Outcome of Primary Anterior Cruciate Ligament Reconstruction with Peroneus Longus and Bone–Patellar Tendon–Bone Autografts: A Clinical Comparative Study

Goncharov, Evgeniy Nikolaevich; Koval, Oleg Aleksandrovich; Bezuglov, Eduard Nikolaevich; Vetoshkin, Aleksandr Aleksandrovich; Goncharov, Nikolay Gavriilovich; Encarnación Ramirez, Manuel; Nurmukhametov, Renat; Montemurro, Nicola

doi:10.3390/surgeries4030043

Cited by 4 publications

(1 citation statement)

References 23 publications

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“…However, the increased complexity of double-bundle techniques may lead to longer surgical times and a more challenging rehabilitation process. Some studies have found no significant difference in outcomes between single-and double-bundle techniques in the general population, suggesting that the choice should be based on the specific needs and goals of the patient, as well as the surgeon's expertise [19].…”

Section: Introductionmentioning

confidence: 99%

Evaluating the Efficacy of Reconstruction: Systematic Review of Six-Strand Hamstring Autografts for Anterior Cruciate Ligament Reconstruction: Biomechanical and Clinical Outcomes

Vyacheslavovich,

Vladimirovna,

Bekzhan

et al. 2024

Surgeries

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Introduction: Anterior Cruciate Ligament (ACL) injuries are a major concern in orthopedics, particularly affecting active individuals and often necessitating surgery. The incidence of ACL injuries is rising, especially in women, comprising half of knee joint injuries. These injuries, common in sports with pivoting actions, can lead to long-term joint issues like osteoarthritis. Advances in surgical methods and understanding of postoperative recovery are crucial for improving patient outcomes, with considerations for graft size, material, and reconstruction technique critical in the rehabilitation process. Material and Methods: A systematic review was conducted by searching PubMed, MEDLINE, and SCOPUS for studies from 2009 to 10 February 2024, focusing on “six-strand hamstring graft” outcomes in ACL reconstruction. Inclusion criteria were English publications on 6HS autografts’ biomechanical and clinical outcomes. Excluded were non-specific, BTB, or hybrid studies, and non-research articles. Out of 347 records, 9 were analyzed after rigorous screening and quality assessment. This review, emphasizing six-strand hamstring autografts, enriches orthopedic knowledge, particularly for ACL surgery. Results: This review evaluated studies on six-strand hamstring (6HS) autografts for ACL reconstruction, encompassing prospective, retrospective, and cadaveric studies with subjects ranging from 12 to 413. Findings indicate that 6HS autografts enhance knee stability and increase graft diameter, correlating with reduced graft failure rates and improved clinical outcomes, including high patient satisfaction and low re-injury rates. Rehabilitation varied, with recovery times quicker due to larger graft sizes, and most studies reported low complication rates, underscoring 6HS autografts’ efficacy in ACL surgery. Conclusions: Performing 6HS autografts in ACL reconstruction reveals that they offer improved knee stability and graft diameter, leading to better clinical outcomes. These autografts are associated with high patient satisfaction and low re-injury rates, suggesting their effectiveness in mimicking native ACL function and enhancing rehabilitation. However, research limitations highlight the need for further long-term, comprehensive studies.

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Section: Introductionmentioning

confidence: 99%

Evaluating the Efficacy of Reconstruction: Systematic Review of Six-Strand Hamstring Autografts for Anterior Cruciate Ligament Reconstruction: Biomechanical and Clinical Outcomes

Vyacheslavovich,

Vladimirovna,

Bekzhan

et al. 2024

Surgeries

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Comparative effectiveness of peroneus longus tendon (PLT) autografts versus hamstring tendon (HT) autografts in anterior cruciate ligament reconstruction: a comprehensive systematic review and meta analysis

Park,

Fernandes,

Park

et al. 2024

Eur J Orthop Surg Traumatol

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The hamstring tendon (HT) autograft is currently the most widely utilised autograft option for anterior cruciate ligament (ACL) reconstruction. However, recent studies endorse the peroneus longus tendon (PLT) autograft as a viable alternative. To evaluate this, we systematically reviewed randomised controlled trials (RCTs) to compare the efficacy of PLT against HT autografts. Our search encompassed Cochrane, Embase, OVID, PubMed, and Scopus databases for RCTs comparing outcomes of PLT and HT autografts in ACL reconstruction. Primary outcomes included Lysholm and International Knee Documentation Committee (IKDC) scores, while secondary outcomes involved American Orthopaedic Foot and Ankle Society (AOFAS) scores, graft diameters and donor-site complications. Statistical analysis was performed using Review Manager 5.4 (Cochrane Collaboration) and heterogeneity was assessed with I2 statistics. 683 patients from 6 RCTs were included, with 338 (49.5%) patients treated with PLT autografts. Follow-up ranged from 12 to 30 months. Despite lower preoperative Lysholm scores in the PLT group, no significant differences were observed at 6 and 12 months. Although preoperative and 6-month IKDC scores were lower in the PLT group, no significant differences were found at 12 and 24 months. AOFAS scores showed no significant preoperative difference, but slightly lower scores were noted in the PLT group at 12 or 24 months. There was no significant difference in graft diameter, while donor-site complications were fewer in the PLT group. In summary, the PLT autograft is a promising and non-inferior alternative to the HT autograft, demonstrating equivalent outcomes in patient-reported knee and ankle metrics, comparable graft diameters and fewer donor-site complications.

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Postoperative Multimodal Approach to Pain Control in Anterior Cruciate Ligament Autograft Surgery: A Single-Center Series

Cheykin,

Goncharov,

Koval

et al. 2024

Surgeries

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Background: Anterior cruciate ligament (ACL) injuries are prevalent and represent a significant socioeconomic burden, as ACL injuries account for nearly 60% of all knees joint traumas. The purpose of this study is to emphasize the role of arthroscopic ACL reconstruction and the challenges in postoperative pain management. Methods: This study involved 90 patients undergoing ACL reconstruction, categorized into three groups receiving different pain management protocols. The focus was on evaluating the efficacy of multimodal analgesia using lidocaine and magnesium sulfate. The main outcome was pain assessment using the Visual Analog Scale (VAS). Results: Patients receiving fentanyl, lidocaine, and magnesium sulfate (FLM) reported significantly lower pain scores in the postoperative period. Minimal use of additional opioids was observed, suggesting effective pain management with the multimodal analgesia regimen. Conclusions: The study showed that multimodal analgesia, including FLM, effectively manages postoperative pain following ACL reconstruction. This study showed significantly lower pain scores with FLM, highlighting its potential in early postoperative pain relief. Future research should consider long-term outcomes and cost-effectiveness, emphasizing the need for more comprehensive evaluations of multimodal analgesia’s impact.

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Outcome of Primary Anterior Cruciate Ligament Reconstruction with Peroneus Longus and Bone–Patellar Tendon–Bone Autografts: A Clinical Comparative Study

Cited by 4 publications

References 23 publications

Evaluating the Efficacy of Reconstruction: Systematic Review of Six-Strand Hamstring Autografts for Anterior Cruciate Ligament Reconstruction: Biomechanical and Clinical Outcomes

Evaluating the Efficacy of Reconstruction: Systematic Review of Six-Strand Hamstring Autografts for Anterior Cruciate Ligament Reconstruction: Biomechanical and Clinical Outcomes

Comparative effectiveness of peroneus longus tendon (PLT) autografts versus hamstring tendon (HT) autografts in anterior cruciate ligament reconstruction: a comprehensive systematic review and meta analysis

Postoperative Multimodal Approach to Pain Control in Anterior Cruciate Ligament Autograft Surgery: A Single-Center Series

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