Press-Fit-Hybrid Technique for Anterior Cruciate Ligament Reconstruction With Autologous Hamstring Tendons
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ABSTRACT:
SUBMITTER: Volz R
PROVIDER: S-EPMC10995807 | biostudies-literature | 2024 Jan
REPOSITORIES: biostudies-literature
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Project description:Implant-free press-fit tibial fixation technique has gained popularity recently due to the problems in bone tunnel expansion, defect, and revision surgery due to the tibial fixation material preferred in anterior cruciate ligament surgery. Patellar tendon-tibial bone autograft offers several advantages in anterior cruciate ligament reconstruction. We describe a tibial tunnel preparation method and the use of patellar tendon-bone graft in the implant-free tibial press-fit technique. We call this the Kocabey press-fit technique. Technique Video Video 1 İllustration of the tibial press-fit fixation technique in anterior cruciate ligament reconstruction.
| S-EPMC10265682 | biostudies-literature
Project description:Implant-free press-fit tibial fixation technique has recently gained popularity in anterior cruciate ligament reconstruction because it does not cause tunnel widening, does not cause complications associated with additional fixation materials, allows bone-to-bone healing, and does not cause defects in revision surgery. Bone-patellar tendon autograft offers the advantage of direct bone-to-bone integration of the graft, and anterior knee pain is less expected than bone-patellar tendon-bone autograft. This technical report includes details of arthroscopic ACL reconstruction of patellar tendon-tibial tubercle bone autograft distal press-fit fixation technique. We call this the Kocabey distal press-fit technique.
| S-EPMC10714575 | biostudies-literature
Project description:The main objective of this study is to describe a surgical technique that combines intra- and extra-articular techniques using the semitendinosus, gracilis, and peroneus longus to perform reconstruction of the anterior cruciate ligament and anterolateral ligament. This technique offers a more stable, fast, low-cost, and widely accessible procedure and consists of drilling 3 tunnels-1 femoral and 2 tibial tunnels-in which the grafts are fixed with interference screws. The fact that the peroneus longus graft is long and thick allows for robust reconstruction of the aforementioned ligaments.
| S-EPMC7917200 | biostudies-literature
Project description:Hamstring autograft is one of the most used grafts for anterior cruciate ligament (ACL) reconstruction, although there are several graft preparation techniques. It is extremely difficult to mimic the biomechanical properties of the native ACL; thus, it is important to achieve a proper graft configuration, diameter, and length. To avoid reruptures, an optimal and reproducible hamstring autograft is desired. Hamstring autograft has been traditionally devalued when compared with other options such as bone-patellar tendon-bone autograft. The purpose of this Technical Note is to describe in detail a hamstring braid graft configuration that could potentially overcome the past disadvantages of ACL reconstruction.
| S-EPMC6823734 | biostudies-literature
Project description:Several factors affect the success of an anterior cruciate ligament reconstruction, including graft origin, type, and morphology. Hamstring and bone-patellar tendon-bone autografts are the most widely used, and there are many different techniques of graft preparation with each. In this Technical Note and accompanying video, a 4-strand hamstring autograft technique is described that uses a simple diamond-type braid to produce a more ovoid morphology with increased cross-sectional area. Increased graft diameters have been associated with higher success rates and more positive long-term outcomes. Therefore, this braiding construct may provide additional tensile strength with increased resistance to failure than grafts that are otherwise undersized using conventional techniques.
| S-EPMC8085571 | biostudies-literature
Project description:PurposeTo assess the discrepancy in graft diameter between double- and quadruple-folded hamstring autografts and the need for allograft augmentation to obtain an adequate graft diameter during arthroscopic anterior cruciate ligament reconstruction.MethodsAll patients undergoing anterior cruciate ligament reconstruction with hamstring autograft between 2017 and 2021 at a single institution by a single surgeon were identified. The surgeon changed from double-folded hamstring autograft to quadruple-folded hamstring autograft within the study period.ResultsA total of 191 patients were identified, of whom 57 received double-folded autografts and 134 quadruple-folded autografts. Patient characteristics between cohorts were similar. Median double-folded graft size (7.5 mm; interquartile range, 7.0-8.0 mm) was significantly thinner than the quadruple-folded graft size (9 mm; interquartile range, 8.5-9.5 mm, P = .001). Quadruple-folded autograft was less likely to require an allograft augmentation than the double-folded autograft (0.7% vs 26.3%) (odds ratio 0.02; 95% confidence interval 0.00-0.16; P < .001).ConclusionsQuadruple-folded hamstring autograft provides a larger graft diameter and reduced need for allograft augmentation.Level of evidenceLevel III, retrospective comparative study.
| S-EPMC9791809 | biostudies-literature
Project description:Patellar tendon grafts have long been considered the gold standard for anterior cruciate ligament reconstruction (ACLR). This Technical Note describes ACLR using bone-patella tendon-bone (BPTB) autograft with press-fit femoral fixation using an outside-in drilling technique. Technique Video Video 1 This technical note describes the original technique which is an anterior cruciate ligament reconstruction using bone-patella tendon-bone autograft with press-fit femoral fixation using an outside-in drilling technique.
| S-EPMC9705405 | biostudies-literature
Project description:Hamstring autografts are frequently used for anterior cruciate ligament reconstruction. The inherent variability in graft diameter has been stated as a disadvantage in its use because the presence of smaller graft diameters has been correlated with increased risk of re-rupture. Several techniques have been described to address this concern. Modifications of the basic Graftlink technique allows for increased control over final graft diameter using a standard harvest of the semitendinosus tendon with or without the gracilis tendon, and results in a graft of adequate length and diameter in all patients with rigid cortical fixation on the femur and tibia.
| S-EPMC5765566 | biostudies-literature
Project description:Scientific interest in optimizing outcomes after anterior cruciate ligament (ACL) reconstruction is ongoing, and some recent developments have focused on graft shape as one of the most important factors of anatomic graft placement. The double-bundle or fanlike structure of the native ACL seems to more closely restore normal function and control of rotational stability of the knee with implant-free or press-fit techniques, creating a favorable situation in terms of direct graft-tunnel healing. The ACL reconstruction technique presented in this article enables safe, reproducible, and anatomic fixation of the patellar tendon autograft, providing the biological and biomechanical benefits of direct bony integration of the ribbonlike bone-patellar tendon-bone graft. Because press-fit fixation represents a technically challenging surgical procedure, the goal of the described technique is to enable direct bone-to-bone healing by using secondary extracortical femoral and tibial fixation without the need for a true press-fit situation. Safe and anatomic femoral tunnel drilling is achieved with an outside-in technique (retrograde drilling), hence providing advantages in the routine clinical setting in terms of applicability and time effort. To reduce donor-site morbidity caused by bone block harvesting, refilling of the harvest sites with autologous material is performed.
| S-EPMC7029172 | biostudies-literature
Project description:Anterior cruciate ligament reconstruction is one of the most commonly performed procedures in orthopaedics, with more than 125,000 performed in the United States per year. There are several reconstruction graft choices that can be used to reconstruct the native anterior cruciate ligament, with autograft hamstring tendons being one of the most commonly used. Preparation of a hamstring autograft varies depending on patient characteristics and physician preference. The purpose of this Technical Note is to describe in detail different variants of hamstring graft preparation techniques that are commonly used in practice.
| S-EPMC5766355 | biostudies-literature