Does synovialization after anterior cruciate ligament reconstruction have a positive effect on functional performance, outcomes scores, stability and muscle strength? A 2-year follow-up study after reconstruction

Chung, Kyu Sung; Ha, Jeong Ku; Jong, Ho; Kim, Sang Bum; Lee, Gu Hyun; Kim, Jin Goo

doi:10.1007/s00402-017-2808-6

Cited by 12 publications

(7 citation statements)

References 23 publications

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“…The ligamentization process has been mainly described in the patellar tendon graft and the hamstring tendon graft. Studies that describe the ligamentization process of the QTB autograft are lacking [40,41].…”

Section: Discussionmentioning

confidence: 99%

Quadriceps tendon vs. patellar tendon autograft for ACL reconstruction using a hardware-free press-fit fixation technique: comparable stability, function and return-to-sport level but less donor site morbidity in athletes after 10 years

Barié

Sprinckstub²,

Huber³

et al. 2020

Arch Orthop Trauma Surg

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Introduction The use of quadriceps tendon–patellar bone (QTB) autograft for anterior cruciate ligament (ACL) reconstruction is gaining momentum. Yet, long-term results that compare this procedure with established methods are lacking. The aim of this study was to report and compare long-term results of ACL reconstruction using QTB autografts versus bone–patellar tendon–bone (BPTB) autografts, both anchored using a hardware-free press-fit fixation technique. Materials and methods 60 athletes (Tegner score ≥6) with primary ACL rupture were prospectively randomized into two groups. 56 patients were evaluated after a mean duration of 12.2 ± 1.9 months (range 10–14) and 43 patients after 10.3 ± 0.2 years (range 10–11). Results On final follow-up, 90% of patients scored very good and good results in the functional Lysholm score (mean 99 ± 7.1, range 74–100 points). Normal or almost normal IKDC score was reported by 84% of the patients (mean 97 ± 9.5, range 60–100 points). The activity level decreased in the Tegner score from median of 7 before injury to 6 after 10 years. The KT-1000 arthrometer showed a difference in the anterior translation of less than 3 mm (mean 1.0 ± 1.2, range − 1 to 5 mm) in 91% of the patients. Significant degeneration was radiologically detected in one patient per group. No tunnel widening was seen in any patient. Up to 97% of all patients were satisfied with the operative procedure. No significant differences were found in the mentioned parameters between the two groups and also in comparison with the 1-year results. The only significant difference was in the donor site morbidity. Significantly more patients in the BPTB group had complaints during kneeling both at 1 (p < 0.001) and 10 years (p = 0.019). Squatting was also subjectively more problematic in the BPTB group than in the QTB group both after 1 (p = 0.003) and 10 years (p = 0.046). Conclusions This study shows equally good functional, clinical and radiological long-term results for both hardware-free methods of ACL reconstruction. These results clinically confirm the safety of press-fit anchoring after 10 years. The failure rate in this study was very low, with only one re-rupture in 10 years. The increased donor site morbidity when using the BPTB autograft compared to the QTB autograft supports already reported data. It was also seen in this study for the implant-free press-fit techniques. Study design Prospective and randomized, level of evidence 2.

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Section: Discussionmentioning

confidence: 99%

Quadriceps tendon vs. patellar tendon autograft for ACL reconstruction using a hardware-free press-fit fixation technique: comparable stability, function and return-to-sport level but less donor site morbidity in athletes after 10 years

Barié

Sprinckstub²,

Huber³

et al. 2020

Arch Orthop Trauma Surg

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“…24 Arthroscopy of the knee joint was performed approximately 1 year after ACL reconstruction, when the patient had resumed daily activities, to remove the tibial internal fixation. During arthroscopy, the following was evaluated: (1) the continuity of the ACL graft; (2) the tension of the graft (examined using a probe hook with the knee joint at 30 degrees of flexion); (3) the synovial covering of the graft surface as observed via the anterolateral approach (good coverage was defined as synovial coverage of the visible portion of the graft surface exceeding 50%) 25,26 ; (4) the condition of the menisci (including whether a sutured meniscus had healed or retorn); and (5) the location and degree of any cartilage damage. 26 Statistical Analysis SPSS 22.0 (IBM Corp., Armonk, NY) was used for the analysis.…”

Section: Follow-up and Outcome Measuresmentioning

confidence: 99%

Reconstruction of the Anterior Cruciate Ligament Using Ruler-Assisted Positioning of the Femoral Tunnel Relative to the Posterior Apex of the Deep Cartilage: A Single-Center Case Series

et al. 2021

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The techniques available to locate the femoral tunnel during anterior cruciate ligament (ACL) reconstruction have notable limitations. To evaluate whether the femoral tunnel center could be located intraoperatively with a ruler, using the posterior apex of the deep cartilage (ADC) as a landmark. This retrospective case series included consecutive patients with ACL rupture who underwent arthroscopic single-bundle ACL reconstruction at the Department of Orthopedics, Beijing Tongren Hospital between January 2014 and May 2018. During surgery, the ADC of the femoral lateral condyle was used as a landmark to locate the femoral tunnel center with a ruler. Three-dimensional computed tomography (CT) was performed within 3 days after surgery to measure the femoral tunnel position by the quadrant method. Arthroscopy was performed 1 year after surgery to evaluate the intra-articular conditions. Lysholm and International Knee Documentation Committee (IKDC) scores were determined before and 1 year after surgery. The final analysis included 82 knees of 82 patients (age = 31.7 ± 6.1 years; 70 males). The femoral tunnel center was 26 ± 1.5% in the deep-shallow (x-axis) direction and 31 ± 3.1% in the high-low (y-axis) direction, close to the “ideal” values of 27 and 34%. Lysholm score increased significantly from 38.5 (33.5–47) before surgery to 89 (86–92) at 1 year after surgery (p < 0.001). IKDC score increased significantly from 42.5 (37–47) before surgery to 87 (83.75–90) after surgery (p < 0.001). Using the ADC as a landmark, the femoral tunnel position can be accurately selected using a ruler.

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“…However, strength, functional outcome, and postural stability are reduced despite ACL reconstruction (ACLR) [1,2]. To recover the function of the lower extremities, clinical score, balance test, and functional performance test have been evaluated after ACLR in a clinical setting [3]. Due to a lack of proprioceptive information resulting from the substitution of ACL by the graft, sensory and motor behavior changes become visible [4].…”

Section: Introductionmentioning

confidence: 99%

Static and Dynamic Balance Comparison Between the Involved and Uninvolved Sides in Patients Who had Anterior Cruciate Ligament Reconstruction: One-year Follow-up Study

Kim

Choi

Kong

et al. 2020

Physical Therapy Korea

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Does synovialization after anterior cruciate ligament reconstruction have a positive effect on functional performance, outcomes scores, stability and muscle strength? A 2-year follow-up study after reconstruction

Cited by 12 publications

References 23 publications

Quadriceps tendon vs. patellar tendon autograft for ACL reconstruction using a hardware-free press-fit fixation technique: comparable stability, function and return-to-sport level but less donor site morbidity in athletes after 10 years

Quadriceps tendon vs. patellar tendon autograft for ACL reconstruction using a hardware-free press-fit fixation technique: comparable stability, function and return-to-sport level but less donor site morbidity in athletes after 10 years

Reconstruction of the Anterior Cruciate Ligament Using Ruler-Assisted Positioning of the Femoral Tunnel Relative to the Posterior Apex of the Deep Cartilage: A Single-Center Case Series

Static and Dynamic Balance Comparison Between the Involved and Uninvolved Sides in Patients Who had Anterior Cruciate Ligament Reconstruction: One-year Follow-up Study

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