Abstract:Although both techniques provided satisfactory clinical results, DB-ACLR using the existing footprint remnant for tunnel placement showed better functional results with respect to faster ROM recovery, higher subjective outcome scores, and better arthroscopic second-look with no revision cases.
“…Considering the heterogeneity in anatomic landmarks, placement of the tibial tunnel using an existing footprint remnant might be a better approach than using bony or meniscal landmarks to restore the anatomic position of the ACL. Supporting this, a recent study showed that ACL reconstructions using an existing footprint remnant for tunnel placement provide better objective and subjective clinical results than reconstructions using bony landmarks (Lu et al 2015). …”
BackgroundTo determine if tibial tunnel reaming during anatomic single-bundle anterior cruciate ligament (ACL) reconstruction using hamstring autograft can result in anterolateral meniscal root injury, as diagnosed by magnetic resonance imaging (MRI).MethodsA case series of 104 primary anatomic single-bundle ACL reconstructions using hamstring autograft was retrospectively reviewed. Pre- and post-operative (>1 year) MRIs were radiologically evaluated for each patient, with a lateral meniscus extrusion > 3 mm at the level of the medial collateral ligament midportion on a coronal MRI, to establish anterolateral meniscal root injury.ResultsNo patients presented radiological findings of anterolateral meniscal root injury in this case series.ConclusionsExamining a single-bundle ACL reconstruction technique using hamstring autograft that considered tibial tunnel positioning in the center of the tibial footprint, this case series found no evidence of anterolateral meniscal root injury in patient MRIs, even more than 1-year post-operation.
“…Considering the heterogeneity in anatomic landmarks, placement of the tibial tunnel using an existing footprint remnant might be a better approach than using bony or meniscal landmarks to restore the anatomic position of the ACL. Supporting this, a recent study showed that ACL reconstructions using an existing footprint remnant for tunnel placement provide better objective and subjective clinical results than reconstructions using bony landmarks (Lu et al 2015). …”
BackgroundTo determine if tibial tunnel reaming during anatomic single-bundle anterior cruciate ligament (ACL) reconstruction using hamstring autograft can result in anterolateral meniscal root injury, as diagnosed by magnetic resonance imaging (MRI).MethodsA case series of 104 primary anatomic single-bundle ACL reconstructions using hamstring autograft was retrospectively reviewed. Pre- and post-operative (>1 year) MRIs were radiologically evaluated for each patient, with a lateral meniscus extrusion > 3 mm at the level of the medial collateral ligament midportion on a coronal MRI, to establish anterolateral meniscal root injury.ResultsNo patients presented radiological findings of anterolateral meniscal root injury in this case series.ConclusionsExamining a single-bundle ACL reconstruction technique using hamstring autograft that considered tibial tunnel positioning in the center of the tibial footprint, this case series found no evidence of anterolateral meniscal root injury in patient MRIs, even more than 1-year post-operation.
“…Most studies had retrospective, non-randomized designs. There were only five randomized controlled trials or prospective cohort studies (levels of evidence I and II) [7,8,14,17,18], probably because of the invasive nature of second-look arthroscopy. Eleven of the remaining 23 studies were retrospective comparative studies (level of evidence III) and 12 studies were case series (level of evidence IV).…”
Section: Study Quality Assessmentmentioning
confidence: 99%
“…1). All studies except one [19] were from northeast Asian regions including South Korea [6, 9-11, 14, 20, 22, 24, 26, 27, 31, 33], Japan [5,7,8,12,13,17,21,23,25,[28][29][30]32], and China [18,34]. Year of publication ranged from 1994 to 2017.…”
Section: Study Identification and Characteristicsmentioning
confidence: 99%
“…The most common classification of graft integrity involved three categories according to the severity of graft tear: intact, partial (or superficial) tear, and complete (or substantial) tear [13,25,31]. Moreover, five studies categorized the percentage of the intact portion of the entire graft volume [9,10,18,28,29]. Ohsawa et al [28,29] described the integrity of the graft as "no tear" when more than 80% of the graft was intact, "partial tear" when 30-80% of the graft was intact, and "complete tear" when less than 30% of the graft was intact.…”
Section: Graft Integrity On Second-look Arthroscopymentioning
Purpose: The purpose of this systematic review was to investigate and summarize the evaluation methods of graft maturation on second-look arthroscopy following anterior cruciate ligament (ACL) reconstruction. Methods: A literature search was performed on articles before December 2017 to identify the literature that has evaluated graft maturation on second-look arthroscopy following ACL reconstruction. Only studies using human grafts, evaluating graft maturation with two or more gross findings were included. Study design, grafts, surgical techniques, follow-up period, evaluation parameters, and categories were compiled. Results: Twenty-eight studies were included in this study. All studies evaluated graft maturation with two or more of the following three findings: graft integrity, tension, and synovial coverage. Two to four categories were used for evaluating each parameter, but the criteria for classification were slightly different for each study. Several studies reported neo-vascularization of grafts and the total maturation score by summing up the scores assigned to each evaluation parameter. Three studies reported that there was no correlation between second-look findings and patient-reported outcomes. Conclusions: Graft integrity, tension, and synovial coverage were the most frequently evaluated for graft maturation on second-look arthroscopy. However, there is no uniform criterion for evaluation. Therefore, development of a valid, uinform criterion is required. Level of evidence: Level IV, systematic review of level I-IV investigations.
“…Soft tissue remnants, along with bony landmarks, are essential in determining the anatomic tunnel positions during ACL reconstruction surgery 67 68. A deficient interobserver agreement between surgeons can be present if these structures are not considered for anatomic tunnel placement 69…”
Section: Acl Reconstruction: Current State Of the Artmentioning
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