The effects of graft size and insertion site location during anterior cruciate ligament reconstruction on intercondylar notch impingement

Orsi, Alexander; Canavan, Paul K.; Vaziri, Askhan; Goebel, Ruben; Kapasi, Onaly A.; Nayeb-Hashemi, Hamid

doi:10.1016/j.knee.2017.02.010

Cited by 31 publications

(27 citation statements)

References 45 publications

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“…There is evidence that impingement on the intercondylar wall may weaken the ACL and be a major factor with its injury. 3 In a recent study, Orsi et al 35 stated that small changes in graft size lead to large increases of impingement force and contact area. This may be one reason why PT grafts are successful, although, on average, they are smaller than QT and HS autografts.…”

Section: Discussionmentioning

confidence: 99%

“…Certainly, correct placement of the graft by accurate femoral and tibial tunnel drilling is crucial and cannot be overstressed. 19,26,35…”

Section: Discussionmentioning

confidence: 99%

“…The present study shows that the CSA of potential autografts varies greatly among patients, which should be considered in preoperative planning. Given the aforementioned clinical and biomechanical studies, 3,6,10,35,37,38 it is desirable to avoid under- and oversizing of the autograft to prevent its failure. Particularly when the PT or QT is considered as a possible transplant, its thickness should be measured and possible CSA calculated preoperatively, as options to adapt the resulting graft size are limited as compared with HS autografts.…”

Section: Discussionmentioning

confidence: 99%

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Individualized Anterior Cruciate Ligament Graft Matching: In Vivo Comparison of Cross-sectional Areas of Hamstring, Patellar, and Quadriceps Tendon Grafts and ACL Insertion Area

et al. 2018

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Section: Discussionmentioning

confidence: 99%

“…Certainly, correct placement of the graft by accurate femoral and tibial tunnel drilling is crucial and cannot be overstressed. 19,26,35…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Individualized Anterior Cruciate Ligament Graft Matching: In Vivo Comparison of Cross-sectional Areas of Hamstring, Patellar, and Quadriceps Tendon Grafts and ACL Insertion Area

et al. 2018

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“…Previous studies demonstrated that graft diameter has a strong effect on ACL reconstruction oucomes. 4,7,12,22 Graft diameters of the autografts and hybrid grafts were indicated in 9 of the 10 studies in the present review. 3,8,9,13,14,24,30,32,33 The mean diameters of autografts ranged from 6.4 6 0.2 mm to 8.8 6 0.5 mm, and those of hybrid grafts ranged from 8.9 6 1.0 mm to 9.9 6 0.8 mm.…”

Section: Discussionmentioning

confidence: 95%

Hamstring Autograft Versus Hybrid Graft for Anterior Cruciate Ligament Reconstruction: A Systematic Review

2019

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Background: Hamstring tendon autografts are commonly used for primary anterior cruciate ligament (ACL) reconstruction. Some patients have small hamstring tendons however, which may compromise the clinical outcome of the autograft. To solve this problem, many surgeons use hybrid grafting that involves augmentation of small hamstring autografts with allograft tissue. Purpose/Hypothesis: The purpose was to compare the clinical outcomes between primary ACL reconstructions performed with hamstring autografts and those performed with hybrid grafts in terms of patient-reported evaluation, failure rate, and knee stability. The hypothesis was that primary ACL reconstruction performed with hamstring autograft alone will not differ significantly from that performed with a hybrid graft in terms of patient-reported evaluation, failure rate, or knee stability. Study Design: Systematic review. Methods: A systematic review was performed to identify prospective and retrospective comparative studies and cohort studies (evidence levels 1-3) comparing outcomes of primary ACL reconstructions performed with hamstring autografting alone and hybrid grafting. Outcomes included patient-reported evaluation, failure rate, and knee stability. Results: Ten studies were included: 1 of level 2 and 9 of level 3. Collectively, they included 398 autografts and 341 hybrid grafts. Mean respective follow-up durations ranged from 24.0 to 69.6 months and from 24.0 to 70.8 months. Patient-reported evaluations, including Lysholm, Tegner, and subjective International Knee Documentation Committee scores, were reported in 8 of 10 studies. Failure rates were reported in all 10 studies. Results of knee stability examinations—including KT-1000 arthrometer measurements, the pivot-shift test, Lachman test, and overall International Knee Documentation Committee results—were reported in 4 of 10 studies. In this review, there were no statistically significant differences between autografts and hybrid grafts in terms of patient-reported evaluations, failure rates, or KT-1000 measurements. Conclusion: In this systematic review, there was no significant difference in patient-reported evaluation or failure rate between primary ACL reconstructions performed with autografts alone and those performed with hybrid grafts. Whether there is a substantial difference in knee stability examination results between autografts and hybrid grafts remains unknown, given a relative lack of reports on knee stability.

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“…34 Inadequate notchplasty can also lead to impingement, although with current ACL reconstruction techniques that orient the graft less vertically, notchplasty is less commonly needed. 54 Osteophytes and scarring can also lead to impingement. Patients with impingement present with a block to full knee extension and morning stiffness that improves as the day progresses.…”

Section: Graft Impingementmentioning

confidence: 99%

Knee Imaging Following Anterior Cruciate Ligament Reconstruction: The Surgeon's and Radiologist's Perspectives

Srinivasan

Wan

Allen

et al. 2018

Semin Musculoskelet Radiol

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Anterior cruciate ligament (ACL) tears are common injuries that if left untreated can result in chronic instability, cartilage damage, meniscal tears, and ligamentous injuries, eventually leading to early osteoarthritis. ACL reconstruction surgeries are therefore increasingly being performed. Despite the fact that most patients achieve excellent postoperative results, patients can present with recurrent instability and pain. These patients often undergo imaging with radiographs, magnetic resonance imaging, and/or computed tomography. An understanding of the imaging appearance of the normal ACL reconstruction and common causes of failure is therefore essential for the interpreting radiologist. This article reviews surgical techniques for ACL reconstruction, highlighting recent technical advances, the normal imaging appearance after ACL reconstruction, etiologies for reconstruction failure, and the diagnosis of these with the aid of imaging.

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The effects of graft size and insertion site location during anterior cruciate ligament reconstruction on intercondylar notch impingement

Cited by 31 publications

References 45 publications

Individualized Anterior Cruciate Ligament Graft Matching: In Vivo Comparison of Cross-sectional Areas of Hamstring, Patellar, and Quadriceps Tendon Grafts and ACL Insertion Area

Individualized Anterior Cruciate Ligament Graft Matching: In Vivo Comparison of Cross-sectional Areas of Hamstring, Patellar, and Quadriceps Tendon Grafts and ACL Insertion Area

Hamstring Autograft Versus Hybrid Graft for Anterior Cruciate Ligament Reconstruction: A Systematic Review

Knee Imaging Following Anterior Cruciate Ligament Reconstruction: The Surgeon's and Radiologist's Perspectives

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