A prospective randomized comparison of bone-patellar tendon-bone and hamstring grafts for anterior cruciate ligament reconstruction

Laxdal, Gauti; Kartus, Jüri; Hansson, Leif; Heidvall, M.; Ejerhed, Lars; Karlsson, Jón

doi:10.1016/j.arthro.2004.09.014

Cited by 176 publications

(173 citation statements)

References 45 publications

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“…In the paper by Biau and co-workers, we identified 14 primary studies with data available on anterior knee pain from 1991 to 2005 (Marder et al 1991, Aglietti et al 1994, 1997, Callaway et al 1994, Aune et al 2001, Eriksson et al 2001a, b, Feller et al 2001, Ropke et al 2001, Beynnon et al 2002, Shaieb et al 2002, Ejerhed et al 2003, Feller and Webster 2003, Hantes et al 2004, Ibrahim et al 2005, Laxdal et al 2005, Biau et al 2006). Our cumulative meta-analysis showed that statistical significance that hamstring autograft reduces ante- …”

Section: Cumulative Meta-analysis On Anterior Knee Pain (Figure 1)mentioning

confidence: 99%

Hamstring tendon autograft better than bone patellartendon bone autograft in ACL reconstruction A cumulative meta-analysis and clinically relevant sensitivity analysis applied to a previously published analysis

2007

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Background Current debate on treatment options for anterior cruciate ligament (ACL) reconstruction complicate the choice between hamstring and bone patellartendon bone autografts. We hypothesized a priori that cumulative meta-analysis (a form of sensitivity analysis) might show that the evidence for reduction of morbidity by hamstring grafts could have been reached at an earlier time. Furthermore, we hypothesized a priori that modern state-of-the-art hamstring graft fixation technique would give similar results regarding stability as bone-patellar tendon-bone autografts.Methods We performed a cumulative meta-analysis and sensitivity analysis based on femoral graft fixation techniques to compare hamstring autograft and bonepatellar tendon-bone autografts in ACL reconstruction derived from a previously published meta-analysis.Results Cumulatively, that hamstring autograft reduces anterior knee pain had already reached statistical significance in 2001 (relative risk 0.49 (95%CI: 0.32-0.76; p = 0.001, I2 = 0%)). The modern endobutton hamstring graft fixation technique (2 studies) yielded similar stability in the Lachman test as bone-patellar tendon-bone grafts, with a relative risk of 1.1 (95%CI: 0.82-1.5; p = 0.6, I2 = 0%). Exclusion of the endobutton group explains the increased laxity in the hamstring graft group.Interpretation Cumulative meta-analysis strengthens the evidence for reduced morbidity using hamstring tendon autograft for anterior cruciate ligament reconstruction. Sensitivity analysis focusing on state-of-the-

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Section: Cumulative Meta-analysis On Anterior Knee Pain (Figure 1)mentioning

confidence: 99%

Hamstring tendon autograft better than bone patellartendon bone autograft in ACL reconstruction A cumulative meta-analysis and clinically relevant sensitivity analysis applied to a previously published analysis

2007

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“…anterior knee pain, kneeling discomfort) as compared to BPTB graft. 2,3 Availability of improved fixation devices like EndoButton and tight rope has also encouraged the use of hamstring graft. 4 However, there are concerns associated with the harvesting of STG graft.…”

Section: Introductionmentioning

confidence: 99%

Equation-based precise prediction of length of hamstring tendons and quadrupled graft diameter by various anthropometric variables for knee ligament reconstruction in Indian population

Gupta

Malhotra

Masih

et al. 2017

J Orthop Surg (Hong Kong)

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Preoperative prediction of hamstring tendon lengths and graft diameter for anterior cruciate ligament (ACL) reconstruction enables better preoperative planning. Presently, no study exists for Indian population where both derivation and verification of a mathematical equation for accurate prediction of hamstring graft dimensions have been done. This study was conducted in two phases: First phase (derivation cohort): devoted to the study of correlation of length of hamstring tendons and graft diameter with various anthropometric measurements in 123 patients undergoing ACL reconstruction. Length of semitendinosus (ST) was observed to have a strong correlation with leg length (r ¼ 0.719), whereas that of gracilis (G) had a strong correlation with patient height (r ¼ 0.768). Quadrupled diameter (QD) had a strong correlation with patient height and thigh length (r ¼ 0.685 and 0.680, respectively). Using Pearson correlation coefficient, multiple stepwise linear regressions, and analysis of variance test, predictive equations were developed to predict the length of ST and G and QD. Second phase (verification cohort): This was a blinded prospective study done on 300 patients to further authenticate and test the accuracy of equations developed. Here, a steady correlation was found between the observed and predicted values of length of ST, G and QD, with correlation coefficients being 0.838, 0.847, and 0.767, respectively. Thus, we can safely conclude that clinically measurable anthropometric variables can reliably predict hamstring graft dimensions. This is likely to prove useful in better preoperative planning of ligament reconstructions.

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“…Accurate computer-navigated placement of the tunnel is an essential prerequisite to achieve a good clinical outcome with the procedure. Several studies have shown that an incorrectly placed tunnel is the main reason for graft failure and is frequently associated with instability of the knee joint after ACL reconstruction [11]. The question remains as to whether the use of four tunnels in a double-bundle construct rather than two in a single-bundle repair would increase the rate of failure.…”

Section: Discussionmentioning

confidence: 99%

“…Incorrect placement of the tibial and femoral tunnels is the main reason for technical failure in ACL reconstruction [10]. (2) The second problem is persistent instability of the knee after single-bundle ACL reconstruction despite correctly positioned tunnels [11]. The influence of the "mini" pivot shift phenomenon, a measurable positive pivot shift sign too low to introduce any subjective symptoms of instability but high enough to indicate degeneration of the meniscus and degenerative osteoarthritis, has been extensively and controversially discussed [12].…”

Section: Discussionmentioning

confidence: 99%

Application of a computerised navigation technique to assist arthroscopic anterior cruciate ligament reconstruction

Zhu

Lü

Han

et al. 2013

International Orthopaedics (SICOT)

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Purpose Based on biomechanical cadaver studies, anatomical double-bundle reconstruction of the anterior cruciate ligament (ACL) was introduced to achieve better stability in the knee, particularly in respect of rotatory loads. Previously, the success of ACL reconstruction was believed to be mainly dependent on correct positioning of the graft, irrespective of the number of bundles for which computer-assisted surgery was developed to avoid malpositioning of the tunnel. The aim of this study was to compare rotational and translational stability after computer-navigated standard single-bundle and anatomical double-bundle ACL reconstruction. Methods The authors investigated 42 consecutive patients who had undergone the single-bundle or double-bundle ACL reconstruction procedure using autogenous hamstring tendon grafts and ENDOBUTTON fixation in patients who had been followed up for a minimum of 24 months. Postoperative anteroposterior and rotational laxity was measured with the KT3000 and compared between groups. Results Both surgical procedures significantly improve rotational and translational stability compared to the preoperative ACL-deficient knee (P<0.05). No significant differences were registered between groups with regard to anteroposterior displacement of the tibia. The International Knee Documentation Committee (IKDC) and Lysholm scores were significantly higher in the double-bundle group. However, the results were excellent in both groups. Conclusions The use of computer-assisted ACL reconstruction, which is a highly accurate method of graft placement, could be useful for inexperienced surgeons to avoid malposition. Long-term results of at least five years are needed to determine whether double-bundle ACL reconstruction, which was associated with improved rotational laxity and significantly better IKDC and Lysholm scores compared to the standard single-bundle ACL reconstruction procedure, exerts an influence in terms of avoiding osteoarthritis or meniscus degeneration.

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A prospective randomized comparison of bone-patellar tendon-bone and hamstring grafts for anterior cruciate ligament reconstruction

Cited by 176 publications

References 45 publications

Hamstring tendon autograft better than bone patellartendon bone autograft in ACL reconstruction A cumulative meta-analysis and clinically relevant sensitivity analysis applied to a previously published analysis

Hamstring tendon autograft better than bone patellartendon bone autograft in ACL reconstruction A cumulative meta-analysis and clinically relevant sensitivity analysis applied to a previously published analysis

Equation-based precise prediction of length of hamstring tendons and quadrupled graft diameter by various anthropometric variables for knee ligament reconstruction in Indian population

Application of a computerised navigation technique to assist arthroscopic anterior cruciate ligament reconstruction

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