ACL reconstruction in sports active people: Transtibial DB technique with ST/G vs. transtibial SB technique with BPTB: Preliminary results

Volpi, Piero; Cervellin, M.; Denti, Matteo; Bait, Corrado; Melegati, Gianluca; Quaglia, Alessandro; Girolamo, Laura de

doi:10.1016/j.injury.2010.09.029

Cited by 26 publications

(24 citation statements)

References 35 publications

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“…Moreover, it should be avoided in patients with ST tendon smaller than 6 mm and G tendon smaller than 5 mm, in order to guarantee an acceptable size of the graft. 30,31 P value: result of Mann-Whitney U test (< 0.05 = statistically significant); Age: median ± standard deviation; M: male; Follow up: median (range); Tegner Lysholm score: mean ± standard deviation (range); IKDC subjective score: mean ± standard deviation (range); NA: not applicable.…”

Section: Discussionmentioning

confidence: 99%

“…4 Double bundle (DB) ACL reconstruction (DB-ACLr) technique was proposed to reproduce a more anatomic and functional ligament, reconstructing both the ACL bundles. Various studies have shown a superiority of DB-ACLr respect to SB technique to restore rotatory stability of the knee, 22,23,30 while other studies found no differences between the two procedures in term of outcomes, complications and failure rate. 17,18 The primary purpose of our study was to evaluate the failure rate of DB-ACLr technique at a long term follow-up.…”

Section: Introductionmentioning

confidence: 97%

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Double bundle anterior cruciate ligament reconstruction: Failure rate and patients-reported outcomes at 4–11 years of follow up

Volpi

Quaglia

Carimati

et al. 2019

Journal of Orthopaedics

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Background: Biomechanical studies have demonstrated that single bundle (SB) anterior cruciate ligament (ACL) reconstruction (SB-ACLr), which represents the gold standard for the management of ACL lesions, is not sufficient to completely restore the rotational stability and resistance to valgus stress of the knee. Purpose: To evaluate the failure rate and patients reported outcomes at a long-term follow-up of double bundle anterior cruciate ligament reconstruction (DB-ACLr). Study design: Retrospective cohort study. Materials and methods: The database of arthroscopic DB-ACLr procedures performed from 2006 to 2015 at our Institution was retrospectively reviewed. Patients were screened for eligibility according to the following inclusion criteria: magnetic resonance imaging (MRI) evidence of anterior cruciate ligament (ACL) lesion, positive anterior drawer test and/or Lachman test; age ≤ 45 years at the time of surgery; DB-ACLr with autologous hamstrings, minimum follow up of 24 months. Patients were excluded if they presented associated lesions of the knee preoperatively or at the time of surgery, expect for meniscal lesions, or in case of inability to complete clinical questionnaires. Clinical outcomes were assessed at a mean follow up of 95.4 ± 21.9 months (range 51-129 months; median 98 months) using the Tegner-Lysholm score and the IKDC subjective score. Failures were defined as Tegner-Lysholm score ≤65 points, and were confirmed with MRI. Results: 58 (81.7%) male and 13 (18.3%) female patients (mean age 29.7 ± 7.8 years) were included in the study. 2 (2.8%, 95% CI 0.3-9.8%) patients had a failure of DB-ACLr both occurred after a sports trauma. The IKDC subjective score was statically better in patients younger than 30 years. Tegner-Lysholm and IKDC subjective score were statistically better in professional athletes and in patients with isolated medial or lateral meniscus lesion instead of combined medial and lateral meniscus lesion. Conclusion: DB-ACLr technique provides excellent clinical results at a long term follow-up. Low failure rate and high percentage of return to sports participation at the same pre-injury level was found in our cohort of patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 97%

Double bundle anterior cruciate ligament reconstruction: Failure rate and patients-reported outcomes at 4–11 years of follow up

Volpi

Quaglia

Carimati

et al. 2019

Journal of Orthopaedics

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“…The ability of resuming the same level of sporting activities is a major concern in the active population with an ACL tear [4][5][6] . In our case series, 71.6% of patients were able to return to their preprimary level of activity and sport.…”

Section: Discussionmentioning

confidence: 99%

“…ACL surgery is recommended for patients who have symptomatic objective patholaxity following ACL lesion, as it is essential for restoring joint stability and functional capacity and is therefore indicated in patients aiming to return to sports participation, especially to sports that require cutting and pivoting 3 . Return to sports following ACL surgery, and the capacity of resuming sporting activities comparable to those engaged prior to the traumatic injury, is a major concern for young active patients undergoing ACL surgery [4][5][6] .…”

Section: Introductionmentioning

confidence: 99%

Return to sports and re-rupture rate following anterior cruciate ligament reconstruction in amateur sportsman: long-term outcomes

Legnani

Peretti

et al. 2019

J Sports Med Phys Fitness

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BACKGROUNDː The aim of this study was to retrospectively evaluate patient satisfaction, the return-to-sport rate and activity level at a long-term follow-up in a large cohort of amateur sportsmen who underwent primary ACL reconstruction. METHODSː a total of 218 patients who underwent primary ACL reconstruction between 2004 and 2011, were successfully recontacted and retrospectively reviewed at an average follow-up of 10.5 years (range, 7 to 14 years). All surgeries were performed by one single surgeon. All of them underwent primary ACL reconstruction with autogenous hamstring tendon grafts. Assessment included Knee Osteoarthritis Outcome Score (KOOS) score, International Knee Documentation Committee (IKDC) Subjective Knee Form, Tegner activity level. Patients were also asked what kind of injury they sustained (either direct or indirect trauma), what kind of sport they were performing when they got injured, at what time they did return to sports and which sport they practised before and after surgery. RESULTSː Fourteen patients underwent re-rupture. In 11 cases, this was due to a new trauma occurring at an average time of 22.9 (SD 23.8) months following primary surgery. In 3 cases rupture occurred during rehabilitation period. Mean postoperative KOOS score was 88.5 (SD 8.5), while mean IKDC subjective score was 87.5 (SD 10.9). At the time of followup, most patients (214 subjects, 98%) were participating in sport. 156 subjects returned to pre-injury level (71.6%). CONCLUSIONSː The study reported long-term favourable subjective outcomes in amateur sportsman following ACL reconstruction, with a low re-rupture rate and a high percentage of subjects (93.6%) returning to sports participation 12 months after surgery. Most patients (71.6%) were able to return to their preprimary level of activity and sport. Younger age at the time of ACL reconstruction positively affected return to sports; however, younger patients were significantly more likely than older patients to undergo re-rupture.

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“…Also, conventional transtibial ACL reconstruction, which often locates the graft away from anatomic location [3], leads to abnormal biomechanical behavior and in vivo knee kinematics [4–6], which could influence long-term knee joint health [7, 8]. On the other hand, the anatomical ACL reconstruction procedure, either single-bundle or double-bundle technique, could provide better knee kinematics than nonanatomic reconstruction [9–11] and promising clinical results [12–20]. Appropriate anatomic evaluation of the native ACL for each individual patient can provide critical information for planning ACL reconstruction in an anatomic fashion, while postoperative evaluation of the reconstructed ACL graft location could predict the prognosis after the surgery and give valuable feedback to surgeons.…”

Section: Introductionmentioning

confidence: 99%

Three-Dimensional Anatomic Evaluation of the Anterior Cruciate Ligament for Planning Reconstruction

Hoshino

Kim

2012

Anatomy Research International

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Anatomic study related to the anterior cruciate ligament (ACL) reconstruction surgery has been developed in accordance with the progress of imaging technology. Advances in imaging techniques, especially the move from two-dimensional (2D) to three-dimensional (3D) image analysis, substantially contribute to anatomic understanding and its application to advanced ACL reconstruction surgery. This paper introduces previous research about image analysis of the ACL anatomy and its application to ACL reconstruction surgery. Crucial bony landmarks for the accurate placement of the ACL graft can be identified by 3D imaging technique. Additionally, 3D-CT analysis of the ACL insertion site anatomy provides better and more consistent evaluation than conventional “clock-face” reference and roentgenologic quadrant method. Since the human anatomy has a complex three-dimensional structure, further anatomic research using three-dimensional imaging analysis and its clinical application by navigation system or other technologies is warranted for the improvement of the ACL reconstruction.

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ACL reconstruction in sports active people: Transtibial DB technique with ST/G vs. transtibial SB technique with BPTB: Preliminary results

Cited by 26 publications

References 35 publications

Double bundle anterior cruciate ligament reconstruction: Failure rate and patients-reported outcomes at 4–11 years of follow up

Double bundle anterior cruciate ligament reconstruction: Failure rate and patients-reported outcomes at 4–11 years of follow up

Return to sports and re-rupture rate following anterior cruciate ligament reconstruction in amateur sportsman: long-term outcomes

Three-Dimensional Anatomic Evaluation of the Anterior Cruciate Ligament for Planning Reconstruction

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