Is Quadriceps Tendon Autograft a Better Choice Than Hamstring Autograft for Anterior Cruciate Ligament Reconstruction? A Comparative Study With a Mean Follow-up of 3.6 Years

Background: The quadriceps tendon (QT) autograft is known as an effective graft for anterior cruciate ligament (ACL) reconstruction and shows a similar functional outcome to the bone-patellar tendon-bone (BPTB) in randomized controlled trials, with a lesser incidence of complications. Up until now, only 2 studies have compared QT to hamstring tendon (HT) autograft. Hypothesis: The functional outcomes of the QT technique are at least as good as those of the HT technique, with the same morbidity. Study Design: Cohort study; Level of evidence, 3. Methods: Ninety-five patients underwent isolated ACL reconstruction between January 1 and December 31, 2012. Fifty underwent ACL reconstruction with the QT and 45 with the HT. The same surgical technique, fixation method, and postoperative protocol were used in both groups. The following parameters were evaluated: surgical revisions, functional outcome (Lysholm, Knee injury and Osteoarthritis Outcome Score [KOOS], Tegner, subjective International Knee Documentation Committee), joint stability (KT-1000, Lachman, pivot shift), anterior knee pain (Shelbourne-Trumper score), and isokinetic strength. Descriptive statistics are presented for these variables using the Student t test. Results: Eighty-six patients (45 QT, 41 HT) were reviewed with a mean follow-up of 3.6 ± 0.4 years; minimum follow-up was 3 years. There were 4 reoperations in the QT group (including 1 ACL revision) and 3 in the HT group (including 2 ACL revisions) ( P > .05). The Lysholm (89 ± 6.9 vs 83.1 ± 5.3), KOOS Symptoms (90 ± 11.2 vs 81 ± 10.3), and KOOS Sport (82 ± 11.3 vs 67 ± 12.4) scores were significantly better in the QT group than in the HT group. In terms of stability, the mean side-to-side difference was 1.1 ± 0.9 mm for the QT group and 3.1 ± 1.3 mm for the HT group based on KT-1000 measurements ( P < .005). The negative Lachman component was higher in the QT group than in the HT group (90% vs 46%, P < .005). There was a trend for the negative pivot-shift component to be higher in the QT group than in the HT group (90% vs 64%, P = .052). The Shelbourne-Trumper score was the same in both groups. There was no difference between groups in terms of isokinetic strength. Conclusion: The use of a QT graft in ACL reconstruction leads to equal or better functional outcomes than does the use of an HT graft, without affecting morbidity.

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Clinical outcome of anterior cruciate ligament reconstruction with modified transtibial and anteromedial portal

MUSCULOSKELETAL SURGERY ◽

10.1007/s12306-021-00727-6 ◽

2021 ◽

Author(s):

S. Vijayan ◽

H. Kyalakond ◽

M. S. Kulkarni ◽

M. N. Aroor ◽

S. Shetty ◽

...

Keyword(s):

Anterior Cruciate Ligament ◽

Acl Reconstruction ◽

Functional Outcomes ◽

Pivot Shift ◽

Cruciate Ligament ◽

Anteromedial Portal ◽

Anterior Drawer ◽

Significant Difference ◽

Kt 1000 ◽

Anterior Cruciate

AbstractArthroscopic ACL reconstruction is the current standard care of treatment for anterior cruciate ligament (ACL) injuries. Modified transtibial (mTT) and anteromedial portal (AMP) techniques aim at the anatomical placement of femoral tunnel. Controversy existed in the literature with regard to the outcome of these techniques. Hence, we designed a retrospective comparative study to analyse the clinical and functional outcomes of mTT and AMP techniques. We hypothesized that there would be no difference between the clinical and functional outcomes in mTT and AMP techniques. This retrospective observational study was conducted in consecutive patients who underwent arthroscopic ACL reconstruction using semitendinosus-gracilis (STG) quadrupled graft in our tertiary care centre with a minimum follow-up of two years. Out of 69 patients, 37 had undergone ACL reconstruction by mTT technique and remaining by AMP technique. All the patients were assessed clinically by anterior drawer, Lachman’s, pivot shift and single-legged hop test. Lysholm Knee Scoring Scale and International Knee Documentation Committee (IKDC) subjective knee evaluation score were used for the functional status. Knee instability was assessed objectively by KT-1000 arthrometer. There was no statistically significant difference in baseline demographic characteristics between mTT and AMP groups. At the end of 2 years, no statistically significant difference was noted in the anterior drawer and Lachman’s test. Though not significant, IKDC scores and Lysholm’s scores showed a better outcome in the AMP group when compared to the mTT group. AMP group showed significantly better outcome with KT-1000 arthrometer. Based on the results obtained, we presume that overall both mTT and AMP have similar functional outcome. However, as AMP technique offers significantly improved subjective rotational stability on pivot shift test, better hop limb symmetry index and KT 1000 readings compared to mTT, we suggest AMP over mTT.

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Xenograft for anterior cruciate ligament reconstruction was associated with high graft processing infection

Journal of Experimental Orthopaedics ◽

10.1186/s40634-020-00292-0 ◽

2020 ◽

Vol 7 (1) ◽

Author(s):

Willem Van Der Merwe ◽

Martin Lind ◽

Peter Faunø ◽

Kees Van Egmond ◽

Stefano Zaffagnini ◽

...

Keyword(s):

Anterior Cruciate Ligament ◽

Acl Reconstruction ◽

Infection Rate ◽

Pivot Shift ◽

Cruciate Ligament ◽

Pivot Shift Test ◽

Tunnel Widening ◽

Kt 1000 ◽

Anterior Cruciate

Abstract Purpose To evaluate clinical ad radiological outcomes of anterior cruciate ligament (ACL) reconstruction with an immunochemically modified porcine patellar tendon xenograft controlled against human Achilles tendon allograft at 24-month minimum follow-up. Methods 66 patients undergoing arthroscopic ACL reconstruction were randomized into 2 groups: 34 allografts and 32 xenografts treated to attenuate the host immune response. Follow-up was 24-month minimum. Anterior knee stability was measured as KT − 1000 side-to-side laxity difference (respect to the contralateral healthy knee). Functional performance was assessed by one-legged hop test. Objective manual pivot-shift test and subjective (IKDC, Tegner and SF-36) outcomes were collected. MRI and standard X-Ray were performed. Results 61 subjects (32 allograft, 29 xenograft) were evaluated at 12 and 24 months. Six of the subjects in xenograft group (20.6%) got an infection attributed to a water-based pathogen graft contamination in processing. Intention-to-treat analysis (using the last observation carried forward imputation method) revealed higher KT − 1000 laxity in xenograft group at 24-month follow-up (P = .042). Also pivot-shift was higher in xenograft group at 12-month (P = .015) and 24-month follow-up (P = .038). Per-protocol analysis (missing/contaminated subjects excluded) did not revealed clinical differences between groups. Tibial tunnel widening in the allograft group was low, whereas xenograft tunnel widening was within the expected range of 20–35% as reported in the literature. No immunological reactivity was associated to xenograft group. Conclusions High infection rate (20.6%) was reported in xenograft group. Both groups of patients achieved comparable clinical outcomes if missing/contaminated subjects are excluded. Improved harvesting/processing treatments in future studies using xenografts for ACL reconstruction are needed to reduce infection rate, otherwise xenograft should not be used in ACL reconstruction. Level of evidence Multicenter and double-blinded Randomized Controlled Clinical Trial, Level I.

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Clinical outcomes of combined anterior cruciate ligament and anterolateral ligament reconstruction: a systematic review and meta-analysis

Knee Surgery and Related Research ◽

10.1186/s43019-021-00115-1 ◽

2021 ◽

Vol 33 (1) ◽

Author(s):

Diego Ariel de Lima ◽

Lana Lacerda de Lima ◽

Nayara Gomes Reis de Souza ◽

Rodrigo Amorim de Moraes Perez ◽

Marcel Faraco Sobrado ◽

...

Keyword(s):

Anterior Cruciate Ligament ◽

Clinical Outcomes ◽

Acl Reconstruction ◽

Pivot Shift ◽

Cruciate Ligament ◽

Meta Analysis ◽

Anterolateral Ligament ◽

Cochrane Library ◽

Anterior Cruciate

Abstract Objectives To compare the clinical outcomes of isolated anterior cruciate ligament (ACL) reconstruction with combined reconstruction of the ACL and anterolateral ligament (ALL) of the knee. Methods A search was conducted on the PubMed, Medline, Google Scholar, EMBASE, and Cochrane library databases, in line with the PRISMA protocol. The indexation terms used were “anterior cruciate ligament” OR “acl” AND “anterolateral ligament” AND “reconstruction.” Articles that compared patients submitted to combined ACL and ALL reconstruction with those submitted to isolated reconstruction of the ACL, with levels of evidence I, II, and III, were included. Studies with follow-up of less than 2 years and articles that did not use “anatomical” techniques for ALL reconstruction, such as extraarticular tenodesis, were excluded. A meta-analysis with R software was conducted, with a random effects model, presented as risk ratio (RR) or mean difference (MD), with a 95% confidence level (CI) and statistically significant at p < 0.05. Results Ten articles were selected, with a total of 1495 patients, most of whom were men, of whom 674 submitted to ACL and ALL reconstruction and 821 to isolated ACL reconstruction. Combined ACL and ALL reconstruction exhibited a statistically significant advantage in residual pivot shift (RR 0.34, 95% CI 0.24–0.47, I2 = 0%, p < 0.01), rerupture rate (RR 0.34, 95% CI 0.19–0.62, I2 = 0%, p < 0.01), Lachman test (RR 0.59, 95% CI 0.40–0.86, I2 = 21%, p < 0.01), and postoperative Lysholm score (MD 2.28, CI 95% 0.75–3.81, I2 = 73%, p < 0.01). Conclusions Combined ACL and ALL reconstruction obtained better postoperative clinical outcomes when compared with isolated ACL reconstruction, especially in reducing residual pivot shift and rerupture rate.

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Simultaneous Double-boundle “All Inside” Posterior Cruciate Ligament and Anterior Cruciate Ligament Reconstruction: 2 Years Follow Up

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967118s00185 ◽

2018 ◽

Vol 6 (12_suppl5) ◽

pp. 2325967118S0018

Author(s):

Franco Farina ◽

Matías Orlando ◽

Ma. Florencia Weisburd ◽

Francisco Vega ◽

Emilio Morales ◽

...

Keyword(s):

Anterior Cruciate Ligament ◽

Posterior Cruciate Ligament ◽

Acl Reconstruction ◽

Cruciate Ligament ◽

Anatomical Reconstruction ◽

Pcl Reconstruction ◽

Kt 1000 ◽

Anterior Cruciate ◽

Anterior Posterior

The purpose of this study was to evaluate the clinical results of simultaneuos Double-boundle “All Inside” posterior Cruciate Ligament (PCL) and Anterior Cruciate Ligament (ACL) Reconstruction. Methods: this study population included 31 men and 2 women with 26 acute and 7 chronic knee injuries. Ligament injuries included 21 ACL / PCL / Posterolateral instability, 9 ACL / PCL / Medial Cruciate Ligament (MCL), 3 ACL / PCL instability. Artroscopically assited combined ACL/PCL. Reconstruction were performed using the All Inside PCL reconstruction and ACL anatomical Reconstruction. The patients were followed up for a minimum of 2 years and evaluated according to the International Knee Documentation Committee (IKDC) and Lysholm Rating scale. The anterior-posterior knee laxity was assessed by KT-1000 examination. Results: At the last Follow Up, all patients showed normal knee extension. Two patients had 10 grades flexion limitation, and five had a 5 grades flexion limitation. The Lysholm scores was 90,4 +/- 4,6. According to the last IKDC evaluation, the results were graded as normal in 21 patients (63,6%), nearly normal in 11 patients (33,3%), and abnormal in 1 patient (3,1%). The KT-1000 examination showed that de side to side difference in overall anterior-posterior laxity at 70 grades flexion was 0 to 2 mm in 24 patients, 3 to 5 mm in 8 patients, and 6 to 10 mm in 1 patient; the side to side difference in overall anterior-posterior laxity at 20 grades flexion was 0 to 2 mm in 23 patients, 3 to 5 mm in 9 patients and 6 to 10 mm in 1 patient. Conclusion: simultaneuos Double-Boundle “All Inside” PCL and ACL reconstruction can effectively and safely restore knee stability, and can yield normal results in 62,5% of patients and nearly normal in 33,3% at minimum 2 years.

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Prospective study to assess functional outcomes in patients undergoing single bundle arthroscopic reconstruction of primary anterior cruciate ligament tear comparing with bone quadriceps tendon versus hamstring tendon autograft

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20201528 ◽

2020 ◽

Vol 6 (3) ◽

pp. 511

Author(s):

Gagan Khanna ◽

Raman Attri ◽

Rohit Sharma

Keyword(s):

Anterior Cruciate Ligament ◽

Acl Reconstruction ◽

Cruciate Ligament ◽

Quadriceps Tendon ◽

Hamstring Tendon ◽

Fixation Method ◽

Isokinetic Strength ◽

Acl Injuries ◽

Ikdc Score ◽

Anterior Cruciate

Background: Anterior cruciate ligament (ACL) injuries are one of the most common ligament injuries of knee. Arthroscopic ACL reconstruction has become the standard of care for ACL injuries in the active patient. In present study good bone quadriceps tendon (BQT) autograft and hamstring tendon (HT) autograft will be used for primary arthroscopic ACL reconstruction and its data regarding clinical and functional results will be evaluated and compared.Methods: Sixty patients underwent isolated ACL reconstruction. 30 underwent ACL reconstruction with the BQT and 30 with the HT. The same surgical technique, fixation method and postoperative protocol were used in both groups. Functional outcome in terms of International Knee Documentation Committee (IKDC) score, joint stability (anterior drawer, Lachman, pivot shift), anterior knee pain and isokinetic strength was evaluated.Results: IKDC score in bone quadriceps tendon and hamstring tendon group after 9 months follow up showing no statistical significance. The negative Lachman component was higher in the BQT group than in the HT group. There was no difference between groups in terms of isokinetic strength.Conclusions: Our study shows no statistically significant difference between both groups.

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Surgical intra- and extra-articular anterior cruciate ligament reconstruction: a meta-analysis

10.21203/rs.2.20069/v1 ◽

2020 ◽

Author(s):

Xiangyun Cheng ◽

Fanxiao Liu ◽

Dongsheng Zhou ◽

Alexander C. Paulus

Keyword(s):

Anterior Cruciate Ligament ◽

Acl Reconstruction ◽

Pivot Shift ◽

Cruciate Ligament ◽

Meta Analysis ◽

Cochrane Library ◽

Pivot Shift Test ◽

Reconstruction Technique ◽

Anterior Cruciate

Abstract Background: It is still controversial whether the combination of anterior cruciate ligament (ACL) reconstruction and extra-articular reconstruction (EAR) have good clinical efficacy. This meta-analysis aims to compare the clinical effectiveness of ACL reconstruction and combined reconstruction. Methods: Electronic databases, including Medline/PubMed, Embase and the Cochrane Library, were systematically searched to identify targeted studies. A meta-analysis aims to pool the outcome estimates of interest, such as the Lysholm, International Knee Documentation Committee (IKDC) and Tegner scores and the results from the KT-1000/2000 arthrometer test, the Lachman test and the pivot shift test. Results : Twelve studies involving 1146 knees were identified. Compared with single ACL reconstruction, combined reconstruction had better results for a pivot shift of grade 1 (relative ratio [RR] = 0.88, 95% CI: 0.83-0.94) and grade 2 (RR = 0.95, 95% CI: 0.91-0.99) rather than grade 3 (RR = 0.98, 95% CI: 0.90-1.06) and no statistically significant difference for both Lachman grade 1 (RR = 0.96, 95% CI: 0.89-1.05) and grade 2 (RR = 0.96, 95% CI: 0.90-1.03). Combined reconstruction resulted in significant improvements on the instrumented joint laxity test when considering a failure standard of more than 5 mm (a side-to-side arthrometric difference) (RR = 0.94, 95% CI: 0.89-0.98) rather than 3 mm (RR = 0.94, 95% CI: 0.86-1.03). Moreover, combined reconstruction increased the IKDC score at the 12-month (weighted mean difference [WMD] = -6.38, 95% CI: -9.66 to -3.10), 24-month (WMD = -5.60, 95% CI: -8.54 to -2.66) and 36-month follow-ups (WMD = -4.71, 95% CI: -7.59 to -1.83) and the Tegner score at the 36-month follow-up (WMD = -0.53, 95% CI: -0.97 to -0.09), but it did not increase the Lysholm score at the 36-month follow-up (WMD = -0.84, 95% CI: -2.02 to 0.34). Conclusion : With the advances in reconstruction techniques, combined reconstructions were found to be effective in improving rotational stability and to lead to good functional scores. However, obviously, the combined reconstruction technique is more time-consuming and requires an additional incision, which is not suitable for all ACL-deficient patients. Therefore, programs should be personalized and customized for the specific situation of each patient.

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Comparing Knee Laxity After Anatomic Anterior Cruciate Ligament Reconstruction Using Quadriceps Tendon Versus Semitendinosus Tendon Graft

Orthopaedic Journal of Sports Medicine ◽

10.1177/23259671211014849 ◽

2021 ◽

Vol 9 (7) ◽

pp. 232596712110148

Author(s):

Katrin Karpinski ◽

Martin Häner ◽

Sebastian Bierke ◽

Theresa Diermeier ◽

Wolf Petersen

Keyword(s):

Acl Reconstruction ◽

Cruciate Ligament ◽

Quadriceps Tendon ◽

Pivot Shift Test ◽

Significant Difference ◽

Kt 1000 ◽

The Mean ◽

Anterior Cruciate ◽

Primary Acl Reconstruction

Background: The choice of graft in anterior cruciate ligament (ACL) reconstruction is still under discussion. The hamstrings are currently the most used grafts for primary ACL reconstruction in Europe. However, increased interest has arisen in the quadriceps tendon (QT) as an alternative autologous graft option for primary ACL reconstruction. Purpose: To evaluate knee stability and the subjective outcome after ACL reconstruction using either autologous QT graft in implant-free femoral press-fit fixation technique or semitendinosus tendon (ST) graft. Study Design: Cohort study; Level of evidence, 2. Methods: We evaluated 50 patients who underwent ACL reconstruction, including 25 patients who received autologous ipsilateral QT graft (QT group) and 25 patients who received the ipsilateral ST graft (ST group). The follow-up for this prospective comparative study was at least 2 years after surgery, comprising KT-1000 arthrometer testing, pivot-shift test, Knee injury and Osteoarthritis Outcome Score (KOOS), Lysholm score, and rerupture rate. Results: The mean patient age was 31.72 years (9 women, 16 men) in the QT group and 32.08 years (13 women, 12 men) in the ST group. The mean ± standard deviation postoperative side-to-side difference assessed using KT-1000 arthrometer was 1.56 ± 1.56 mm for the QT group and 1.64 ± 1.41 mm for the ST group, with no significant difference. No significant difference was found on any of the KOOS subscale scores ( P = .694) or the Lysholm score ( P = .682). No rerupture or positive pivot-shift test occurred during follow-up. No difference was found in donor-site morbidity between the study groups. Conclusion: Clinical outcomes were not significantly different between QT and ST grafts in the current study. Thus, the QT may serve as a good alternative graft for primary ACL reconstruction.

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Twenty-Year Outcomes After Anterior Cruciate Ligament Reconstruction: A Systematic Review of Prospectively Collected Data

The American Journal of Sports Medicine ◽

10.1177/03635465211027302 ◽

2021 ◽

pp. 036354652110273

Author(s):

Joshua S. Everhart ◽

Sercan Yalcin ◽

Kurt P. Spindler

Keyword(s):

Systematic Review ◽

Anterior Cruciate Ligament ◽

Acl Reconstruction ◽

Cruciate Ligament ◽

Knee Function ◽

Increased Risk ◽

Patient Reported ◽

The Mean ◽

Anterior Cruciate

Background: Several long-term (≥20 years) follow-up studies after anterior cruciate ligament (ACL) reconstruction have been published in recent years, allowing for a systematic evaluation of outcomes. Purpose: To summarize outcomes at ≥20 years after ACL reconstruction and identify patient and surgical factors that affect these results. Study Design: Systematic review; Level of evidence, 4. Methods: Prospective studies of primary ACL reconstructions with hamstring or bone–patellar tendon—bone (BTB) autograft via an arthroscopic or a mini-open technique and with a mean follow-up of ≥20 years were identified. When possible, the mean scores for each outcome measure were calculated. Factors identified in individual studies as predictive of outcomes were described. Results: Five studies met the inclusion and exclusion criteria with a total of 2012 patients. The pooled mean follow-up for patient-reported outcome measures was 44.2% (range, 29.6%-92.7%) and in-person evaluation was 33.2% (range, 29.6%-48.9%). Four studies (n = 584) reported graft tears at a mean rate of 11.8% (range, 2%-18.5%) and 4 studies (n = 773) reported a contralateral ACL injury rate of 12.2% (range, 5.8%-30%). Repeat non-ACL arthroscopic surgery (4 studies; n = 177) to the ipsilateral knee occurred in 10.4% (range, 9.5%-18.3%) and knee arthroplasty (1 study; n = 217) in 5%. The pooled mean of the International Knee Documentation Committee subjective knee function (IKDC) score was 79.1 (SD, 21.8 [3 studies; n = 644]). In 2 studies (n?= 221), 57.5% of patients continued to participate in strenuous activities. The IKDC-objective score was normal or nearly normal in 82.3% (n = 496; 3 studies), with low rates of clinically significant residual laxity. Moderate-severe radiographic osteoarthritis (OA) (IKDC grade C or D) was present in 25.9% of patients (n = 605; 3 studies). Medial meniscectomy is associated with increased risk of radiographic OA. Radiographic OA severity is associated with worse patient-reported knee function, but the association with knee pain is unclear. Conclusion: Currently available prospective evidence for ACL reconstruction with hamstring or BTB autograft provides several insights into outcomes at 20 years. The rates of follow-up at 20 years range from 30% to 93%. IKDC-objective scores were normal or nearly normal in 82% and the mean IKDC-subjective score was 79 points.

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GRAFT CHOICE FOR ADOLESCENT ATHLETES RETURNING TO HIGH-RISK SPORTS: A MATCHED COHORT ANALYSIS OF PATELLAR TENDON AND HAMSTRING AUTOGRAFTS

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967119s00075 ◽

2019 ◽

Vol 7 (3_suppl) ◽

pp. 2325967119S0007

Author(s):

Crystal Perkins ◽

Michael Busch ◽

Melissa Christino ◽

Belinda Schaafsma ◽

S. Clifton Willimon

Keyword(s):

Anterior Cruciate Ligament ◽

High Risk ◽

Acl Reconstruction ◽

Patellar Tendon ◽

Graft Failure ◽

Cruciate Ligament ◽

Graft Rupture ◽

Graft Choice ◽

Anterior Cruciate

Background: Graft selection for skeletally mature adolescents undergoing anterior cruciate ligament (ACL) reconstruction is guided by surgeon and patient preference. In young patients returning to high-risk cutting and pivoting sports, graft rupture is the most feared complication of ACL reconstruction. Some studies have demonstrated slightly lower rates of graft failure and decreased laxity in the short term associated with patellar tendon (BTB) autografts as compared to hamstring (HS) autografts, but these studies are limited by their heterogeneity of ages and activity level1-3. The purpose of this study is to compare the rates of graft failure between BTB and HS ACL reconstruction cohorts matched by age, sex, and sport. Methods: A single-institution retrospective review was performed of consecutive patients less than 19 years of age treated with ACL reconstructions using either patellar tendon (BTB) or hamstring (HS) autograft performed by a single surgeon. Skeletally mature or nearly mature patients in “high-risk” ACL injury sports (basketball, football, soccer, lacrosse, and gymnastics) were initially treated with hamstring autografts but the graft preference transitioned to BTB autografts as the preferred graft choice during the study period. This transition in graft preference for adolescents participating in “high risk” sports allows for a comparison of outcomes based on graft types. Inclusion criteria were ages 13 – 18 years, participation in a “high risk” sport, and minimum 6-month follow-up. The two cohorts of patients were matched by age, gender, and sport. The primary outcome measure was graft rupture. Results: One hundred fifty-two patients with an average age of 16 years (range 13 – 18 years) underwent ACL reconstruction during the study period. There were 71 BTB reconstructions and 81 HS reconstructions. There were 64 females and 88 males. There was no difference in age, sex, BMI, or laterality between groups. There were more patients who played soccer in the BTB cohort (44%) vs HS cohort (20%) and fewer who played basketball in the BTB cohort (24%) vs HS cohort (41%), p = 0.005. There were no differences between the BTB and HS cohorts in terms of meniscus tears (61% v 72%, p = 0.15), meniscus repair (21% v 32%, p = 0.13), or partial meniscectomy (32% v 33%, p = 0.90). Mean duration of follow-up was 28 months (range 7-57 months). There was no difference in follow-up between cohorts (BTB 28 months and HS 29 months, p = 0.19). There were a total of 16 graft ruptures (10.5%). There was no difference in the rate of graft rupture between cohorts (BTB 8.5% vs HS 12.3%, p = 0.60). Mean time to graft rupture was 21 months (range 8 – 35 months) and Kaplan-Meier survival curves demonstrated no difference between cohorts. Conclusions: ACL reconstruction in adolescents returning to high-risk sports can be performed utilizing BTB or HS autografts with similar rates of graft rupture. There is a trend toward lower rates of graft rupture associated with BTB autografts, but additional patients will be necessary to determine if this trend will become a statistically significant difference. Beynnon BD, Johnson RJ, Fleming BC, et al. Anterior cruciate ligament replacement: comparison of bone-patellar tendon bone grafts with two-strand hamstring grafts. A prospective, randomized study. J Bone Joint Surg Am 2002;84(9):1503-1513. Ho B, Edmonds EW, Chambers HG et al. Risk factors for early ACL reconstruction failure in pediatric and adolescent patients: a review of 561 cases. J Pediatr Orthop 2016. Samuelsen BT, Webster KE, Johnson NR, et al. Hamstring autograft versus patellar tendon autograft for ACL reconstruction: is there a difference in graft failure rate? A meta-analysis of 47,613 patients. Clin Orthop Relat Res 2017;475(10):2459-2468.

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Clinical Outcome, Return to Pre-injury Activities and Patients Satisfaction after Open ACL Reconstruction And Arthroscopic Reconstruction; An Experience From A Developing Country

Global Journal of Medical Research ◽

10.34257/gjmrhvol20is2pg13 ◽

2020 ◽

pp. 13-17

Author(s):

Prof. Shehzad Javed ◽

Dr. Muhammad Farrukh Bashir ◽

Dr. Zubair Khalid ◽

Dr. Umair Ahmed ◽

Prof Amer Aziz

Keyword(s):

Anterior Cruciate Ligament ◽

Clinical Outcome ◽

Acl Reconstruction ◽

Cruciate Ligament ◽

Open Technique ◽

Arthroscopic Reconstruction ◽

Open Procedure ◽

Patients Satisfaction ◽

Anterior Cruciate

Introduction: There are two techniques for reconstruction of anterior cruciate ligament (ACL), open technique and arthroscopic assisted technique. Arthroscopic assisted technique has many advantages over open procedure but it needs more expertise and cost comparatively.The objective of this study is to identify the clinical outcomes on basis of lyshlomknee score (LKS) system and find out patients satisfaction after performing both procedures in two groups separately. Material and Methods: Retrospective analysis of 600 patients undergoing open ACL reconstruction and arthroscopic reconstruction from 2005 to 2018 was done, at the Department of Orthopaedics, Ghurki Hospital, Lahore. We included all those patients who were 18 to 45 years of age and had at least 1 year follow up.

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