Patellar tendon graft position after anterior cruciate ligament reconstruction: Interobserver variability on lateral radiographs

Klos, Tiburtius V S; Harman, Melinda K.; Devilee, Roger J.J.; Banks, Scott; Cook, Frank F.

doi:10.3109/17453679909011259

Cited by 8 publications

(3 citation statements)

References 14 publications

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“…Finally, measuring laxity with clinical and instrumental methods (like the KT1000 arthrometer) may be imprecise and technically incapable to depict the advantages of CAOS in restoring physiological knee kinematics, as demonstrated in experimental settings [20, 62, 83]. Established methods of determining tunnel alignment on conventional radiographs may suffer from similar limitations [15, 41–43]. All physical examinations, as well as the reviews of digital radiographs were conducted by a single observer each, thereby reducing inter‐rater, but not intra‐rater variability.…”

Section: Discussionmentioning

confidence: 99%

Functional outcomes and health-related quality of life after robot-assisted anterior cruciate ligament reconstruction with patellar tendon grafts

Stengel

Klufmöller

Rademacher

et al. 2009

Knee Surg Sports Traumatol Arthrosc

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During a short period of time, surgical robots had been propagated for automated tunnel placement in anterior cruciate ligament (ACL) reconstruction. Clinical outcome data are currently unavailable. Between 2000 and 2003, 152 patients underwent ACL replacement with the assistance of the Computer Assisted Surgical Planning and Robotics system (CASPAR, OrtoMaquet, Germany) at our hospital. After minimal invasive pin placement in both the tibia and femur, computed tomography was used to register anatomical landmarks and to plan graft tunnel alignment. The robot was used to drill tibial and femoral tunnels in an outside-in fashion according to pre-operative planning. There was one procedure-specific Serious Adverse Event (i.e., an intraoperative transection of the posterior cruciate ligament). After IRB approval, all patients were invited for a follow-up examination. Data from 100 patients (35 women, 65 men, mean age 35 [SD 11] years, median follow-up 61 [range 42-77] months) form the basis of this report. Side-to-side differences in anterior laxity were measured with the KT-1000 arthrometer. Patient-centered outcomes included the Lysholm-Score, the lower extremity functional scale (LEFS), and the Short Form 36 (SF36). The mean KT-1000 side-to-side difference was 0.89 [95% confidence interval (CI) 0.52-1.26] mm. Eight and five patients had a positive Lachman and pivot shift test, respectively. The Lysholm-Score averaged 86 (95% CI 83-89) points. Excellent, good, fair, and poor outcomes were reported by 38, 32, 20, and 10 patients. The LEFS averaged 85 (95% CI 82-88) points. The mean SF36 Physical Component Score was 48.4 (95% CI 46.5-50.3), indicating residual deficits compared to the population norm. All tibial graft tunnels did not cross the Blumensaat line, but were placed slightly anterior to the optimal center of 42% reported in previous studies. Compared to literature data, robot-assisted ACL reconstruction with BTB grafts may lead to higher knee stability, but poorer functional outcomes. The immense additional efforts with the procedure did not pay off in a benefit to patients.

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Section: Discussionmentioning

confidence: 99%

Functional outcomes and health-related quality of life after robot-assisted anterior cruciate ligament reconstruction with patellar tendon grafts

Stengel

Klufmöller

Rademacher

et al. 2009

Knee Surg Sports Traumatol Arthrosc

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“…Analysing the interobserver variability of graft position measurements Klos et al [18] investigated 17 cases of fluoroscopic-assisted ACL reconstructions. Determining a high intraclass correlation coefficient, variability and ranges of the tunnel positions were not determined.…”

Section: Discussionmentioning

confidence: 99%

Variability of tunnel positioning in fluoroscopic-assisted ACL reconstruction

Shafizadeh

Balke

Hoeher³

et al. 2014

Knee Surg Sports Traumatol Arthrosc

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“…In postoperative assessment, radiographs are a common means of validation (6,7) . Several authors have published correlations between the natural insertion sites in human cadaveric knees and radiographs taken from those specimens (8)(9)(10) or correlations between graft position and clinical outcome (11,12) .…”

Section: Introductionmentioning

confidence: 99%

Image-guided reconstruction of the anterior cruciate ligament

Sabczynski¹,

Dries²,

Zylka³

et al. 2004

IJMRCAS

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The replacement of the ruptured Anterior Cruciate Ligament (ACL) of the knee is a biomechanically difficult task. The correct placement of the graft, especially the isometry of the tibial and femoral insertion points, is critically to the success of the procedure. However, during arthroscopy, the planning of the insertion points and accurate execution of the plan is difficult. This paper reports an X-ray based system for navigation of the ACL graft implant. The system integrates arthroscopy and intra-operative X-ray imaging to identify the correct insertion points of the graft. Furthermore, it allows testing the isometry of these points before drilling of the femoral and tibial tunnel, and guides the drilling itself.

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Patellar tendon graft position after anterior cruciate ligament reconstruction: Interobserver variability on lateral radiographs

Cited by 8 publications

References 14 publications

Functional outcomes and health-related quality of life after robot-assisted anterior cruciate ligament reconstruction with patellar tendon grafts

Functional outcomes and health-related quality of life after robot-assisted anterior cruciate ligament reconstruction with patellar tendon grafts

Variability of tunnel positioning in fluoroscopic-assisted ACL reconstruction

Image-guided reconstruction of the anterior cruciate ligament

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