Contemporary Graft Options in Anterior Cruciate Ligament Reconstruction

Mehran, Nima; Skendzel, Jack G.; Lesniak, Bryson P.; Bedi, Asheesh

doi:10.1053/j.otsm.2012.10.005

Cited by 5 publications

(4 citation statements)

References 81 publications

(98 reference statements)

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“…24 The ability to offer decreased donor site morbidity with a high biomechanical strength profile and no significant difference in rerupture rates has made HT an attractive option. 6,25 What is less known are outcomes regarding HT ACL reconstruction within high-level football players.…”

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confidence: 99%

Return to Play and Career Length After Anterior Cruciate Ligament Reconstruction Among Canadian Professional Football Players

et al. 2020

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Background: For many athletes, a tear of the anterior cruciate ligament (ACL) represents a significant injury that requires a prolonged period away from the sport with substantial rehabilitation. Hypothesis: There will be no difference in return to play (RTP) and career length after hamstring tendon (HT) ACL reconstruction in a group of Canadian Football League professional players as compared with what has been already been reported in the literature among professional football players. Study Design: Case-control study; Level of evidence, 3. Methods: Data on athletes who sustained an ACL injury were collected by team physicians and head athletic trainers from 2002 to 2017 from 2 Canadian Football League teams. Patient details included age at the time of injury, initial injury date, position, practice versus game injury, and primary versus rerupture with injury-specific data, such as affected limb, concomitant injuries, graft choice, and procedure performed. RTP rates and career length data were collected through publically available internet sources. Comparisons between the non-RTP and RTP groups were made with independent-sample t tests. Binomial logistic regression was performed to determine variables (ie, games preinjury, graft type, meniscal injury, collateral ligament injury) that contributed to players not being able to RTP. Results: A total of 44 ACL reconstructions were performed over the study period (HT, n = 32 [72.7%]; bone–patellar tendon–bone [BPTB], n = 8 [18.2%]; allograft, n = 4 [9.1%]). Overall, 69.8% (n = 30) were able to RTP in at least 1 game, while 30.2% (n = 13) did not return. Mean time to return was 316.1 days (range, 220-427 days), or 10.4 months. For those players who did RTP, mean career length after ACL reconstruction was 2.8 seasons, or 34.4 games. The majority (56.8%) of injuries occurred early in the season. Breakdown by graft type demonstrated RTP rates among HT, BPTB, and allograft of 64.5% (n = 20), 87.5% (n = 7), and 75% (n = 3), respectively. Career length among HT, BPTB, and allograft was 2.9, 2.4, and 3 seasons. Logistic regression analysis found only concomitant medial collateral ligament (MCL) injuries to be a negative predictor for RTP. Meniscal injuries were associated with a decreased RTP rate and career length, but this was not statistically significant. Conclusion: The RTP rates after ACL reconstruction in this study are similar to those reported in National Football League players. A concomitant injury to the MCL injury was a negative predictor of RTP. Meniscal injuries demonstrated a trend for decreased RTP rate and career length, but this was not a significant predictor. A large portion of injuries occur early in the season, and further study should be done to examine potential preventative strategies to reduce ACL injuries.

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confidence: 99%

Return to Play and Career Length After Anterior Cruciate Ligament Reconstruction Among Canadian Professional Football Players

et al. 2020

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“…Considering the average length of the PT observed in this study (which is lower than the required 70 mm graft length required for an ACL reconstruction [ 38 ]), with the incorporation of bone blocks it means that most individuals may still be considered suitable recipients of a PT autograft. The benefit associated with using the BPTB graft is that it incorporates and heals at a much faster rate within the bone tunnels thus affirming its popularity in ACL reconstruction [ 39 , 40 ]. Apart from the benefits of a BPTB, graft site morbidity and return of tendon and knee functions are the other important factors to consider before deciding on harvesting tissues e.g.…”

Section: Discussionmentioning

confidence: 99%

“…At 80% statistical power and a significance level of 5%, the minimum sample size required was 42 cadavers (i.e., 21 cadavers per sex). Thus, the final sample size considered in this study was 40…”

Section: Demographics Of Samplementioning

confidence: 99%

Morphometry of the patellar tendon using a simple tracing method: a gold standard for anterior cruciate ligament reconstruction

Latiff

2023

Anat Cell Biol

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The anterior cruciate ligament (ACL) is mostly damaged in sporting activities. To reconstruct the damaged ACL, a patellar tendon (PT) is often the most preferred graft due to its fast healing and bone integration i.e. bone-patellar tendon-bone graft. Suitability of the PT often depends on the morphometric profile of the tendon. This study reported on the harvestable surface area (SA) of the tendon using a simple tracing method. The PT of 79 adult formalin-fixed cadavers of South Africans of European Ancestry were dissected, and the margins of the PT were traced on a wax paper before the tracings were scanned. The SA, straight proximal width (SPW), curved proximal width (CPW), straight distal width (SDW), curved distal width (CDW) and length of tendon (LOT) from the digitized image of the PT was measured. In addition, the length of the lower limbs was measured to normalize the measurements. The results showed no significant side differences, and the measurements were not sexually dimorphic. A strong correlation was reported for SA vs. LOT, SPW vs. CPW and SDW vs. CDW for both sexes and sides. The presented morphological profile provides additional information on the usability of the graft and with respect to healing and recovery.

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“…Several advantages have been observed for the QT graft, including reduced incidence of anterior knee pain and decreased risk of patellar fracture relative to those of BPTB. A disadvantage in using the QT graft is the difficulty to harvest it because of the dense cortical bone, curved patellar surface, and close adherence to the suprapatellar pouch 23 . Anterior knee pain and weakness of the thigh were not directly evaluated in our study, only two patients complained of this possible complication (anterior knee pain) in the QT group; however, both patients had favorable outcomes at the end of follow-up.…”

Section: Discussionmentioning

confidence: 99%

Lesiones de ligamento cruzado anterior tratadas con autoinjerto de tendón de cuádriceps versus autoinjerto de isquiotibiales: estudio controlado aleatorizado

Vílchez-Cavazos¹,

Dávila-Martínez²,

Garza-Castro³

et al. 2020

CIRU

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Contemporary Graft Options in Anterior Cruciate Ligament Reconstruction

Cited by 5 publications

References 81 publications

Return to Play and Career Length After Anterior Cruciate Ligament Reconstruction Among Canadian Professional Football Players

Return to Play and Career Length After Anterior Cruciate Ligament Reconstruction Among Canadian Professional Football Players

Morphometry of the patellar tendon using a simple tracing method: a gold standard for anterior cruciate ligament reconstruction

Lesiones de ligamento cruzado anterior tratadas con autoinjerto de tendón de cuádriceps versus autoinjerto de isquiotibiales: estudio controlado aleatorizado

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