-
Tytuł:
-
Impact of graft and tunnel orientation on patient-reported outcome in anterior cruciate ligament reconstruction using bone-patellar tendon-bone autografts.
-
Autorzy:
-
Laux CJ; Department of Trauma Surgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland. .
Ulbrich EJ; Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Andreisek G; Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Marcon M; Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Fischer MA; Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Mehra T; Medical Directorate, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Ciritsis BD; Department of Trauma Surgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
-
Źródło:
-
Journal of orthopaedic surgery and research [J Orthop Surg Res] 2018 Oct 03; Vol. 13 (1), pp. 245. Date of Electronic Publication: 2018 Oct 03.
-
Typ publikacji:
-
Journal Article
-
Język:
-
English
-
Imprint Name(s):
-
Original Publication: London : BioMed Central, 2006-
-
MeSH Terms:
-
Patient Reported Outcome Measures*
Anterior Cruciate Ligament Reconstruction/*methods
Bone Transplantation/*methods
Patellar Ligament/*transplantation
Plastic Surgery Procedures/*methods
Adult ; Cohort Studies ; Female ; Femur/surgery ; Follow-Up Studies ; Humans ; Male ; Prospective Studies ; Tibia/surgery ; Transplantation, Autologous ; Young Adult
-
References:
-
Rheum Dis Clin North Am. 2016 May;42(2):239-52. (PMID: 27133487)
Osteoarthritis Cartilage. 2011 Apr;19(4):406-10. (PMID: 21255667)
Arthroscopy. 2007 Dec;23(12):1326-33. (PMID: 18063177)
Arthroscopy. 2007 Jul;23(7):771-8. (PMID: 17637414)
Am J Sports Med. 1999 Mar-Apr;27(2):202-7. (PMID: 10102102)
Health Qual Life Outcomes. 2003 May 25;1:17. (PMID: 12801417)
J Orthop Sports Phys Ther. 1998 Aug;28(2):88-96. (PMID: 9699158)
Rheumatology (Oxford). 2010 Sep;49(9):1654-64. (PMID: 20488927)
Clin Sports Med. 2013 Jan;32(1):177-204. (PMID: 23177471)
Am J Sports Med. 2009 Nov;37(11):2173-8. (PMID: 19729363)
Knee Surg Sports Traumatol Arthrosc. 2006 Oct;14(10):982-92. (PMID: 16897068)
Osteoarthritis Cartilage. 2016 Aug;24(8):1317-29. (PMID: 27012756)
-
Contributed Indexing:
-
Keywords: ACL reconstruction; Anterior cruciate ligament; Bone-patellar tendon-bone; Graft orientation; Outcome
-
Entry Date(s):
-
Date Created: 20181005 Date Completed: 20190125 Latest Revision: 20221207
-
Update Code:
-
20240104
-
PubMed Central ID:
-
PMC6171132
-
DOI:
-
10.1186/s13018-018-0954-3
-
PMID:
-
30285815
-
Background: The optimal positioning of anterior cruciate ligament graft is still controversially discussed. We therefore wanted to determine the tunnel-to-joint (TJA), tunnel-to-shaft (TSA), and graft-tunnel divergence angles which would provide the best outcome, determined by the KOOS (Knee Injury and Osteoarthritis Outcome Score). This study evaluated the clinical influence of graft orientation as measured with the KOOS questionnaire in patients with anterior cruciate ligament reconstruction with bone-patellar tendon-bone autografts.
Methods: We designed a prospective cohort study, with a 1 ¼ year recruitment phase from March 2011 to July 2012 and a minimal follow-up period of 1 year. Inclusion criteria were patients ≥ 18 years of age receiving an ACL reconstruction with bone-patellar tendon-bone autografts at our institution after having suffered an acute ACL rupture. The primary outcome was the KOOS. Independent variables were patient age, gender, laterality of rupture, mechanism of trauma, and type of femoral and tibial fixation, as well as sagittal graft-tunnel divergence, TJA, and TSA, the latter two being assessed on coronal slices of magnetic resonance imaging. Equations modeling the relationship between TJA, TSA, and graft-tunnel divergence with the KOOS overall score were fitted, and the optimum angles were mathematically determined.
Results: In total, 31 patients were included in our study. Our cohort with a median age of 28 years was predominantly male. The mathematically determined optimal placement of the implant in the coronal plane was a TJA of 74.8°, a TSA of 80.1°, and a graft-tunnel divergence angle of 8.5°.
Conclusion: With regard to patient-reported outcome, the optimal graft orientation is provided by a coronal tunnel-to-shaft angle of 80° and tunnel-to-joint angle of 75°, respectively. Interestingly, in our series, patients reported best clinical outcomes with a sagittal graft-tunnel divergence. These results should be validated in larger studies.
Zaloguj się, aby uzyskać dostęp do pełnego tekstu.
