Biomechanical Evaluation of a 1-Stage Revision Anterior Cruciate Ligament Reconstruction Technique Using a Structural Bone Void Filler for Femoral Fixation

Influence of Different Tibial Fixation Techniques on Initial Stability in Single-Stage Anterior Cruciate Ligament Revision With Confluent Tibial Tunnels: A Biomechanical Laboratory Study

“…The biomechanical properties of 1-stage procedures with filling of the femoral tunnel, using a synthetic dowel graft, have been reported. 11,12 Vaughn et al 12 used calcium phosphate cement as a structural bone void filler for a femoral tunnel before revision, comparing it with primary ACL reconstruction in 11 matched pairs of fresh-frozen cadaveric knees. Load-to-failure testing showed no significant differences between the 2 groups.…”

“…In contrast, studies investigating the biomechanical properties of ACL reconstructions in cadaveric knees have been subject to inconsistencies caused by the considerably broad age range of up to 65 years and the donors being considerably older than patients who usually undergo ACL reconstruction. 11,12,27,44 To obviate interindividual differences between different knees, these studies have often compared different techniques of ACL reconstruction in the same knee, filling the bone tunnels with bone cement between the different reconstructions. Because the management of the tibial tunnel was the main variable and the focus of interest of our study, such a comparison was not an option in our setup.…”

“…Whereas some surgeons prefer 2-stage revisions in these patients, others perform single-stage revision by filling the index tunnel with bone substitutes or autografts before creating a new tunnel nearby. [10][11][12][13] Alternatively, dilatation of the newly generated tunnel has also been performed, leading to compression of the primary tunnel. 12,[14][15][16][17] To our knowledge, there has been only 1 study in the international literature addressing single-stage ACL revision.…”

“…[10][11][12][13] Alternatively, dilatation of the newly generated tunnel has also been performed, leading to compression of the primary tunnel. 12,[14][15][16][17] To our knowledge, there has been only 1 study in the international literature addressing single-stage ACL revision. 17 The purpose of this study was therefore to kinematically and biomechanically compare 4 different types of tibial tunnel management in single-stage ACL revision reconstruction with the control: primary ACL reconstruction using a robotic-based knee testing setup.…”

Pullout Strength of Bone–Patellar Tendon–Bone Allograft Bone Plugs: A Comparison of Cadaver Tibia and Rigid Polyurethane Foam

“…Regardless of the biologic medium, significant variability among specimens can exist. Matched pairs 6,7 and randomized testing 8,9 among an adequate number of specimens are approaches designed to compensate for this biologic variability. Synthetic test media may provide an acceptable alternate to biologic specimens, but there are concerns that such media will not accurately replicate the biologic environment.…”