholm score after surgery was89.1±5.6points for the single-bundle group and91.9±4.5points for the double-bundle group. There was no significant difference between the methods in the side-to-side differences by gravity sag view or knee arthrometer evaluation, although several cases in both groups showed a side-to-side difference exceeding 5 mm by the latter evaluation method.Conclusions. We found no significant difference between single- and double-bundle PCL reconstructions during more than 10 years of follow-up.

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PRP on Preventıon of Tunnel Enlargement in ACL Reconstructıon

Ortopedia Traumatologia Rehabilitacja ◽

10.5604/01.3001.0012.6462 ◽

2018 ◽

Vol 20 (4) ◽

pp. 285-291 ◽

Cited By ~ 3

Author(s):

Serkan Sözkesen ◽

Huseyin Gokhan Karahan ◽

Ahmet Kurtulmus ◽

Cemil Kayali ◽

Taskin Altay

Keyword(s):

Acl Reconstruction ◽

Platelet Rich Plasma ◽

Cruciate Ligament ◽

Tibial Tunnel ◽

Hamstring Tendon ◽

Control Group ◽

Tunnel Enlargement ◽

Hamstring Autograft ◽

Significant Difference ◽

Kt 1000

Background. The purpose of this study is to describe the role of Platelet Rich Plasma in preventing tunnel enlargement in anterior cruciate ligament reconstruction with a hamstring autograft Material and methods. Forty-four patients who underwent transtibial reconstructive surgery with a hamstring tendon autograft between March 2014 and July 2015 were included in this study. This study involved two groups. Group A consisted of 18 patients who underwent PRPadministration into the femoral and tibial tunnel. Group B was a control group that included 26 patients who underwent ACL reconstruction surgery with a hamstring autograft without PRP. The patients were evaluated preoperatively and postoperatively with the IKDC score, Lysholm score, Tegner activity scale and a KT-1000 arthrometer device. The diameter of the tibial and femoral tunnels of the operated knees was measured on the first day and at three months postoperatively using CT. Measurements carried out for tomography standardization of the patients were evaluated on coronal, sagittal and axial images from 64-slice MSCT scans. Results. On comparison of radiological data between both groups, there was less tunnel enlargement in PRP-administered group for the femoral tunnel, but the result was not statistically significant. No difference was seen between clinical examination results and the grading scales used. Conclusions. 1. The radiological findings of our study indicated that while there was less tunnel enlargement in the PRP group, there was no statistically significant difference between the groups. 2. Similarly, clinical examination results and scoring scales used did not demonstrate any intergroup difference. 3. As a result, we donot recommend routine use of PRP for the prevention of tunnel enlargement after ACL reconstruction.

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Complications After Anterior Cruciate Ligament Reconstruction and Their Relation to the Type of Graft: A Prospective Study of 958 Cases

The American Journal of Sports Medicine ◽

10.1177/0363546519867913 ◽

2019 ◽

Vol 47 (11) ◽

pp. 2543-2549 ◽

Cited By ~ 11

Author(s):

Romain Rousseau ◽

Charlotte Labruyere ◽

Charles Kajetanek ◽

Olivia Deschamps ◽

Konstantinos G. Makridis ◽

...

Keyword(s):

Acl Reconstruction ◽

Patellar Tendon ◽

Knee Pain ◽

Anterior Knee Pain ◽

Cruciate Ligament ◽

Meniscal Lesions ◽

Significant Difference ◽

Anterior Cruciate ◽

Anterior Knee

Background: Complications and adverse events after anterior cruciate ligament (ACL) reconstruction are well known, but they have been underestimated in previous studies. Purpose: To describe the complications and adverse events after ACL reconstruction within a 2-year follow-up and analyze them in relation to the type of graft. Study Design: Cohort study; Level of evidence, 3. Methods: From 2000 to 2012, 958 patients with an isolated ACL injury underwent surgery by a single knee surgeon. ACL reconstruction was performed with the medial portal technique for the femoral tunnel and the use of bone–patellar tendon–bone (BPTB) or hamstring tendon graft. Patients were reviewed at 6 weeks and 3, 6, 12, and 24 months after surgery with the International Knee Documentation Committee score, plain radiographs, and the KT-1000 arthrometer. Results: Of 958 patients enrolled, 147 (15%) were lost at last follow-up. The 2 groups (bone–patellar tendon–bone [n = 257] and hamstring [n = 554]) were similar regarding the mean age at the time of surgery and preoperative anterior laxity. The main complications were as follows: anterior knee pain (n = 130 of 811, 16%), stiffness (n = 72, 8.8%), secondary meniscal lesions (n = 59, 7.2%), pain attributed to fixation (n = 79, 9.7%), ACL rerupture (n = 47, 5.7%), contralateral ACL ruptures (n = 24, 3%), patellar fractures (n = 3, 0.3%), infections (n = 9, 1%), and thromboembolic complications (n = 5, 0.6%). There was no significant difference between the grafts with respect to the frequency of joint stiffness, secondary meniscal lesions, or anterior knee pain. During the first 2 postoperative years, the percentage of patients with anterior knee pain was higher in the patellar tendon group (23.3% vs 12.6%, P < .001); however, this difference was not significant after the 2-year interval (3.1% vs 2.5%, P = .63). The percentage of patients with a rerupture of the graft was significantly lower in the patellar tendon group than in the hamstring group (25 of 811 [3.1%] vs 57 of 811 [7%], P = .023). Similar results were recorded regarding the pain related to the hardware material (7 of 811 [0.8%] in the BPTB group vs 113 of 811 [13.9%] in the hamstring group, P = .001). The percentage of ACL ruptures contralateral to the repair was higher in the patellar tendon group (41 of 811 [5%] vs 17 of 811 [2%], P = .016). Conclusion: The total rate of complications after an ACL reconstruction was 39%, and the surgical revision rate for any reason was 28%. Problems with the hardware material were more frequent in the hamstring group, leading to an increased rate of surgical revision. Anterior knee pain was initially higher in the patellar tendon group, but there was no significant difference in a 2-year interval. The rerupture rate was statistically higher in the hamstring group.

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Return to Sport After Primary and Revision Anterior Cruciate Ligament Reconstruction: A Prospective Comparative Study of 552 Patients From the FAST Cohort

The American Journal of Sports Medicine ◽

10.1177/0363546516660075 ◽

2016 ◽

Vol 45 (1) ◽

pp. 34-41 ◽

Cited By ~ 66

Author(s):

Nicolas Lefevre ◽

Shahnaz Klouche ◽

Guillaume Mirouse ◽

Serge Herman ◽

Antoine Gerometta ◽

...

Keyword(s):

Acl Reconstruction ◽

Cruciate Ligament ◽

Return To Sport ◽

Primary Reconstruction ◽

Significant Difference ◽

Revision Reconstruction ◽

Anterior Cruciate ◽

Reconstruction Group

Background: Few studies have reported the return-to-sport rate at 1-year follow-up after primary and revision anterior cruciate ligament (ACL) reconstruction. Purpose: To compare the return-to-sport rate 1 year after primary and revision ACL reconstruction in the same cohort according to 2 modalities: any kind of sport and the patient’s usual sport at the same level as before the injury. Study Design: Cohort study; Level of evidence, 3. Methods: A single-center, prospective cohort study of patients undergoing ACL reconstruction (French prospective Acl STudy [FAST]) was begun in 2012. A comparative study was performed based on a retrospective analysis of data collected prospectively. Included were all athletes aged 18 to 50 years who underwent primary or revision isolated ACL reconstruction between 2012 and 2014. Two groups were formed: primary reconstruction and revision reconstruction. The main criterion was return to sport at 1-year follow-up (yes/no); secondary criteria were return to the usual sport at 1-year follow-up, knee function (International Knee Documentation Committee [IKDC] and Knee injury and Osteoarthritis Outcome Score [KOOS] scores), and psychological readiness (ACL–Return to Sports after Injury [ACL-RSI] score) at 6 months and 1 year. Results: A total of 552 patients (primary reconstruction group: n = 497, revision reconstruction group: n = 55) were included in the study. There were 373 men and 179 women (mean [±SD] age, 30.2 ± 8.4 years). No significant difference in the return-to-sport rate was found between the 2 groups at 1-year follow-up (primary reconstruction group: 90.9%, revision reconstruction group: 87.3%; P = .38), but patients in the primary reconstruction group resumed their usual sport significantly more often (primary reconstruction group: 63.6%, revision reconstruction group: 49.1%; P = .04). Eight (1.4%) retears occurred during a new sport-related injury within a mean 8.9 ± 2.9 months: 7 (1.4%) in the primary reconstruction group and 1 (1.8%) in the revision reconstruction group ( P = .8). At 1-year follow-up, functional scores were significantly better in the primary reconstruction group for subjective IKDC (82.6 ± 13.3 vs 78.4 ± 16.6; P = .04); KOOS Symptoms/Stiffness (73.3 ± 15.2 vs 67.7 ± 19.6; P = .02), Activities of Daily Living (96.3 ± 6.4 vs 94.3 ± 9.1; P = .04), Sport (79.7 ± 19.1 vs 69.1 ± 24.8; P = .0004), and Quality of Life (69.6 ± 22.7 vs 54.7 ± 24.8; P < .00001) subscales; and ACL-RSI (65 ± 23 vs 49.5 ± 24.8; P < .00001). On multivariate analysis, patients who were more likely to resume their usual sport at 1 year were high-level players (odds ratio [OR], 2.2) who underwent primary reconstruction (OR, 2.0) and had better KOOS Quality of Life (OR, 1.7) and subjective IKDC (OR, 2.1) scores at 6-month follow-up without complications or retears during the first postoperative year (OR, 2.6). Conclusion: At 1-year follow-up, there was no significant difference in the return-to-sport rate between primary and revision ACL reconstruction. Patients who underwent primary reconstruction returned to their usual sport significantly more often. Trial Registration: NCT02511158 ( ClinicalTrials.gov identifier).

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

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967119888888 ◽

2019 ◽

Vol 7 (12) ◽

pp. 232596711988888 ◽

Cited By ~ 1

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%).

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Prevalence and influence of tibial tunnel widening after isolated anterior cruciate ligament reconstruction using patella-bone-tendon-bone-graft: long-term follow-up

Orthopedic Reviews ◽

10.4081/or.2012.e21 ◽

2012 ◽

Vol 4 (2) ◽

pp. 21 ◽

Cited By ~ 15

Author(s):

Johannes Struewer ◽

Turgay Efe ◽

Thomas Manfred Frangen ◽

Tim Schwarting ◽

Benjamin Buecking ◽

...

Keyword(s):

Anterior Cruciate Ligament ◽

Acl Reconstruction ◽

Cruciate Ligament ◽

Tibial Tunnel ◽

Tunnel Widening ◽

Long Term Follow Up ◽

Grade Ii ◽

Anterior Cruciate

The aim of the present study was to evaluate incidence, degree and impact of tibial tunnel widening (TW) on patient-reported long-term clinical outcome, knee joint stability and prevalence of osteoarthritis (OA) after isolated anterior cruciate ligament (ACL) reconstruction. On average, 13.5 years after ACL reconstruction via patella-bone-tendon-bone autograft, 73 patients have been re-evaluated. Inclusion criteria consisted of an isolated anterior cruciate ligament rupture and reconstruction, a minimum of 10-year follow-up and no previous anterior cruciate ligament repair or associated intra-articular lesions. Clinical evaluation was performed via the International Knee Documentation Committee (IKDC) score and the Tegner and Lysholm scores. Instrumental anterior laxity testing was carried out with the KT-1000™ arthrometer. The degree of degenerative changes and the prevalence of osteoarthritis were assessed with the Kellgren-Lawrence score. Tibial tunnel enlargement was radiographically evaluated on both antero-posterior and lateral views under establishment of 4 degrees of tibial tunnel widening by measuring the actual tunnel diameters in mm on the sclerotic margins of the inserted tunnels on 3 different points (T1-T3). Afterwards, a conversion of the absolute values in mm into a 4 staged ratio, based on the comparison to the results of the initial drill-width, should provide a better quantification and statistical analysis. Evaluation was performed postoperatively as well as on 2 year follow-up and 13 years after ACL reconstruction. Minimum follow-up was 10 years. 75% of patients were graded A or B according to IKDC score. The mean Lysholm score was 90.2 ± 4.8 (25-100). Radiological assessment on long-term follow-up showed in 45% a grade I, in 24% a grade II, in 17% a grade III and in additional 12% a grade IV enlargement of the tibial tunnel. No evident progression of TW was found in comparison to the 2 year results. Radiological evaluation revealed degenerative changes in sense of a grade II OA in 54% of patients. Prevalence of a grade III or grade IV OA was found in 20%. Correlation analysis showed no significant relationship between the amount of tibial tunnel enlargement (P>0.05), long-term clinical results, anterior joint laxity or prevalence of osteoarthritis. Tunnel widening remains a radiological phenomenon which is most commonly observed within the short to midterm intervals after anterior cruciate ligament reconstruction and subsequently stabilises on mid and long- term follow-up. It does not adversely affect long-term clinical outcome and stability. Furthermore, tunnel widening doesn’t constitute an increasing prevalence of osteoarthritis.

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Graft tunnel integration occurs early in the tibial tunnel compared with the femoral tunnel after anterior cruciate ligament reconstruction with preserved insertion hamstring tendon graft

Knee Surgery and Related Research ◽

10.1186/s43019-021-00119-x ◽

2021 ◽

Vol 33 (1) ◽

Author(s):

Ravi Gupta ◽

Sandeep Singh ◽

Anil Kapoor ◽

Ashwani soni ◽

Ravinder Kaur ◽

...

Keyword(s):

Anterior Cruciate Ligament ◽

Acl Reconstruction ◽

Cruciate Ligament ◽

Tibial Tunnel ◽

Hamstring Tendon ◽

Tendon Graft ◽

Hamstring Tendon Graft ◽

The Mean ◽

Anterior Cruciate

Abstract Background Preservation of hamstring tendon insertion at the time of anterior cruciate ligament (ACL) reconstruction is a well-known technique; however, its effect on graft integration is not well studied. The present study was conducted to study the graft integration inside the tibial and femoral tunnels, respectively, after ACL reconstruction using hamstring tendon graft with preserved insertion. Methods Twenty-five professional athletes who underwent ACL reconstruction using hamstring tendon graft with preserved tibia insertion were enrolled in the study. Functional outcomes were checked at final follow-up using Lysholm score and Tegner activity scale. Magnetic resonance imaging (MRI) was done at 8 months and 14 months follow-up to study the graft tunnel integration of the ACL graft at both tibial and femoral tunnels. Results The mean Fibrous interzone (FI) score (tibial tunnel) decreased from 2.61 (1–5) at 8 months to 2.04 (1–4) at 14 months follow-up (p = 0.02). The mean FI score (femoral side) decreased from 3.04 (2–5) at 8 months to 2.57 (2–4) at 14 months (p = 0.02). Conclusions Graft integration occurs early in the tibial tunnel as compared with the femur tunnel with preserved insertion hamstring tendon autograft. Trial registration CTRI/2019/07/020320 [registered on 22/07/2019]; http://www.ctri.nic.in/Clinicaltrials/pdf_generate.php?trialid=33884&EncHid=&modid=&compid=%27,%2733884det%27

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