Knee stability, athletic performance and sportspecific tasks in non-professional soccer players after ACL reconstruction: comparing trans-tibial and antero-medial portal techniques

Tudisco, Cosimo; Bisicchia, Salvatore; Cosentino, Andrea; Chiozzi, Federica; Piva, Massimo

doi:10.11138/mltj/2015.5.3.175

Cited by 6 publications

(6 citation statements)

References 43 publications

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“…In the last two decades, an increase in the use of hamstring grafts for several surgical ligament reconstruction procedures has been observed. In fact, autogenous gracilis and semitendinosus tendons are the first choice of many orthopaedic surgeons when reconstructing the anterior and posterior cruciate ligaments [1][2][3] . Because of low site morbidity, hamstring has started to be used in other surgical procedures such as coracoacromial ligament reconstruction, ulnar collateral ligament reconstruction of the elbow and rotator cuff repair [4][5][6][7] .…”

Section: Introductionmentioning

confidence: 99%

Surgical time for graft preparation using different suture techniques

Giambartino

Lauria

Saporito

et al. 2019

Muscle Ligaments and Tendons J

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Background:The purpose of the present study was to compare the operative time for graft preparation using different techniques for graft suturing. Material and methods: Flexor profundus tendons were harvested from fresh pig hind-leg trotters. Three different suture techniques were investigated: the Krackow stitch (K), the Whipstitch (W), and the Modified Finger-Trap suture (MFT). Tendons were sutured starting at 10 mm from the distal free end of the tendon. The suture configurations of the Krackow stitch and Whipstitch were completed with five suture throws. According to the MFT technique, the suture was wrapped five times around the tendon over a distance of 30 mm. The time required to perform a complete suture on each tendon was measured. Five independent examiners of different levels of training measured the time required for graft preparation during 3 separate occasions to determine intraobserver repeatability and interobserver reproducibility. Results: The mean time required for graft preparation following the Krackow technique was 69.1 seconds ± 18.3 SD (range 31.8-120). The Whipstitch technique took an average of 59.9 seconds ± 21.2 SD (range 27-93). The MFT suture required a mean of 29.3 seconds ± 11.4 SD for completing the suture (range 21.6-33). In all examiners the time required to complete the MFT suture was significantly less than the other suture techniques (p < 0.05). Intraobserver intraclass correlation coefficients for each examiner ranged from 0.72 to 0.83. Conclusion: Low graft preparation time is required to complete a MFT suture in a porcine tendon model. Further, time required for graft preparation using the MFT was shorter than other suturing techniques such as the Krackow and Whipstitch techniques. Clinical relevance: The MFT suture could be used for graft set-up with the main advantage of reducing the time required in comparison with other suture techniques.

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Section: Introductionmentioning

confidence: 99%

Surgical time for graft preparation using different suture techniques

Giambartino

Lauria

Saporito

et al. 2019

Muscle Ligaments and Tendons J

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“…went ACL reconstruction (bone to elderly or donor animal) 7,8 . The direction of force application in tests to evaluate ultimate tensile load or pull-out strength is only in one direction, while other movements are excluded; or femoral and tibial fixation systems are tested separately, forgiving the complexity of femoral and tibial bone-graft-device system 9 .…”

Section: Correlation Between Fixation Systems Elasticity and Bone Tunmentioning

confidence: 99%

Correlation between fixation systems elasticity and bone tunnel widening after ACL reconstruction

Giorgio

Moretti

Pignataro

et al. 2019

Muscle Ligaments and Tendons J

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Background: Femoral and tibial tunnel widening (TW) after ACL reconstruction is a phenomenon increasing talk in the literature. It is underlying biological and mechanical causes. Objective: The aim of this study was to evaluate the relationship between bone tunnel enlargement and two different ACL fixation systems. Patients and Methods: 40 patient underwent ACL reconstruction with hamstring; randomly divided into group A with 20 patients treated with stiff systems (femoral Rigidfix and tibial interference screw), and into group B, with 20 patients treated with morel elastic system (femoral and tibial Tight-rope). Evaluated postoperatively with knee MRI at 40 days, 3 months, 6 months to measure bone tunnel diameters widening. Results: At 40 days tunnel widening between two groups shows no statistically difference. At 3 months postoperatively, femoral bone tunnel widening amounted on average to 1.84 mm in middle of tunnel and 1 mm at the mouth in joint in group A, and respectively 3.2 mm and 2.5 mm in group B (p<0.05). Tibial tunnel widening was 1.24 mm at the mouth in joint and 1.3 mm in middle in group A and respectively 2.26 mm and 2.43 mm in group B (p<0.05). At 6 months femoral tunnel widening amounted on average to 2.45 mm in middle and 1.35 mm at the mouth in joint in group A and respectively 3.5 mm and 2.7 mm in group B (p<0.01). Tibial tunnel widening amounted on average to 1.27 at mouth in joint and 1 mm in middle of tunnel in group A and respectively 2.6 mm and 2.3 mm in group B (p<0.01). Conclusions: This study results suggest elastic fixation system increases bone tunnel enlargement after ACL reconstruction with hamstring without correlation with worse clinical performance. Level of evidence: IV.

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“…Medial rotation laxity after anterior cruciate ligament reconstruction (ACLr) has a profound impact on the quality of life [1,2] and is a key clinical challenge for single-bundle reconstruction in different femoral drillings [3][4][5][6]. Thus, lateral extra-articular tenodesis (LET) has developed because all anterolateral knee structures contribute to minimizing anterolateral rotational laxity, and LET accounts for an increased rotatory knee arm [7][8][9], complementing single-bundle ACLr.…”

Section: Introductionmentioning

confidence: 99%

Exploratory Anterior Cruciate Ligament Graft Stress during Medial Knee Rotation with and without Iliotibial Band–Intermuscular Septum Lateral Extra-Articular Tenodesis for Transtibial and Anteromedial Femoral Tunnels

Yañez,

Silvestre,

Roby

et al. 2024

Applied Sciences

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Traditional lateral extra-articular tenodesis (LET) using fixation elements constrains medial knee rotation laxity after anterior cruciate ligament reconstruction (ACLr). However, the mechanical behavior of an LET made with an iliotibial band–intermuscular septum is unknown using different anterior cruciate ligament (ACL) reconstruction drillings and would be crucial for constraining the rotatory components of direction change movements. Thus, this study aimed to explore the maximum principal stresses and their distribution in grafts during medial knee rotation with and without iliotibial band–intermuscular septum lateral extra-articular tenodesis for the transtibial technique (TT), hybrid transtibial technique (HTT), and anteromedial portal technique (AM) in single-bundle ACLr. The maximum von Mises principal stresses and their distribution under medial knee rotation were described using a finite element model generated from a healthy knee. LET with HTT, TT, and AM decreases stress by 97%, 93%, and 86% during medial rotation compared to each technique without LET, respectively. The stress concentration for the AM portal and TT techniques was located at the femoral tunnel, and for HTT with LET, it was located across the distal thirds of the anterior aspect of the graft. In conclusion, the HTT with LET diminishes graft stress more than the HTT, TT, and AM without LET, and the TT and AM with LET during medial knee rotation. The AM portal, HTT, and TT techniques without LET show higher stress concentration patterns at the femoral tunnel, establishing a biomechanical risk of femoral tunnel enlargement when LET is not performed.

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Knee stability, athletic performance and sportspecific tasks in non-professional soccer players after ACL reconstruction: comparing trans-tibial and antero-medial portal techniques

Cited by 6 publications

References 43 publications

Surgical time for graft preparation using different suture techniques

Surgical time for graft preparation using different suture techniques

Correlation between fixation systems elasticity and bone tunnel widening after ACL reconstruction

Exploratory Anterior Cruciate Ligament Graft Stress during Medial Knee Rotation with and without Iliotibial Band–Intermuscular Septum Lateral Extra-Articular Tenodesis for Transtibial and Anteromedial Femoral Tunnels

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