Anterior cruciate ligament reconstruction with the Leeds-Keio prosthesis plus extra-articular tenodesis. Results after six years

Dandy, David J.; Gray, A. J. R.

doi:10.1302/0301-620x.76b2.8113274

Cited by 50 publications

(24 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The techniques of operation [3,11] remained constant throughout this period apart from the changes described below. All patients underwent the same procedure dming each phase of this period, and the choice of procedure was determined by date alone.…”

Section: Methodsmentioning

confidence: 99%

“…The operations were performed between September 1987 and September 1988. The technique, described elsewhere [3], is identical to that used for groups 1-3 except for the use of the Leeds-Keio prosthesis in place of the patellar tendon graft. The management of the patients after operations was identical to that in group 2.…”

Section: Group 5: Leeds-keio Prosthesis (40 Patients)mentioning

confidence: 99%

See 1 more Smart Citation

Problems in regaining full extension of the knee after anterior cruciate ligament reconstruction: does arthrofibrosis exist?

Dandy

Edwards

1994

Knee Surg, Sports traumatol, Arthroscopy

View full text Add to dashboard Cite

A total of 194 patients was reviewed after ACL reconstruction using a patellar tendon graft or Leeds-Keio prosthesis supplemented with a MacIntosh lateral substitution. There were five groups of patients: patellar tendon with cast immobilisation in flexion (n = 34); restricted extension but no cast (n = 40); immediate full extension (n = 40); 40); immediate full extension with notch widening (n = 40); Leeds-Keio ligament prosthesis (n = 40). The incidence of a click or a block to extension requiring operation ranged from 59% following cast immobilisation to 2.5% with the Leeds-Keio ligament. The incidence was significantly less when a Leeds-Keio prosthesis was used, and these problems may be associated with biological materials only. Restricting extension after operation significantly increased the loss of extension, confirming the work of others. Loss of extension was due to a mechanical block in all cases examined arthroscopically. All were relieved by arthroscopic surgery, and no case of flexion contracture or arthrofibrosis was encountered. A simple mechanical block to extension caused by a Cyclops lesion should be clearly distinguished from flexion contracture and arthrofibrosis, conditions which are probably extremely rare and overdiagnosed.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Group 5: Leeds-keio Prosthesis (40 Patients)mentioning

confidence: 99%

Problems in regaining full extension of the knee after anterior cruciate ligament reconstruction: does arthrofibrosis exist?

Dandy

Edwards

1994

Knee Surg, Sports traumatol, Arthroscopy

View full text Add to dashboard Cite

show abstract

“…The combination of extraarticular reconstruction with an intra-articular patellar tendon graft gave satisfactory results in 93% of knees after 6 years [19] regardless of the patient's age, severity of the symptoms, or interval between injury and operation [19]. These results are superior to those of the other groups studied [22][23][24] and to other reported results [25,26]. From a review of the literature, we feel that intra-articular reconstruction as well as extra-articular augmentation are essential since the first provides the primary restraint against excessive anterior translations of the tibia on the femur, and extra-articular procedures are not sufficient by themselves for young athletes.…”

Section: Discussionmentioning

confidence: 89%

Anterior Cruciate Ligament Reconstruction by Combined Intra-Articular (K. Lambert) and Extra-Articular Iliotibial Band Tenodesis (MacIntosh; Autologous Grafts)

Ibrahim¹

1999

Med Princ Pract

View full text Add to dashboard Cite

Objective: To assess the results of anterior cruciate ligament reconstruction in a group of sports players. Methods: A total of 153 sports players were reviewed 70 months (range 39–84 months) after they had anterior cruciate ligaments reconstruction by autologous patellar tendon graft (K. Lambert intra-articular reconstruction) combined with extra-articular tenodesis using iliotibial band (MacIntosh tenodesis). Results: We found all the patients were able to return to their normal active life and 131 atheletes were able to return to full sports activities, while 21 patients were not able to go back to their sports or had to modify their sports activities. The knees were assessed using Lysholm knee score, Shino grading system and clinical examination for anterior drawer, Lachman and pivot shift signs. The mean Lysholm knee score was 94.9 (range 71–100) while Shino grading for 64 knees was very good, for 68 knees good, and 21 knees fair. None of the patients had poor results. Conclusions: Depending on the type and degree of functional instability, we recommend anterior cruciate ligament reconstruction by autologous tendon graft and in all cases, extra-articular procedures are required.

show abstract

“…Severe injuries can lead to chronic instability of the joint and require surgical reconstruction of the ligament [1,2]. While various procedures including reconstruction using autograft tissue [3], allograft tissue [4] and synthetic materials [5] have been reported for ligament reconstruction, these procedures have yet to be refined. For example, using autologous tissue for ligament reconstruction has been associated with donor site weakness and morbidity.…”

Section: Introductionmentioning

confidence: 99%

“…Since the use of allogenic tissue increases the risk of disease transmission and an immunogenic response by the host, non-absorbable synthetic grafts have been used to reduce these disadvantages. However, non-absorbable synthetic grafts can cause bone erosion, which leads to joint instability and overall failure of the surgery [5,6]. The outcome of anterior cruciate ligament (ACL) substitution using the Leeds-Keio polyester ligament at a mean of 13.3 years showed a high rate of rupture and joint laxity [7].…”

Section: Introductionmentioning

confidence: 99%

Ligament regeneration using an absorbable stent-shaped poly-l-lactic acid scaffold in a rabbit model

Nishimoto

Kokubu

Inui

et al. 2012

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

Purpose Ligaments are frequently damaged in sports activities and trauma, and severe ligament injury can lead to joint instability and osteoarthritis. In this study, we aimed to regenerate the medial collateral ligament (MCL) using an absorbable stent-shaped poly-L-lactic acid (PLLA) scaffold in a rabbit model to examine the biocompatibility and mechanical properties. Methods Twenty-three Japanese white rabbits were used in this study. MCL defects were surgically created in the knee joints and then reconstructed using stent-shaped PLLA scaffolds. As controls, flexor digitorum longus (FDL) tendons were implanted into the contralateral knees. Seven rabbits were sacrificed at three time points, conducted four, eight and 16 weeks after the operation. The regenerated tissues were histologically evaluated using fibre alignment scoring, morphology of fibroblast scoring and immunohistochemical analysis of types I and III collagen. The regenerated tissues were also biomechanically evaluated by measuring the ultimate failure load and stiffness. Results At four weeks post-operation, spindle-shaped cells were observed on the inside of the scaffolds. At eight weeks, maturation of the regenerated tissues and collagen fibre alignment parallel to the ligaments was observed. At 16 weeks, the fibre alignment had become denser. The fibre alignment and morphology of fibroblast scores significantly increased in a time-dependent manner. Expression of type I collagen was more strongly observed in the scaffold group at eight and 16 weeks post-operation than at four weeks. Type III collagen was also observed at four, eight and 16 weeks post-operation. A thin layer of fibrocartilage was observed at the ligament-bone junction at eight and 16 weeks. The ultimate failure load of the scaffold group was 46.7±20.7 N, 66.5±11.0 N and 74.3±11.5 N at four, eight and 16 weeks post-operation, respectively. There was no statistical difference between the normal MCL and the scaffold group at 16 weeks post-operation. Conclusions The stent-shaped PLLA scaffold allowed for MCL regeneration with type I collagen expression and fibrocartilage formation and resulted in sufficient mechanical function.

show abstract

Anterior cruciate ligament reconstruction with the Leeds-Keio prosthesis plus extra-articular tenodesis. Results after six years

Cited by 50 publications

References 0 publications

Problems in regaining full extension of the knee after anterior cruciate ligament reconstruction: does arthrofibrosis exist?

Problems in regaining full extension of the knee after anterior cruciate ligament reconstruction: does arthrofibrosis exist?

Anterior Cruciate Ligament Reconstruction by Combined Intra-Articular (K. Lambert) and Extra-Articular Iliotibial Band Tenodesis (MacIntosh; Autologous Grafts)

Ligament regeneration using an absorbable stent-shaped poly-l-lactic acid scaffold in a rabbit model

Contact Info

Product

Resources

About