A comparative study of the healing of tendon autograft and tendon-bone autograft using patellar tendon in rabbits

Park, M.J.; Lee, M.C.; Seong, Sang Cheol

doi:10.1007/s002640000199

Cited by 93 publications

(65 citation statements)

References 10 publications

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“…Another disadvantage to using hamstrings tendon grafts is that soft-tissue to bone healing takes longer than bone-to-bone healing and is less reliable. 15 Soft tissue grafts may also have a propensity to cause tunnel widening. 16 However, there is little evidence that tunnel widening affects clinical or arthrometric outcomes following ACL reconstruction.…”

Section: Discussionmentioning

confidence: 99%

Comparative study between bone patellar tendon bone and quadrupled hamstring autografts in arthroscopic anterior cruciate ligament reconstruction with aperture fixation

Shaktawat¹,

Mishra²,

Kashid³

et al. 2017

Int J Res Orthop

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Background: Bone patellar tendon bone (BPTB) and hamstring (HT) auto grafts have been used routinely in reconstruction of ACL over past two decades. Controversy still remains as to which graft is superior over other. Many studies have compared these graft options using different implants and different methods of fixation. Continuation of efforts in the same direction; purpose of the study is to compare these two graft options utilizing identical implants and similar method of fixation.Methods: 40 patients of clinically and radiologically diagnosed ACL tear fulfilling the inclusion and exclusion criteria were randomized into two groups to undergo arthroscopic ACL reconstruction using quadrupled hamstring graft (n=20) and bone patellar tendon bone auto graft (n=20) utilizing bioscrew by aperture fixation method in both the groups. They were compared post operatively for symptomatic improvement, clinical and rolimeter laxity tests and Lysholm functional knee scoring at 02 year.Results: At the end of 02 years laxity measurement by rolimeter showed slightly better results in BPTB group; however it was not statistically significant (p value= 0.362). Knee pain at the end of 02 year was slightly more in HT groups (45%) as compared to BPTB group (35%) but not significant (p value =0.748). Instability symptoms are comparable in both the groups (sense of giving away on exertion). Manual laxity testing by Lachman and Pivot shift tests were comparable in both the groups with p value of 0.695 and 0.999 respectively. Lysholm functional knee score also showed no statistical significance (p value =0.957).Conclusions: There is no significant difference between HT and BPTB auto grafts in terms of clinical and functional outcome at the end of 02 years.

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Section: Discussionmentioning

confidence: 99%

Comparative study between bone patellar tendon bone and quadrupled hamstring autografts in arthroscopic anterior cruciate ligament reconstruction with aperture fixation

Shaktawat¹,

Mishra²,

Kashid³

et al. 2017

Int J Res Orthop

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“…Several animal models have shown a slower incorporation rate into the bone tunnel with soft-tissue grafts compared to bone-plug grafts such as bone-patellar tendonbone (BTB) [73,74,81,105].…”

Section: Autograftmentioning

confidence: 99%

“…In the bone-to-bone tunnel, the bone plug showed complete incorporation at 6 weeks; however, in the tendon-bone tunnel-though there were some Sharpey 0 s like fibers-graft incorporation was incomplete. A rabbit model study found that the healing of bone-to-bone was mature at 8 weeks, whereas the healing of tendon-to-bone was mature at 12 weeks [74]. Although different animal models were used, the similarity of results in the aforementioned studies indicates that soft-tissue graft is slower to incorporate than bone-plug graft (Fig.…”

Section: Autograftmentioning

confidence: 99%

Graft healing in anterior cruciate ligament reconstruction

Ekdahl

Wang

Ronga

et al. 2008

Knee Surg Sports Traumatol Arthr

200

146

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Graft healing within the bone tunnel after anterior cruciate ligament (ACL) reconstruction is still a complex, poorly understood biological process that is influenced by multiple surgical and postoperative variables. However, remarkable advances in knowledge of this process have been made based primarly on animal models. According to the findings of this review, some surgical and postoperative variables are known to directly affect time-course and quality of graft-tunnel healing. The type of graft, graft motion, and fixation methods have shown to directly affect time-course and quality of graft-tunnel healing. Therefore, the application of early and aggressive rehabilitation protocols should be cautious when using soft-tissue graft, allografts, and direct or aperture type of fixation for ACL reconstruction. With regard to graft placement, several cadaveric models showed biomechanical advantages of a more anatomical graft location; however, there are no studies that explore the relationship between graft placement and healing process. The precise effect of graft tensioning, graft/tunnel diameter disparity, and graft length within the bone tunnel in the graft healing process remains unclear and requires more research. To enhance graft-tunnel healing, tissue-engineering approaches, including the use of growth factors, mesenchymal stem cells, and periosteum graft augmentation, have been tested on animal models. These have shown promising results in terms of enhancement of bone-graft healing rate.

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“…Average age = 23.7 (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29) years. The left knee was involved 6 times and the right knee 12 times.…”

Section: Methodsmentioning

confidence: 99%

Arthroscopic ACL reconstruction with Δ plasty: an innovative approach with hamstrings’ transfer and double tibial tunnel

Papachristou

Sourlas

Plessas

et al. 2007

Knee Surg Sports Traumatol Arthr

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We propose a new technique, with double bundle, double tibial tunnels with a bridge between them, using the hamstrings as auto-grafts, retaining either their central or peripheral attachment. A prospective series of 41 patients underwent primary reconstruction of the anterior cruciate ligament by one surgeon, arthroscopically and electronically assisted; 37 were men and 4 were women with a mean age of 24.7 years. The mean follow-up was 19.05 (12-30) months. Normal function and joint stability was achieved. The patients returned to full occupational activities within 3-6 months after the operation. The function of hamstrings was not disturbed. Two patients have sustained a new injury without rupture of the grafts. The Noulis-Lachman test was negative in 35 knees. Positive Pivot shift, post-operatively, was present in 15.45% of patients. The IKDC score was 84.55. In the proposed ACL reconstruction technique, the two tendons are transferred and used as grafts, with gracillis and semitendinosus retaining their distal and central attachment, respectively; the former superimposed upon the latter while entering the femoral tunnel. The tibial tunnels leave a bone bridge ranging between 12 and 15 mm within the footprints of ACL. The two bundles are tensioned, each at different angle. This configuration imitates both the anatomy and the function of ACL and controls not only the anterior translation, but also the rotatory stability. With this innovative technique, the final outcome is improved, thus being closer to normal, as evidenced from previous experiments and the present prospective series.

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A comparative study of the healing of tendon autograft and tendon-bone autograft using patellar tendon in rabbits

Cited by 93 publications

References 10 publications

Comparative study between bone patellar tendon bone and quadrupled hamstring autografts in arthroscopic anterior cruciate ligament reconstruction with aperture fixation

Comparative study between bone patellar tendon bone and quadrupled hamstring autografts in arthroscopic anterior cruciate ligament reconstruction with aperture fixation

Graft healing in anterior cruciate ligament reconstruction

Arthroscopic ACL reconstruction with Δ plasty: an innovative approach with hamstrings’ transfer and double tibial tunnel

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