Dataset Information

All-Inside Anterior Cruciate Ligament Reconstruction as a Salvage for Small or Attenuated Hamstring Grafts.

ABSTRACT: Anterior cruciate ligament (ACL) tears represent one of the most common sports-related injuries in the young population. There are multiple studies showing higher failure rates in the younger population with an allograft supporting the routine use of an autograft. In addition, higher failure rates have been shown with grafts narrower than 8 mm in diameter. This places the surgeon in an operative dilemma determining what to do with a narrow graft or an attenuated hamstring during harvest. All-inside ACL reconstruction is a promising technique for reliably creating sufficiently wide grafts without the need for allograft augmentation. The purpose of this Technical Note is to detail a graft preparation using the all-inside technique as a bailout during hamstring autograft ACL when the graft is narrow or one of the tendons is attenuated during harvest.

SUBMITTER: Jones PE

PROVIDER: S-EPMC5984294 | biostudies-literature | 2018 May

REPOSITORIES: biostudies-literature

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All-Inside Anterior Cruciate Ligament Reconstruction as a Salvage for Small or Attenuated Hamstring Grafts.

Jones Patrick E PE Schuett Dustin J DJ

Arthroscopy techniques 20180409 5

Anterior cruciate ligament (ACL) tears represent one of the most common sports-related injuries in the young population. There are multiple studies showing higher failure rates in the younger population with an allograft supporting the routine use of an autograft. In addition, higher failure rates have been shown with grafts narrower than 8 mm in diameter. This places the surgeon in an operative dilemma determining what to do with a narrow graft or an attenuated hamstring during harvest. All-ins ...[more]

PMID: 29868418

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Project description:PurposeTo compare the (1) rates of complications and reoperations, (2) rate of anterior cruciate ligament (ACL) graft failure, and (3) patient-reported outcomes (PROs) among patients after hamstring autograft ACL reconstruction (ACLR) with and without independent suture tape reinforcement at a minimum 2-year clinical follow-up.MethodsWe performed a 1:2 matched-cohort comparison of patients who underwent hamstring autograft ACLR with and without independent suture tape reinforcement between July 2011 and July 2017. Patients were matched according to age, sex, body mass index, preinjury Tegner activity score, and concomitant meniscal injury. Medical records were reviewed for demographic characteristics, additional injuries, and concomitant procedures. PRO scores (including Tegner activity, Lysholm, and International Knee Documentation Committee scores) and physical examination findings were collected both preoperatively and at a minimum of 2 years postoperatively.ResultsOverall, 108 patients who underwent ACLR were included: 36 patients (mean age, 25.3 years; range, 13-44 years) with independent suture tape reinforcement and 72 patients (mean age, 24.9 years; range, 13-54 years) without suture tape reinforcement. Overall, 5 of 36 suture tape patients (14%) and 10 of 72 control patients (14%) underwent reoperations. At an average follow-up of 26.1 months in the suture tape cohort and 31.3 months in the control cohort, 1 patient in the suture tape cohort and 4 patients in the control cohort experienced graft failure. There were no statistically significant differences between the suture tape and control groups regarding return-to-sport rate (89% and 88%, respectively), postoperative International Knee Documentation Committee score (94.4 and 93.8, respectively), and postoperative Lysholm score (95.6 and 94, respectively). There was a statistically significant difference between the suture tape and control groups in postoperative Tegner activity score, at 7.1 (95% confidence interval, 6.5-7.6) and 6.4 (95% confidence interval, 6.2-6.6), respectively (P = .026).ConclusionsACLR with hamstring autograft and independent suture tape reinforcement was performed safely with low rates of complications, graft failure, and reoperations with similar PROs, function, and return-to-sport rates when compared with hamstring autograft ACLR without suture tape reinforcement at a minimum 2-year follow-up.Level of evidenceLevel III, retrospective comparative study.

Dataset Information

All-Inside Anterior Cruciate Ligament Reconstruction as a Salvage for Small or Attenuated Hamstring Grafts.

Publications

All-Inside Anterior Cruciate Ligament Reconstruction as a Salvage for Small or Attenuated Hamstring Grafts.

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