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- Karikis, Ioannis, 1985, et al.
(författare)
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Radiographic Tibial Tunnel Assessment After Anterior Cruciate Ligament Reconstruction Using Hamstring Tendon Autografts and Biocomposite Screws: A Prospective Study With 5-Year Follow-Up
- 2017
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Ingår i: Arthroscopy - Journal of Arthroscopic and Related Surgery. - : Elsevier BV. - 0749-8063 .- 1526-3231. ; 33, s. 2184-2194
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Tidskriftsartikel (refereegranskat)abstract
- © 2017 Arthroscopy Association of North America Purpose To radiographically assess the tibial tunnel up to 5 years after anterior cruciate ligament (ACL) reconstruction using hamstring tendon autografts and biocomposite interference screws. Methods Fifty-one patients underwent anatomic single-bundle ACL reconstruction with metal interference screws in the femur and biocomposite interference screws in the tibia. Standardized digital radiographs with weight-bearing anteroposterior and lateral views of the index knee were taken in the early postoperative period and at 2 and 5 years postoperatively. Of 51 patients, 40 (78%) underwent radiographic assessment on all 3 occasions. Subjective and objective clinical assessments were obtained preoperatively and at the 5-year follow-up. Results The mean follow-up period was 65 months (±3.9 months), with a minimum of 59 months. The width of the tibial tunnel on the anteroposterior view was 9.4 mm (±1.4 mm) in the early postoperative period and 9.2 mm (±1.5 mm) at 5 years (P =.64). The corresponding widths on the lateral view were 9.6 mm (±1.5 mm) in the early postoperative pe riod and 9.0 mm (±1.4 mm) at 5 years (P =.014). In 33 of 40 patients (83%) the width of the tibial tunnel had decreased on 1 or both views at 5 years compared with the early postoperative period. The study group had improved significantly at the 5-year follow-up compared with the preoperative assessments in terms of the KT-1000 arthrometer laxity tests (MEDmetric, San Diego, CA), pivot-shift test, Tegner activity scale, and Lysholm knee score (P < .001). No correlations were found between the tunnel widths and the KT-1000 assessment. Conclusions In 83% of patients, the width of the tibial tunnel had decreased on 1 or both radiographic views at 5 years compared with the early postoperative period after ACL reconstruction using biocomposite interference screws. Level of Evidence Level II, prospective study.
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| 3. |
- Karikis, Ioannis, 1985, et al.
(författare)
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The Long-Term Outcome After Early and Late Anterior Cruciate Ligament Reconstruction.
- 2018
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Ingår i: Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association. - : Elsevier BV. - 1526-3231. ; 34:6, s. 1907-1917
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Tidskriftsartikel (refereegranskat)abstract
- To compare long-term clinical and radiographic outcomes in patients undergoing either early (group A) or late (group B) surgery after anterior cruciate ligament (ACL) injury.ACL reconstruction using hamstring tendon autografts was performed in 30 patients in group A (median age, 23years; range, 17-49years) and 31 patients in group B (median age, 27years; range, 17-38years). The patients in group A were operated on within 5months (median, 3months; range, 2-5months) of injury, whereas those in group B were operated on more than 24months (median, 30months; range, 24-48months) after injury. The follow-up period was 10years (median, 117months [range, 77-222months] in group A and 129months [range, 77-206months] in group B; P= .44). Multiple objective clinical evaluation tests and patient-reported outcome measures were obtained preoperatively and at follow-up. At follow-up, radiographic assessments of knee osteoarthritis (OA) bilaterally were performed.The frequency of meniscectomy at the index operation was significantly lower in group A (20%) than in group B (52%) (P= .01). There were no significant differences between the groups in terms of Tegner and Lysholm scores and laxity tests both preoperatively and at follow-up. Both groups improved over time in terms of Tegner and Lysholm scores (P < .05). At follow-up, significantly more medial-compartment OA in the index knee was found in group B than in group A (P= .037) according to the Ahlbäck classification system. The index knee showed significantly more OA than the contralateral knee in both groups (P< .01).Patients who underwent early ACL reconstruction required significantly fewer meniscectomies at the index operation than patients who underwent late reconstruction and showed significantly less OA on the medial side of the knee 10years after reconstruction. However, no significant differences were found between the groups in terms of clinical assessments.Level III, retrospective comparative study.
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- Stener, Sven, 1953, et al.
(författare)
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A long-term, prospective, randomized study comparing biodegradable and metal interference screws in anterior cruciate ligament reconstruction surgery: radiographic results and clinical outcome.
- 2010
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Ingår i: The American journal of sports medicine. - : SAGE Publications. - 1552-3365 .- 0363-5465. ; 38:8, s. 1598-605
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Tidskriftsartikel (refereegranskat)abstract
- During the past decade, the use of biodegradable implants in anterior cruciate ligament surgery has increased.Poly-L-lactide acid (PLLA) interference screws would render the same clinical results but greater tunnel enlargement than metal screws 8 years after anterior cruciate ligament reconstruction using hamstring tendon (semitendinosus/gracilis) autografts.Randomized controlled trial; Level of evidence, 1.A randomized series of 77 patients, all with a unilateral anterior cruciate ligament rupture, were divided into 2 groups (PLLA and metal). In both groups, hamstring tendon autografts were used with interference screw fixation at both ends and the patients were examined with standard radiographs, Tegner activity level, Lysholm knee score, single-legged hop test, early C-reactive protein response, and KT-1000 arthrometer knee laxity measurements.The preoperative assessments in both groups were similar in terms of gender, clinical tests, and the time from injury to surgery. The patients returned for a radiographic and clinical examination a mean of 96 months (range, 78-120 months) after the index operation. The PLLA group displayed significantly larger bone tunnels on the radiographs than the metal group on the femoral side (mean, 11.4 mm [range, 0-17.8 mm] vs 8.0 mm [range, 0-16.3 mm]; P < .005) but not on the tibial side (mean, 10.7 mm [range, 7.8-14.1 mm] vs 10.5 mm [range, 0-20.3 mm]; difference not significant). At follow-up, no significant differences were found between the PLLA and metal groups in terms of knee laxity measurements (median, 1.0 mm [range, -2.0-4.0 mm] vs 1.0 mm [range, -3.0-6.5 mm]), Tegner activity level (median, 7 [range,3-9] vs 6 [range, 2-9]), or the Lysholm knee score (median, 90 points [range, 51-100] vs 89 points [range, 53-100]). The C-reactive protein values did not differ significantly between the 2 groups except for an increase in the PLLA group compared with the metal group at day 1 postoperatively-23 mg/L (range, <6-55) vs 9 mg/L (range, <6-55) (P < .001).There were significantly larger radiographically visible bone tunnels on the femoral side but not on the tibial side in the PLLA group compared with the metal group 8 years after anterior cruciate ligament reconstruction using hamstring tendon autografts. This finding did not correlate with inferior clinical results. Because of the results in the present study, the authors have discontinued the use of PLLA interference screws.
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- Åhlén, Martina, et al.
(författare)
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Inflammatory Cytokines and Biomarkers of Cartilage Metabolism 8 Years After Anterior Cruciate Ligament Reconstruction: Results From Operated and Contralateral Knees.
- 2015
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Ingår i: The American journal of sports medicine. - : SAGE Publications. - 1552-3365 .- 0363-5465. ; 43:6, s. 1460-1466
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Tidskriftsartikel (refereegranskat)abstract
- Patients who sustain an acute anterior cruciate ligament (ACL) rupture are at increased risk to develop posttraumatic arthritis (PTA) in the injured knee whether the ACL is reconstructed or treated nonoperatively. Inflammatory cytokines and cartilage degradation biomarkers are elevated at the time of acute injury and postoperatively. This suggests that one mechanism for PTA may be an inflammatory degradative process initiated on the acute injury and sustained for some length of time independent of whether adequate joint stability is restored.
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