ACL Reconstruction History and Current Concepts

Hazzard, Sean

doi:10.2106/jbjs.jopa.15.00034

Cited by 4 publications

(4 citation statements)

References 21 publications

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“…Anterior cruciate ligament (ACL) surgical reconstruction dates back to the late nineteenth century when Dr. Robson performed the first successful ACL repair on a 41-year’s old coal miner [ 1 , 2 ]. Over the years, the techniques were changed and improved, becoming less invasive.…”

Section: Introductionmentioning

confidence: 99%

All-inside technique in ACL reconstruction: mid-term clinical outcomes and comparison with AM technique (Hamstrings and BpTB grafts)

Pautasso

Capella

Barberis

et al. 2020

Eur J Orthop Surg Traumatol

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Purpose The aim of this study was to define the subjective and objective clinical results of all-inside surgical technique at a medium-term follow-up and to compare these results with those obtained from antero-medial (AM) ACL reconstruction technique using hamstrings (HS) or bone-patellar tendon-bone (BpTB) grafts to detect eventual superiority of one technique to another. Methods A retrospective analysis of routinely collected data was conducted. Inclusion criteria were ACL reconstruction through all-inside technique or AM technique with HS or BpTB performed between January 2015 and May 2018; age between 15 and 30 year old; minimum 24 months’ available follow-up. Exclusion criteria were contralateral ACL reconstruction; need for any other associated procedures during surgery. Clinical outcomes were assessed with KOOS, Lysholm, Tegner scores and KT-1000 device. Results According to the selection criteria, 157 patients were enrolled and divided subsequently into 3 groups: all-inside (51 patients), AM-HS (53 patients) and AM-BpTB (53 patients). A significant postoperative improvement of each score in all groups was detected. The mean KT-1000 was 3.1 ± 1.0 mm in all-inside group, while 3.3 ± 1.4 mm and 2.5 ± 0.4 mm in AM-HS and AM-BpTB groups, respectively. Comparing the results obtained, no statistically significant difference was found between the three techniques (p = 0.27). Statistically significant differences were highlighted in surgical duration: all-inside method was the longest (117′), followed by AM-BpTB surgery (101′) and AM-HS technique (87′). Conclusions The all-inside technique showed good postoperative results at medium-term follow-up. It could be a valuable solution for ACL reconstruction, especially in young patients due to its less invasiveness, despite surgical skills and time needed. Levels of evidence Level IV.

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Section: Introductionmentioning

confidence: 99%

All-inside technique in ACL reconstruction: mid-term clinical outcomes and comparison with AM technique (Hamstrings and BpTB grafts)

Pautasso

Capella

Barberis

et al. 2020

Eur J Orthop Surg Traumatol

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“…Grafts were first introduced as a means of ACL reconstruction in 1917, with the use of the iliotibial band in the reconstructive treatment of an ACL rupture. 3 However, it was not until 1939 that the hamstring tendons were described as a viable graft source for the procedure. Since then, the technique has greatly improved, and standard tools now exist to ensure safe and easy graft harvesting.…”

Section: Discussionmentioning

confidence: 99%

“… 1 The anterior cruciate ligament (ACL) is the most commonly injured ligament in the knee. 2 Although different grafts have been applied over the years, 3 hamstring tendon grafts lead to significantly less anterior knee pain, have lower harvest-site morbidity, and help preserve the extensor mechanism of the knee. 1 , 4 …”

mentioning

confidence: 99%

The “Motionless Gastrocnemius”: A Reliable Sign for Safe Graft Harvesting

Fırat

Veizi

Çepni

et al. 2020

Arthroscopy Techniques

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Difficulties in graft harvesting of the hamstring have been the topic of many studies. These difficulties are related to the aponeurotic or fibrous attachments of the hamstrings with the medial head of the gastrocnemius muscle, soleus muscle, and leg fascia. Freeing the graft from these attachments is important because insufficient release prior to stripper insertion can lead to premature transection or amputation. We describe a reliable intraoperative physical examination sign to help understand the sufficient amount by which a tendon graft needs to be released prior to stripper insertion. The presence of the motionless gastrocnemius (“motionless gastroc”) phenomenon is used in our clinic as a sign that the grafts have been sufficiently freed and that a tendon stripper can be used without fear of transection or graft amputation.

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“…Anterior cruciate ligament (ACL) tear is one of the most frequent ligamentous injuries [1], with authors commonly reporting 100,000-200,000 cases per year in the United States, nearly half of which are treated surgically [1][2][3]. In this context, a plethora of surgical procedures has been described, from ACL repair, first described in 1903 by Mayo Robson [4], to ACL reconstruction (ACLR) using various grafts [5].…”

Section: Introductionmentioning

confidence: 99%

Bridge enhanced ACL repair vs. ACL reconstruction for ACL tears: A systematic review and meta-analysis of comparative studies

Mansour

Ghanimeh²,

Ghoul³

et al. 2023

SICOT-J

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Introduction: Anterior cruciate ligament (ACL) tear is one of the most frequent ligamentous injuries. The gold standard for ACL tears is autograft reconstruction. However, ACL repair has regained enthusiasm with more recent results showing comparable outcomes to its reconstructive counterpart. Methods: PubMed, Cochrane, and Google Scholar (pp. 1–20) were searched until November 2022. The clinical outcomes consisted of the International Knee Documentation Committee (IKDC) score, Knee Injury and Osteoarthritis Outcome Score (KOOS), the side-to-side difference in Anteroposterior (AP) knee laxity, the forces of the hamstring, quadriceps, and hip abduction as well as hopping tests. Results: Only two studies were included in this meta-analysis. ACL repair was shown to have better Hamstrings strength. The rest of the analyzed outcomes were comparable. Discussion: This is the first meta-analysis comparing these two treatments. The ACL repair showed no differences in muscle strength (quadriceps and hip abductors), postoperative knee scores, and knee joint laxity when compared to ACL reconstruction. However, it showed better hamstring strength. Further randomized clinical studies will be needed to compare both of these techniques.

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ACL Reconstruction History and Current Concepts

Cited by 4 publications

References 21 publications

All-inside technique in ACL reconstruction: mid-term clinical outcomes and comparison with AM technique (Hamstrings and BpTB grafts)

All-inside technique in ACL reconstruction: mid-term clinical outcomes and comparison with AM technique (Hamstrings and BpTB grafts)

The “Motionless Gastrocnemius”: A Reliable Sign for Safe Graft Harvesting

Bridge enhanced ACL repair vs. ACL reconstruction for ACL tears: A systematic review and meta-analysis of comparative studies

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