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Non-anatomic tunnel...
Non-anatomic tunnel position increases the risk of revision anterior cruciate ligament reconstruction
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Byrne, K. J. (författare)
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- Hughes, Jonathan D. (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för ortopedi,Institute of Clinical Sciences, Department of Orthopaedics
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Gibbs, C. (författare)
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Vaswani, R. (författare)
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Meredith, S. J. (författare)
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Popchak, A. (författare)
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Lesniak, B. P. (författare)
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- Karlsson, Jón, 1953 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för ortopedi,Institute of Clinical Sciences, Department of Orthopaedics
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Irrgang, J. J. (författare)
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Musahl, V. (författare)
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(creator_code:org_t)
- 2021-05-13
- 2022
- Engelska.
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Ingår i: Knee Surgery Sports Traumatology Arthroscopy. - : Springer Science and Business Media LLC. - 0942-2056 .- 1433-7347. ; :30, s. 1388-1395
- Relaterad länk:
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https://gup.ub.gu.se...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Purpose Anterior cruciate ligament (ACL) graft failure is a complication that may require revision ACL reconstruction (ACL-R). Non-anatomic placement of the femoral tunnel is thought to be a frequent cause of graft failure; however, there is a lack of evidence to support this belief. The purpose of this study was to determine if non-anatomic femoral tunnel placement is associated with increased risk of revision ACL-R. Methods After screening all 315 consecutive patients who underwent primary single-bundle ACL-R by a single senior orthopedic surgeon between January 2012 and January 2017, 58 patients were found to have both strict lateral radiographs and a minimum of 24 months follow-up without revision. From a group of 456 consecutive revision ACL-R, patients were screened for strictly lateral radiographs and 59 patients were included in the revision group. Femoral tunnel placement for each patient was determined using a strict lateral radiograph taken after the primary ACL-R using the quadrant method. The center of the femoral tunnel was measured in both the posterior-anterior (PA) and proximal-distal (PD) dimensions and represented as a percentage of the total distance (normal center of anatomic footprint: PA 25% and PD 29%). Results In the PA dimension, the revision group had significantly more anterior femoral tunnel placement compared with the primary group (38% +/- 11% vs. 28% +/- 6%, p < 0.01). Among patients who underwent revision; those with non-traumatic chronic failure had statistically significant more anterior femoral tunnel placement than those who experienced traumatic failure (41% +/- 13% vs. 35% +/- 8%, p < 0.03). In the PD dimension, the revision group had significantly more proximal femoral tunnel placement compared with the primary group (30% +/- 9% vs 38% +/- 9%, p < 0.01). Conclusion In this retrospective study of 58 patients with successful primary ACL-R compared with 59 patients with failed ACL-R, anterior and proximal (high) femoral tunnels for ACL-R were shown to be independent risk factors for ACL revision surgery. As revision ACL-R is associated with patient- and economic burden, particular attention should be given to achieving an individualized, anatomic primary ACL-R. Surgeons may reduce the risk of revision ACL-R by placing the center of the femoral tunnel within the anatomic ACL footprint.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Ortopedi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Orthopaedics (hsv//eng)
Nyckelord
- Anterior cruciate ligament
- Revision
- Reconstruction
- Anatomic
- Failure
- ACL
- Trauma
- Arthroscopic
- Value
- Value-based
- single-bundle
- acl revision
- follow-up
- epidemiology
- stability
- Orthopedics
- Sport Sciences
- Surgery
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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Byrne, K. J.
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Hughes, Jonathan ...
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Gibbs, C.
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Vaswani, R.
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Meredith, S. J.
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Popchak, A.
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visa fler...
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Lesniak, B. P.
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Karlsson, Jón, 1 ...
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Irrgang, J. J.
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Musahl, V.
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visa färre...
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