Is all-inside with suspensory cortical button fixation a superior technique for anterior cruciate ligament reconstruction surgery? A systematic review and meta-analysis

Fu, Chun Wei; Chen, Wei-Cheng; Lu, Yung‐Chang

doi:10.1186/s12891-020-03471-3

Cited by 40 publications

(28 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Both in subjective and objective evaluation scales, no statistically significant difference emerged between those techniques. Based on the recent Connaughton et al [6] and Fu et al reviews [32], our results are consistent with the literature.…”

Section: Different Tegner Activity Scale Outcomes For Each Acl Reconssupporting

confidence: 93%

All-inside technique in ACL reconstruction: mid-term clinical outcomes and comparison with AM technique (Hamstrings and BpTB grafts)

Pautasso

Capella

Barberis

et al. 2020

Eur J Orthop Surg Traumatol

View full text Add to dashboard Cite

Purpose The aim of this study was to define the subjective and objective clinical results of all-inside surgical technique at a medium-term follow-up and to compare these results with those obtained from antero-medial (AM) ACL reconstruction technique using hamstrings (HS) or bone-patellar tendon-bone (BpTB) grafts to detect eventual superiority of one technique to another. Methods A retrospective analysis of routinely collected data was conducted. Inclusion criteria were ACL reconstruction through all-inside technique or AM technique with HS or BpTB performed between January 2015 and May 2018; age between 15 and 30 year old; minimum 24 months’ available follow-up. Exclusion criteria were contralateral ACL reconstruction; need for any other associated procedures during surgery. Clinical outcomes were assessed with KOOS, Lysholm, Tegner scores and KT-1000 device. Results According to the selection criteria, 157 patients were enrolled and divided subsequently into 3 groups: all-inside (51 patients), AM-HS (53 patients) and AM-BpTB (53 patients). A significant postoperative improvement of each score in all groups was detected. The mean KT-1000 was 3.1 ± 1.0 mm in all-inside group, while 3.3 ± 1.4 mm and 2.5 ± 0.4 mm in AM-HS and AM-BpTB groups, respectively. Comparing the results obtained, no statistically significant difference was found between the three techniques (p = 0.27). Statistically significant differences were highlighted in surgical duration: all-inside method was the longest (117′), followed by AM-BpTB surgery (101′) and AM-HS technique (87′). Conclusions The all-inside technique showed good postoperative results at medium-term follow-up. It could be a valuable solution for ACL reconstruction, especially in young patients due to its less invasiveness, despite surgical skills and time needed. Levels of evidence Level IV.

show abstract

Section: Different Tegner Activity Scale Outcomes For Each Acl Reconssupporting

confidence: 93%

All-inside technique in ACL reconstruction: mid-term clinical outcomes and comparison with AM technique (Hamstrings and BpTB grafts)

Pautasso

Capella

Barberis

et al. 2020

Eur J Orthop Surg Traumatol

View full text Add to dashboard Cite

show abstract

“…There are still some concerns in AI ACLR, such as graft elongation and fixation stability. 3 , 4 , 5 , 6 , 7 …”

Section: Discussionmentioning

confidence: 99%

“…There are 2 surgical techniques that are widely used: conventional ACL reconstruction (open socket) and all-inside ACL reconstruction (AI ACLR, closed socket). 1 , 2 , 3 , 4 …”

mentioning

confidence: 99%

All-Inside Arthroscopic Anterior Cruciate Ligament Reconstruction and Internal Brace With Recycling Suture

Buranapuntaruk¹,

Kongrukgreatiyos

Itthipanichpong

2021

Arthroscopy Techniques

View full text Add to dashboard Cite

Anterior cruciate ligament (ACL) rupture is a common injury of the knee. Arthroscopic ACL reconstruction is a standard treatment for this condition. All-inside ACL reconstruction has many advantages compared with conventional techniques. However, there are still concerns regarding graft elongation and stability with all-inside ACL reconstruction. Here, we propose an arthroscopic technique using the shortening strands of a flexible suspensory button as an internal brace. This method provides the advantages of increased stability and ACL graft protection while using the same implant as the all-inside ACL reconstruction technique.

show abstract

“…Similarly, Ode et al determined that cortical button fixation for patellar tendon repairs had a more favorable biomechanical profile as compared to suture anchor repair [ 21 ]. Another advantage of using cortical button fixation has been demonstrated by a 2020 meta-analysis [ 22 ], in which the authors compared ACL reconstruction with cortical button fixation versus interference screws and concluded that the former caused a narrower tibial tunnel [ 22 ]. The favorable biomechanics of cortical button fixation can lead to earlier mobilization and quicker return to function [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Successful Surgical Repair of Acute Quadriceps Tendon Rupture Utilizing Cortical Button Fixation: A Case Report

et al. 2021

View full text Add to dashboard Cite

Patient: Male, 69-year-old Final Diagnosis: Quadriceps tendon rupture Symptoms: Knee pain Medication:— Clinical Procedure: Surgery Specialty: Orthopedics and Traumatology Objective: Unusual setting of medical care Background: Timely diagnosis and surgical treatment are often needed to restore function of the extensor mechanism after rupture of the quadriceps tendon. Several techniques for quadriceps tendon repair have been reported, including suture anchors and bone tunnels. Cortical button fixation, or the use of an adjustable cortical fixation device, is a local and biomechanically strong internal brace technique used to treat ligament and tendon injuries. This report is of a 69-year-old man who experienced a quadriceps tendon rupture while golfing and underwent a successful surgical repair using cortical button fixation. Case Report: A 69-year-old man sustained an injury after slipping while golfing. He had immediate left knee pain and inability to bear weight. Radiographs demonstrated patella baja with an acute superior pole avulsion fracture of the patella, consistent with rupture of the quadriceps tendon. Surgical repair was discussed. Technique: After soft tissue debridement, the quadriceps tendon was debrided from the frayed and edematous edges. Two Krackow-type stitches were placed with #2 Fibertape and passed through 2 cortical buttons. Two bone tunnels were drilled from the superior to the inferior poles of the patella, bicortically. The cortical button was passed and appropriately tensioned. Conclusions: Although acute quadriceps tendon rupture is commonly treated with transosseous suture repair and suture anchor repair, this report demonstrates that cortical button fixation was a successful procedure with strong biomechanical properties, resulting in the early return of function and range of motion.

show abstract

Is all-inside with suspensory cortical button fixation a superior technique for anterior cruciate ligament reconstruction surgery? A systematic review and meta-analysis

Cited by 40 publications

References 29 publications

All-inside technique in ACL reconstruction: mid-term clinical outcomes and comparison with AM technique (Hamstrings and BpTB grafts)

All-inside technique in ACL reconstruction: mid-term clinical outcomes and comparison with AM technique (Hamstrings and BpTB grafts)

All-Inside Arthroscopic Anterior Cruciate Ligament Reconstruction and Internal Brace With Recycling Suture

Successful Surgical Repair of Acute Quadriceps Tendon Rupture Utilizing Cortical Button Fixation: A Case Report

Contact Info

Product

Resources

About