Transtibial vs anatomical single bundle technique for anterior cruciate ligament reconstruction: A Retrospective Cohort Study

Kılınç, Bekir Eray; Kara, Adnan; Öç, Yunus; Çelik, Haluk; Çamur, Savaş; Bılgın, Emre; Erten, Yunus Turgay; Şahinkaya, Türker; Eren, Osman Tuğrul

doi:10.1016/j.ijsu.2016.03.025

Cited by 38 publications

(31 citation statements)

References 37 publications

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“…Although, there is no need to worry about the iatrogenic problems that are potential complica-tions in the transportal technique, it is relatively demanding to reach the center of the native ACL footprint using this technique. 35,37,72,78,79,82,87 In the outside-in technique, no restrictions exist for femoral tunnel placement. However, special devices such as a backward drill are required, and a femoral incision is needed.…”

Section: Discussionmentioning

confidence: 99%

“…have reported that the traditional transtibial technique is unsuitable, and the superiority of the transportal technique has been suggested. [33][34][35][36][37][38] In the transportal technique, the femoral tunnel is created from the medial or far-medial portal. Using this technique, surgeons are able to drill deep and low tunnels in the femoral intercondylar notch.…”

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confidence: 99%

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Systematic Review of Surgical Technique and Tunnel Target Points and Placement in Anatomical Single-Bundle ACL Reconstruction

Iriuchishima¹,

Goto²

2020

J Knee Surg

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The purpose of this systematic review was to reveal the trend in surgical technique and tunnel targets points and placement in anatomical single-bundle anterior cruciate ligament (ACL) reconstruction. Following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement, data collection was performed. PubMed, EMBASE, and Cochran Review were searched using the terms “anterior cruciate ligament reconstruction,” “anatomic or anatomical,” and “single bundle.” Studies were included when they reported clinical results, surgical technique, and/or tunnel placement evaluation. Laboratory studies, technical reports, case reports, and reviews were excluded from this study. From these full article reviews, graft selection, method of creating the femoral tunnel, and femoral and tibial tunnel target points and placement were evaluated. In the 79 studies included for data evaluation, the selected grafts were: bone patella tendon bone autograft (12%), and hamstring autograft (83%). The reported methods of creating the femoral tunnel were: transportal technique (54%), outside-in technique (15%), and transtibial technique (19%). In the 60 studies reporting tunnel target points, the target point was the center of the femoral footprint (60%), and the center of the anteromedial bundle footprint (22%). In the 23 studies evaluating tunnel placement, the femoral tunnel was placed in a shallow–deep direction (32.3%) and in a high–low direction (30.2%), and the tibial tunnel was placed from the anterior margin of the tibia (38.1%). The results of this systematic review revealed a trend in anatomical single-bundle ACL reconstruction favoring a hamstring tendon with a transportal technique, and a tunnel target point mainly at the center of the ACL footprint. The level of evidence stated is Systematic review of level-III studies.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Systematic Review of Surgical Technique and Tunnel Target Points and Placement in Anatomical Single-Bundle ACL Reconstruction

Iriuchishima¹,

Goto²

2020

J Knee Surg

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“…It is shown that anatomical approach brought the tunnel layout to a more horizontal position and thus biomechanical studies have shown that in the coronal plane, it provides the anterior-posterior and the internal rotational stability better ( Kilinc et al, 2016 ; Miller et al, 2011 ; Scopp et al, 2004 ; Seon et al, 2011 ).…”

Section: Discussionmentioning

confidence: 99%

Is anterior cruciate ligament surgery technique important in rehabilitation and activity scores?

et al. 2016

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To compare the two different anterior cruciate ligament surgery techniques’ effect in rehabilitation and activity performance. Fifty-five patients were evaluated. Twenty-seven patients with transtibial technique (TT), 28 with anatomic single-bundle technique (AT) included. Tegner Activity Scale (TAS) was performed at preoperation and follow-up. The returning time of the sport and work was evaluated at follow-up. Single-leg hop test was performed at follow-up. Outcomes were compared between the two groups. The determined length difference between the operated knee and the intact knee was compared between the two groups. Average age of TT and AT was 27.9±6.4 yr, 28.3±6 yr, respectively. There was a significant difference between the two groups in duration of returning to sport. TT group had higher duration to return to sport (P<0.01). No difference between the two groups in duration of returning to work (P>0.05). There was a significant difference between the two groups. TT group had significantly higher values than AT group (P<0.01). No difference in TAS between the two techniques at preoperation and at last follow-up (P>0.05). The increase of TAS in patients who had AT was higher than the patients who had TT (P>0.05). No difference in single-leg hop test at 55%–65%, 65%–75%, and 85%–95% level (P>0.05). In this test at 75%–85% TT group had higher values than AT group (P<0.05), AT group had higher values at 95%–105% level (P<0.05). Good short and long-term knee outcome scores depend on rehabilitation protocol after surgery. Surgery technique should provide the adequate stability in rehabilitation period. AT obtains better outcomes in rehabilitation.

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“…At the same time, 36 hamstring tendons were obtained from the same limbs for ACL reconstruction. The hamstring grafts were prepared as the traditional single-bundle technique [28] . Two ends of the graft were woven separately for about 3.5 cm with a diameter of 8 mm and a length of 8.5 cm, and the grafts were left to defrost in isotonic saline (0.9% NaCl solution) for 1 hour prior to the test ( Figure 1 ).…”

Section: Methodsmentioning

confidence: 99%

“…The tunnel was prepared according to the traditional single-bundle technique in Groups B, C, and D, following a published protocol [28] . Using a 55° tibial drill guide, a trained surgeon advanced a guide wire into the centre of the tibial footprint, and an 8-mm tibial tunnel was drilled over the guide wire.…”

Section: Methodsmentioning

confidence: 99%

Biomechanical comparison of pure magnesium interference screw and polylactic acid polymer interference screw in anterior cruciate ligament reconstruction—A cadaveric experimental study

Song

Zhong

et al. 2017

Journal of Orthopaedic Translation

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SummaryBackgroundPolylactic acid polymer interference screws are commonly used in anterior cruciate ligament (ACL) reconstructions, especially in proximal tibia fixation. However, several concerns have been raised, including the acid products during its degradation in vivo. In recent years, biodegradable magnesium (Mg)-based implants have become attractive because of their favourable mechanical properties, which are more similar to those of natural bone when compared with other degradable materials, such as polymers, apart from their alkaline nature during degradation.MethodsWe developed a pure Mg interference screw for ACL reconstruction. In the present study, 24 fresh cadaver knees were used to compare the mechanical properties of pure Mg interference screws and polylactic acid polymer interference screws for ACL reconstruction via their application on the proximal tibia tested using specific robotics.ResultsResults showed that the pure Mg interference screw group showed similar mechanical stability to the polylactic acid polymer interference screw group, implying comparable postoperative fixation effects.ConclusionAs there are no commercially available Mg-based interference screws for ACL reconstruction clinically and the in vivo degradation of pure Mg promotes bone formation, our cadaveric study supports its clinical tests for ACL reconstruction.

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Transtibial vs anatomical single bundle technique for anterior cruciate ligament reconstruction: A Retrospective Cohort Study

Cited by 38 publications

References 37 publications

Systematic Review of Surgical Technique and Tunnel Target Points and Placement in Anatomical Single-Bundle ACL Reconstruction

Systematic Review of Surgical Technique and Tunnel Target Points and Placement in Anatomical Single-Bundle ACL Reconstruction

Is anterior cruciate ligament surgery technique important in rehabilitation and activity scores?

Biomechanical comparison of pure magnesium interference screw and polylactic acid polymer interference screw in anterior cruciate ligament reconstruction—A cadaveric experimental study

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