Press-fit fixation using autologous bone in the tibial canal causes less enlargement of bone tunnel diameter in ACL reconstruction - a CT scan analysis three months postoperatively

Akoto, Ralph; Müller-Hübenthal, Jonas; Balke, Maurice; Albers, Malte; Bouillon, Bertil; Helm, Philip; Banerjee, Marc; Höher, Jürgen

doi:10.1186/s12891-015-0656-5

Cited by 23 publications

(27 citation statements)

References 45 publications

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“…Ideal bone-to-bone healing is achieved when bone blocks are fixed with press-fit techniques, 12 additionally avoiding bony defects or potential tunnel widening. 13 Surgical techniques for and clinical results of press-fit and implant-free ACL reconstruction have been previously published, and interest in biologically more advantageous ACL reconstruction clearly exists. 4 Still, press-fit fixation of an ACL graft can be a challenging and time-consuming procedure, leading to low clinical acceptance.…”

Section: Biological Benefits and Press-fit Techniquementioning

confidence: 99%

Bone-on-Bone Anatomic Patellar Tendon Graft Anterior Cruciate Ligament Reconstruction: A Reproducible Technique Combining Press-Fit and Extracortical Fixation

Brandl¹,

Ostermann²,

Pauzenberger

et al. 2020

Arthroscopy Techniques

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Scientific interest in optimizing outcomes after anterior cruciate ligament (ACL) reconstruction is ongoing, and some recent developments have focused on graft shape as one of the most important factors of anatomic graft placement. The double-bundle or fanlike structure of the native ACL seems to more closely restore normal function and control of rotational stability of the knee with implant-free or press-fit techniques, creating a favorable situation in terms of direct graft-tunnel healing. The ACL reconstruction technique presented in this article enables safe, reproducible, and anatomic fixation of the patellar tendon autograft, providing the biological and biomechanical benefits of direct bony integration of the ribbonlike boneepatellar tendonebone graft. Because press-fit fixation represents a technically challenging surgical procedure, the goal of the described technique is to enable direct bone-to-bone healing by using secondary extracortical femoral and tibial fixation without the need for a true press-fit situation. Safe and anatomic femoral tunnel drilling is achieved with an outside-in technique (retrograde drilling), hence providing advantages in the routine clinical setting in terms of applicability and time effort. To reduce donor-site morbidity caused by bone block harvesting, refilling of the harvest sites with autologous material is performed.

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Section: Biological Benefits and Press-fit Techniquementioning

confidence: 99%

Bone-on-Bone Anatomic Patellar Tendon Graft Anterior Cruciate Ligament Reconstruction: A Reproducible Technique Combining Press-Fit and Extracortical Fixation

Brandl¹,

Ostermann²,

Pauzenberger

et al. 2020

Arthroscopy Techniques

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“…КТ сразу после операции не выполняли, а сравнивали полученные результаты с известными диаметрами из протоколов операций всех пациентов. Связано это с доказанным соответствием диаметра сверла, используемого во время хирургического вмешательства, и результатов измерений по КТ, проведенных на следующий день после него [7,15].…”

Section: материал и методыunclassified

“…Множество проведенных биомеханических и клинических исследований подтвердили, что прочность и жесткость подвесных кортикальных фиксаторов и трансплантата из одного сухожилия подколенной ямки являются достаточными и безопасными для восстановления ПКС [1,6,13,14]. Однако существует мнение, что именно этот вид фиксации трансплантата является причиной расширения костных каналов и возникновения осложнений в послеоперационном периоде [15,16]. Так A. E. Weber и соавт.…”

Section: Introductionunclassified

“…Компьютерная томография (КТ) является золотым стандартом оценки состояния костной ткани. Ее использовали для измерений во всех работах, посвященных проблемам расширения костных каналов после пластики ПКС [5,7,15,21]. Несмотря на нерешенность указанной проблемы, опубликовано лишь небольшое количество исследований, в которых сравнивали влияние различных методов фиксации на эффект расширения костных каналов в послеоперационном периоде.…”

Section: Introductionunclassified

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Effect of bone canal widening after anterior cruciate ligament reconstruction

Krasnoperov¹,

Golovakha²

2018

ORTHOPAEDICS, TRAUMATOLOGY and PROSTHETICS

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“…Afterwards, several authors reported their experience with this surgical technique [ 4 – 8 ]. Advantages of the press-fit fixation include direct bone-to-bone healing, accelerated rehabilitation, absence of hardware related complications or allergic reactions, less costs and the ease of revision procedures since there is no metal removal or tunnel enlargement [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Long-term follow-up after anterior cruciate ligament reconstruction using a press-fit quadriceps tendon-patellar bone autograft

Barié

Köpf

Jaber

et al. 2018

BMC Musculoskelet Disord

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BackgroundThe use of a quadriceps tendon-patellar bone (QTPB) autograft provides an alternative procedure in primary reconstruction of the anterior cruciate ligament (ACL). Using the press-fit technique for femoral fixation and knotting over a bone bridge as well as additional spongiosa filling for tibial fixation can completely eliminate the need for fixation implants. The objective of this study was to evaluate the long-term clinical, functional and radiological results of this operating method.MethodsSixty-nine patients (27 female-42 male) were included in this study. Fifty-seven patients (83%) received a comprehensive follow-up review after an average period of 7.5 years (range: 7–8.7). All other patients were surveyed by telephone. Six patients (9%) suffered a re-rupture of the ACL graft caused by a new related trauma and were therefore excluded from the statistical analysis.ResultsOf all patients, 98% were satisfied with the operation. Normal or almost normal results were recorded in the subjective IKDC scores form by 88% of the patients. The Lysholm score demonstrated very good and good results in 83% of the patients. Only 1 patient reported minor complaints in the donor area. Seven (12%) patients developed Cyclops syndrome with limited knee extension. This complication was treated arthroscopically within the first year postoperatively. Their results on follow-up were not worse than the results of the patients without Cyclops syndrome.Regarding the 57 patients who received a comprehensive evaluation, the stability test with the KT-1000 Arthrometer yielded a difference of less than 3 mm in the contralateral comparison for 89% of the operated knees. The pivot-shift test was normal in 79% and almost normal in 21%. In the Single-leg Triple Hop Test, patients achieved an average of 98% of the hopping distance attained with the contralateral leg. The radiological examination revealed a slight deterioration in the Kellgren-Lawrence Score in 2 patients.ConclusionThe ACL reconstruction using the QTPB autograft performed with the press-fit technique leads to good results in comparison with published results of established procedures for primary ACL surgery using other autografts. Further investigations should involve comparative studies with the objective of providing evidence-based, individually adapted therapy for ACL rupture.Electronic supplementary materialThe online version of this article (10.1186/s12891-018-2271-8) contains supplementary material, which is available to authorized users.

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Press-fit fixation using autologous bone in the tibial canal causes less enlargement of bone tunnel diameter in ACL reconstruction - a CT scan analysis three months postoperatively

Cited by 23 publications

References 45 publications

Bone-on-Bone Anatomic Patellar Tendon Graft Anterior Cruciate Ligament Reconstruction: A Reproducible Technique Combining Press-Fit and Extracortical Fixation

Bone-on-Bone Anatomic Patellar Tendon Graft Anterior Cruciate Ligament Reconstruction: A Reproducible Technique Combining Press-Fit and Extracortical Fixation

Effect of bone canal widening after anterior cruciate ligament reconstruction

Long-term follow-up after anterior cruciate ligament reconstruction using a press-fit quadriceps tendon-patellar bone autograft

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