Quantifying the problem of kneeling after a two incision bone tendon bone arthroscopic anterior cruciate ligament reconstruction

Riaz, Osman; Nisar, Sohail; Phillips, Hannah; Siddiqui, A.

doi:10.32098/mltj.03.2015.07

Cited by 5 publications

(4 citation statements)

References 15 publications

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“…Some reported that bone grafting the patellar defect did not alleviate kneeling complaints or patellofemoral problems, but they did not clarify the origin, type, or methods of the bone grafts used [13,51]. Others, including our team, proposed bone grafting as part of the solution to decrease donor-site problems [50,52,53]. There seems to be an agreement among professionals regarding donor site complaints improving with time [13,19], and some studies have shown that by combining bone grafting and special incision techniques to preserve the infrapatellar nerve, only 17% or fewer patients had anterior knee pain after two years [11,52], which is significantly less compared to the previously reported 32-43% [12,54,55].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Serum Albumin-Coated Bone Allograft for Bone Regeneration: A Seven-Year Follow-Up Study of 26 Cases

Gyulay,

Karászi,

Rédei

et al. 2023

IJMS

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We have previously reported that serum albumin-coated bone allograft (BoneAlbumin, BA) is an effective bone substitute. It improves bone regeneration at the patellar and tibial donor sites six months after harvesting bone-patellar tendon-bone (BPTB) autografts for primary anterior cruciate ligament reconstruction (ACLR). In the present study, we examined these donor sites seven years after implantation. The study group (N = 10) received BA-enhanced autologous cancellous bone at the tibial and BA alone at the patellar site. The control group (N = 16) received autologous cancellous bone at the tibial and blood clot at the patellar site. We evaluated subcortical density, cortical thickness, and bone defect volume via CT scans. At the patellar site, subcortical density was significantly higher in the BA group at both time points. There was no significant difference in cortical thickness between the two groups at either donor site. The control group’s bone defect significantly improved and reached the BA group’s values at both sites by year seven. Meanwhile, the bone defects in the BA group did not change significantly and were comparable to the six-month measurements. No complications were observed. There are two limitations in this study: The number of patients recruited is small, and the randomization of the patients could have improved the quality of the study as the control group patients were older compared to the study group patients. Our 7-year results seem to demonstrate that BA is a safe and effective bone substitute that supports faster regeneration of donor sites and results in good-quality bone tissue at the time of ACLR with BPTB autografts. However, studies with a larger number of patients are required to definitively confirm the preliminary results of our study.

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Section: Discussionmentioning

confidence: 99%

Evaluation of Serum Albumin-Coated Bone Allograft for Bone Regeneration: A Seven-Year Follow-Up Study of 26 Cases

Gyulay,

Karászi,

Rédei

et al. 2023

IJMS

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“…As mentioned, up to 27% of patients undergoing ACLR with a hamstring tendon graft report pain at 10 years. Riaz et al [26] demonstrated that up to 31% of patients under a bone‐patella‐bone graft at 6 months. This is in comparison with patients with a quadriceps tendon graft who have a reported kneeling pain rate of 5% [11].…”

Section: Discussionmentioning

confidence: 99%

“…ACL tears and surgical reconstruction predominantly affect young adults, a sub‐population in which kneeling ability plays an important role in knee function for sporting and occupational activities. However, while prior studies have sought to identify the prevalence of kneeling difficulty or pain [19, 21, 22, 26], none quantitatively assessed kneeling tolerance in detail.…”

Section: Introductionmentioning

confidence: 99%

The kneeling test is a valid method of assessing kneeling tolerance

Calvert

Smith

Kuster

et al. 2019

Knee Surg Sports Traumatol Arthrosc

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PurposeNo quantitative test exists to reliably assess kneeling tolerance before and after surgery. The aim of this study was to validate a kneeling test, designed to quantify kneeling tolerance. MethodA total of 179 participants (324 knees) were enrolled into the study, including 124 asymptomatic knees, 98 with osteoarthritis (OA), 85 following total knee arthroplasty (TKA) and 17 following anterior cruciate ligament reconstruction (ACLR). Patients were asked to kneel on a custom‐built platform on a soft, firm and hard surface, at both 90° and 110° of knee flexion. A kneeling score of 0–100 was established for 90° and 110° with 100 being a complete absence of pain or discomfort. A linear mixed model with random intercept was used to estimate differences between conditions (healthy, OA, ACLR and TKA). Pearson’s correlation coefficient was used to test the strength of the association between the kneeling test and the forgotten joint score (FJS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score. Test–retest reliability was estimated by the intraclass correlation coefficient (ICC). ResultsThe kneeling test demonstrated good discriminative validity with differences at 110° between asymptomatic knees and knees with OA (difference = − 42, p < 0.001), following ACLR (− 12, p = 0.013) and TKA (− 26, p < 0.001). Similar differences were observed at 90°. The kneeling test demonstrated construct validity, with a moderately strong correlation observed between the kneeling test and the FJS and the WOMAC at 90° (FJS 0.474 [95%CI: 0.357, 0.577], WOMAC − 0.503 [− 0.389, − 0.602]) and 110° (FJS 0.579 [95% CI: 0.479, 0.665], WOMAC − 0.648 [− 0.560, − 0.722]). The ICC for the kneeling test at 90° and 110° was 0.843 (95% CI: 0.745, 0.905) and 0.926 (95% CI: 0.877, 0.956), respectively. ConclusionsThe kneeling test is a valid technique to quantitatively determine kneeling tolerance. It can aid in the assessment and modification of current surgical techniques to improve patient outcomes. Level of evidenceIII.

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“…Synthetic materials have poor tissue compatibility, cannot be regenerated and replaced and are expensive, while there are various problems such as short service time. Therefore, autologous tissue are mostly used to reconstruct ACL, and bone-tendon-bone (B-T-B) and autologous hamstring tendon (HT) are two of the most commonly used methods for ACL reconstruction at present [8][9][10] . The important problem in the reconstruction of ACL by different methods is the problem of tendon and bone healing of the grafted ligament after surgery, because good insertion point healing is the key to the function of the grafted ACL, and whether the grafted hamstring tendon can form an early and reliable healing with the bone tunnel is the key to the success of ACL reconstruction.…”

Section: Introductionmentioning

confidence: 99%

Effect of Highly Ag-glutinative Staphylococcin Combined with α -Hemihydrate Calcium Sulfate on Tendine-Bone Healing in Cruciate Ligament Reconstruction

Zhang

Huanyu

jun

et al. 2022

Preprint

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Background: To observe the effect of highly ag-glutinative staphylococcin (HAS) combined with α-calcium sulfate hemihydrate (α-CSH) on tendon-bone healing after cruciate ligament reconstruction, and to explore the effect of highly ag-glutinative staphylococcin combined with α-calcium sulfate hemihydrate on anterior cruciate ligament（ACL）reconstruction after ACL reconstruction. Methods: Fifty-four New Zealand white rabbits were randomly divided into three groups: blank control group, α-CSH group, and HAS+α-CSH group. In the blank control group, only autologous ACL reconstruction was performed. HAS binds to a-calcium sulfate hemihydrate complex. At different time after operation (4, 8, 12 weeks after operation), 6 experimental rabbits in each group were randomly selected to be sacrificed and perform gross histological observation, cytological outcome of tendon-bone interface, protein analysis of synovial fluid, and biomechanical test of knee joint. Results: HAS+α-CSH can make the tendon-bone interface appear "tide line"-like structure earlier, reduce the production of TGF-α and IL-1β in synovial fluid, increase the area of new bone formation and the maximum tensile load of the reconstructed tendon , maximum load energy and maximum stress result. Conclusion: The combination of highly ag-glutinative staphylococcin and α-calcium sulfate hemihydrate can promote the tendon-bone healing process after cruciate ligament reconstruction.

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Quantifying the problem of kneeling after a two incision bone tendon bone arthroscopic anterior cruciate ligament reconstruction

Cited by 5 publications

References 15 publications

Evaluation of Serum Albumin-Coated Bone Allograft for Bone Regeneration: A Seven-Year Follow-Up Study of 26 Cases

Evaluation of Serum Albumin-Coated Bone Allograft for Bone Regeneration: A Seven-Year Follow-Up Study of 26 Cases

The kneeling test is a valid method of assessing kneeling tolerance

Effect of Highly Ag-glutinative Staphylococcin Combined with α -Hemihydrate Calcium Sulfate on Tendine-Bone Healing in Cruciate Ligament Reconstruction

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