A Prospective, Randomized Study of Three Operations for Acute Rupture of the Anterior Cruciate Ligament. Five-Year Follow-up of One Hundred and Thirty-one Patients*

Grøntvedt, Torbjørn; Engebretsen, Lars; Benum, Pål; Fasting, O; Mølster, Anders; Strand, Torbjørn

doi:10.2106/00004623-199602000-00001

Cited by 144 publications

(100 citation statements)

References 20 publications

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“…In the same decade, augmented primary ACL repair showed superior results compared with simple suturing. Artificial devices and biological autograft augmentation was performed, and autologous augmentation consistently revealed better results [35]. On the other hand, a biological augmentation using the patellar or hamstring tendon could already be considered as a form of autograft reconstruction rather than a primary ACL repair.…”

Section: Discussionmentioning

confidence: 99%

Biomechanical evaluation of augmented and nonaugmented primary repair of the anterior cruciate ligament: an in vivo animal study

Seitz

Pichl

Matzi

et al. 2013

International Orthopaedics (SICOT)

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Purpose The purpose of this study was to evaluate in a sheep model the biomechanical performance of augmented and nonaugmented primary repair of the anterior cruciate ligament (ACL) following transection at the femoral end during a 12-month postoperative observation. Methods Forty sheep were randomly assigned to nonaugmented or augmented primary ACL repair using a polyethylene terephthalate (PET) band. At two, six, 16, 26 and 52 weeks postoperatively four sheep in each group were sacrificed and biomechanical testing performed. Results Compared with nonaugmented primary ACL repair, the PET-augmented repair demonstrated superior biomechanical results from 16 weeks postoperatively onwards in terms of anterioposterior (AP) laxity, tensile strength and ligament stiffness. The augmentation device works as a stress shield during the ligament healing process. The nonaugmented ACL repair also resulted in ligament healing, but the biomechanical properties were at a significantly lower level. Conclusion These results support the previously reported histological findings following augmented primary ACL repair. This animal study on the healing capacity of the ACL may provide some important contributions to how primary healing in certain types of ruptures can be achieved.

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Section: Discussionmentioning

confidence: 99%

Biomechanical evaluation of augmented and nonaugmented primary repair of the anterior cruciate ligament: an in vivo animal study

Seitz

Pichl

Matzi

et al. 2013

International Orthopaedics (SICOT)

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“…However, prospective randomized clinical studies to distinguish the pivot-rotational stabilizing effects between a conventional ACL reconstruction and a combined ACL/ALL reconstruction are still lacking. Primary suture with or without alloplastic augmentation of the ruptured ACL has resulted in inferior clinical outcomes in prospective and retrospective studies [66,100] . The majority of these alloplastic augmentations have been stiff constructs in a nonanatomical position (overthe-top position or extra-articular) [66,100] .…”

Section: New Trends and Concepts In Acl Reconstruction Surgerymentioning

confidence: 99%

“…An initial clinical study of 20 patients showed satisfying results one year after surgery [104] . The perspective of suturing for preserving autologous graft material and the native ACL has often been considered to reduce morbidity in the past, but the results were not promising [66,100] . For complex ligamentous knee dislocation injuries, there seems to be a good potential for reduced harvesting morbidity and OR time.…”

Section: New Trends and Concepts In Acl Reconstruction Surgerymentioning

confidence: 99%

“…Primary suture with or without alloplastic augmentation of the ruptured ACL has resulted in inferior clinical outcomes in prospective and retrospective studies [66,100] . The majority of these alloplastic augmentations have been stiff constructs in a nonanatomical position (overthe-top position or extra-articular) [66,100] . However, with the aim to restore proprioceptive properties of the ligament and to avoid the harvesting morbidity of tendon grafts, Eggli et al [101] , and Kohl et al [102] have introduced a new method of primary suturing of a traumatic ACL rupture with combined dynamic alloplastic intraligamentous stabilization ( Figure 7A).…”

Section: New Trends and Concepts In Acl Reconstruction Surgerymentioning

confidence: 99%

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Biomechanics of the anterior cruciate ligament: Physiology, rupture and reconstruction techniques

Domnick

Raschke

Herbort

2016

WJO

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ligament (ACL) on kinematics and clinical outcomes have been investigated in many biomechanical and clinical studies over the last several decades. The knee is a complex joint with shifting contact points, pressures and axes that are affected when a ligament is injured. The ACL, as one of the intra-articular ligaments, has a strong influence on the resulting kinematics. Often, other meniscal or ligamentous injuries accompany ACL ruptures and further deteriorate the resulting kinematics and clinical outcomes. Knowing the surgical options, anatomic relations and current evidence to restore ACL function and considering the influence of concomitant injuries on resulting kinematics to restore full function can together help to achieve an optimal outcome. Conflict-of-interest statement:There are no conflicts of interest to declare. Open-Access:This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/ licenses/by-nc/4.0/ [1] . The ACL is a central ligament of the knee. The main functional role of the ACL is to provide stability against anterior tibial translation (ATT) and internal rotation. An acute ACL rupture is a common orthopedic trauma, with an estimated incidence of 78 per 100000 persons and a mean age of 32 years in Sweden and an estimated incidence of up to 84 per 100000 persons in the United States [2,3] . A common and frequent injury mechanism is noncontact combined valgus-and internal-rotation trauma [2,4] . Therefore, ACL injuries are often associated with other ligamentous injuries, such as a (partial) rupture of the medial collateral ligament (MCL) or the menisci. In addition, compression of the lateral condyle with a bone bruise or chondral lesion is often associated with the injury due to the valgus trauma. Persistent instability of the knee may be associated with long-term degenerative lesions. Surgical treatment of the ACL in the context of other injured structures and reconstruction of the intact joint kinematics are suggested to be the keys to a good clinical outcome [5,6] . ANATOMYThe ACL has its origin at the medial area of the lateral femoral condyle and inserts into the center of the eminentia of the tibia plateau next to the anterior horn of the lateral meniscus. The structure of the ACL has been described as two functional bundles: The anteromedial (AM) and the posterolateral (PL) bundle [7] . These two bundles have been associated with different roles in anteroposterior and complex-rotational stabilization of the joint [8][9][10] . The femoral origin was described as oval shaped with a longitudinal diameter of 18 mm and a width of approximately 11 mm [11,12] . ...

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“…Additional randomized, controlled trials have shown no clinical differences in outcome between the use of patellar tendon autograft and the use of hamstring tendon graft [4][5][6][7][8][9][10][11] or between one and two-incision arthroscopic operative techniques 10,[12][13][14] . Thus, reconstructions of the anterior cruciate ligament have been performed to allow patients to resume activities, especially in sports requiring cutting and pivoting, and studies have shown overall good short-term function 15,16 . Fewer investigators have evaluated intermediate (five-year) results.…”

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confidence: 99%

Clinical Outcome at a Minimum of Five Years After Reconstruction of the Anterior Cruciate Ligament

Spindler

Warren²,

Callison³

et al. 2005

J Bone Joint Surg Am

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A Prospective, Randomized Study of Three Operations for Acute Rupture of the Anterior Cruciate Ligament. Five-Year Follow-up of One Hundred and Thirty-one Patients*

Cited by 144 publications

References 20 publications

Biomechanical evaluation of augmented and nonaugmented primary repair of the anterior cruciate ligament: an in vivo animal study

Biomechanical evaluation of augmented and nonaugmented primary repair of the anterior cruciate ligament: an in vivo animal study

Biomechanics of the anterior cruciate ligament: Physiology, rupture and reconstruction techniques

Clinical Outcome at a Minimum of Five Years After Reconstruction of the Anterior Cruciate Ligament

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