Anterior Cruciate Ligament Reconstruction With Preservation of Femoral Anterior Cruciate Ligament Stump

Nag, Hira Lal; Gupta, Himanshu

doi:10.1016/j.eats.2014.06.012

Cited by 5 publications

(5 citation statements)

References 13 publications

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“…A short remnant has been reported in the majority of cases after careful notchplasty. In the present study, we tought it may be beneficial to preserve the ACL remnant at the femoral insertion area, as in the similar technique in which the tibial remnant is preserved (20). In Group A, ACL remnants and/or footprints were not detected at the femoral attachment site in 6 patients (92,86%).…”

Section: Discussionmentioning

confidence: 84%

“…The clinical results of remnant-conserving surgery are still controversial altough the results of histomorphological and animal studies. There are some studies report the positive effect of the preservation of the tibial stump or remnant (19)(20)(21) while other studies report that remnant-preserving has no effect (22) or effective only on knee instability (23). The lack of standardization in study designs and short follow-up periods are the limitations of the studies.…”

Section: Discussionmentioning

confidence: 99%

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Effects of Femoral Remnant Preservation During Anterior Cruciate Ligament Reconstruction on the Clinical and Functional Outcomes

Çetin

Altay

Sipahioğlu

et al. 2022

Harran Üniversitesi Tıp Fakültesi Dergisi

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Amaç: Bu çalışmanın amacı, ön çapraz bağ (ÖÇB) yırtıklarının cerrahi tedavisinde, femoral kalıntıların korunduğu rekonstrüksiyon tekniği ile standart tekniğin fonksiyonel ve klinik sonuçlarının karşılaştırılmasıdır. Hastalar ve yöntemler: İleriye dönük randomize olarak planlanan çalışmaya, ÖÇB yırtığı nedeniyle cerrahi uygulanan 150 hasta (tamamı erkek) dahil edildi. Hastalar randomize olarak iki gruba ayrıldı. Grup A’da (n=75) hastalara hamstring tendon otogrefti kullanılarak tibial ve femoral kalıntıların korunduğu ÖÇB rekonstrüksiyonu uygulandı. Grup B’de (n=75) ise hamstring tendon otogrefti ile standart rekonstrüksiyon tekniği uygulandı ve tibial kalıntılar korunurken femoral kalıntılar temizlendi. Grup A hastaların yaş ortalaması, 27,23±5,64 yıl, Grup B’de ise 26,72±5,82 yıldı. Travma-operasyon arası geçen süre, Grup A’da 4,36±3,21 ay, Grup B’de 3,56±3,08 aydı. Hastaların takip süresi, Grup A için 38,05±6,11 ay, Grup B için ise 36,86±8,04 ay olarak hesaplandı. Her iki grup arasında, hastaların yaşları, travma-operasyon arası geçen süre ve takip süreleri açısından farklılık yoktu (p˃0,05). Cerrahinin klinik sonuçları Lysholm skorlaması, Uluslararası Diz Dokümantasyon Komitesi (IKDC) skoru, Subjektif IKDC 2000 diz skorlaması ve fiziksel instabilite testleriyle değerlendirildi. Bulgular: Grup A ve Grup B hastaların ameliyat öncesi Lysholm, sübjektif ve objektif IKDC diz skorlarında, eklem hareket açıklıklarında ve diz stabilite testlerinde ( Lachman, Pivot Şift, Öne Çekmece) ameliyat sonrası istatistiksel olarak anlamlı düzelme tespit edildi (p<0,001). Erken dönem (18 ay) kontrollerde gruplar arasında ameliyat öncesi ve sonrası karşılaştırma yapıldığında Lysholm, sübjektif ve objektif IKDC diz skorlarında Grup A lehine anlamlı yükseklik saptansa da (p˂0.05) hastaların son kontrollerinde Lysholm, sübjektif ve objektif IKDC diz skorlarında, eklem hareket açıklıklarında ve diz stabilite testleri (Lachman, Pivot Şift, Öne çekmece) açısından anlamlı farklılık izlenmedi (p˃0.05). Sonuç: ÖÇB yırtıklarının cerrahi tedavisinde, femoral kalıntılar korunarak yapılan ÖÇB rekonstrüksiyonunda, ÖÇB femoral kalıntıların histolojik olarak tespit edilen teorik katkısı, klinik ve fonksiyonel sonuçlarda belirgin olarak izlenmemektedir.

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Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Effects of Femoral Remnant Preservation During Anterior Cruciate Ligament Reconstruction on the Clinical and Functional Outcomes

Çetin

Altay

Sipahioğlu

et al. 2022

Harran Üniversitesi Tıp Fakültesi Dergisi

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“…Although removal of any remaining ACL assists in locating the intra-articular bone tunnel and improves the accuracy of surgical procedure, histological studies have confirmed that an abundant blood supply and proprioceptors are present in ligaments and the synovium [ 15 ]. In the present study, all patients underwent reconstruction with remnant preservation [ 16 ]. The remnant ACL was as far as possible pulled into the bone tunnel or tunnel portal when the graft was installed.…”

Section: Discussionmentioning

confidence: 99%

Early Clinical Outcomes of ACL Reconstruction Using Semitendinosus Tendon Combined with LARS Synthetic

Zhang

Xiang

Bian

et al. 2022

Computational and Mathematical Methods in Medicine

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Objective. To compare the early clinical outcomes of ACL reconstruction using the augmented semitendinosus tendon combined with LARS synthetic material and the autologous hamstring tendons. Methods. A total of 68 eligible patients with ACL rupture were reconstructed using either 4-strand autologous hamstring tendons, representing the control group, or the LARS synthetic material augmented grafts. The duration of postoperative swelling and recovery exercise was recorded. Lysholm and IKDC scores were used for evaluation of knee joint function. Lachman and pivot shift tests were conducted to evaluate stability. Results. The scores of the three knee functions in cases of the augmentation group were significantly higher than those of the control group 6 months after surgery ( P < 0.05 ). There were no significant differences in Tegner score in the two groups 12 months after surgery ( P > 0.05 ). In general, the augmentation group returned to exercise 12 weeks after surgery, while the control group required 30 weeks. Conclusions. The present study indicates that synthetic material augmentation grafts allow earlier return to exercise and display more satisfactory results compared with the control group.

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“…It has been widely published that the revascularization of the tendon graft after ACL reconstruction by surgery is a crucial step in the "ligamentization" process (Arnoczky, Tarvin, & Marshall, 1982;Butler et al, 1989;Petersen et al, 2003;Yoshikawa et al, 2006). In fact, some techniques have been described trying to enhance both the revascularization and the proprioception after ACL reconstruction preserving the tibial and/or femoral stumps, which can benefit the patient (Lee, Kwon, Kim, Choi, & Min, 2008;Song et al, 2013;Nag & Gupta, 2014). Revascularization is one of the first processes that must occur for a successful integration of the tendon after ACL reconstruction (Tohyama, Yoshikawa, Ju, & Yasuda, 2009).…”

Section: Discussionmentioning

confidence: 99%

The Use of Autologous Fibroblasts for the Reconstruction of the Anterior Cruciate Ligament Tears

Guillén-García¹,

Rodríguez‐Iñigo²,

Guillén-Vicente³

et al. 2015

IJB

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Surgical reconstruction using an autologous or allogenic allograft is the treatment of choice for anterior cruciate ligament (ACL) tear repair. We have checking the treatment of ACL tears with in vitro cultured autologous fibroblasts on porcine type I/III collagen membranes, in 12 sheep randomly assigned to be treated with collagen membrane without cells or with porcine membrane plus 5 million autologous fibroblasts per cm 2 . The animals underwent a first surgery in which a biopsy of the ACL was taken, and a second one in which the membrane was implanted alone (N=6) or with the fibroblasts (N=6) isolated from the biopsy. After 16 weeks, the animals were sacrificed and samples of healthy and repaired ACL were taken for histological and gene expression of type I collagen (COL1), MMP-13 (matrix metallopeptidase 13), and tenascin-C (TNC) studies. The architecture of normal ACL was not conserved either in the ACL treated with the membrane with or without cells. However, a higher degree of peripheral vascularization was observed in the ACL treated with membrane plus fibroblasts than in those treated with membrane alone. Cellularity and nucleus volume were significantly higher in the center or the periphery of the neo-formed ACL than in the control ACL. No differences between the ACL treated with membrane alone or with membrane plus cells were observed in the relative COL1, MMP-13 and tenascin-C expression. Fibroblasts embedded in porcine type I/III membranes probably enhance vascularization of the graft, so it could be a promising tool for the treatment of ACL tears.

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Anterior Cruciate Ligament Reconstruction With Preservation of Femoral Anterior Cruciate Ligament Stump

Cited by 5 publications

References 13 publications

Effects of Femoral Remnant Preservation During Anterior Cruciate Ligament Reconstruction on the Clinical and Functional Outcomes

Effects of Femoral Remnant Preservation During Anterior Cruciate Ligament Reconstruction on the Clinical and Functional Outcomes

Early Clinical Outcomes of ACL Reconstruction Using Semitendinosus Tendon Combined with LARS Synthetic

The Use of Autologous Fibroblasts for the Reconstruction of the Anterior Cruciate Ligament Tears

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