Dataset Information

The Transportal Graft Passage in Transtibial Posterior Cruciate Ligament Reconstruction With a Bone-Patellar Tendon-Bone Graft.

ABSTRACT: Posterior cruciate ligament injury is one of the most common problems in sports medicine. The treatment of choice for this injury is posterior cruciate ligament reconstruction, which improves the biomechanical and clinical stabilities of the knee. There are many graft choices, of which the bone-patellar tendon-bone (BPTB) graft is a popular option. In applying the BPTB graft, most surgeons use the transtibial technique by passing the graft from the tibial tunnel to the femoral tunnel, which is normally performed without problems, but there is a chance of patellar tendon fiber damage because of the sharp turn required from the tibial tunnel to the femoral tunnel. To minimize this risk, herein we propose a transportal graft passage technique with which it is easy to pass the BPTB graft and reduce the risk of graft damage.

SUBMITTER: Boonriong T

PROVIDER: S-EPMC7823112 | biostudies-literature | 2021 Jan

REPOSITORIES: biostudies-literature

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The Transportal Graft Passage in Transtibial Posterior Cruciate Ligament Reconstruction With a Bone-Patellar Tendon-Bone Graft.

Boonriong Tanarat T Parinyakhup Wachiraphan W Wuttimanop Watit W Chuaychoosakoon Chaiwat C

Arthroscopy techniques 20210120 1

Posterior cruciate ligament injury is one of the most common problems in sports medicine. The treatment of choice for this injury is posterior cruciate ligament reconstruction, which improves the biomechanical and clinical stabilities of the knee. There are many graft choices, of which the bone-patellar tendon-bone (BPTB) graft is a popular option. In applying the BPTB graft, most surgeons use the transtibial technique by passing the graft from the tibial tunnel to the femoral tunnel, which is n ...[more]

PMID: 33532224

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Project description: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.

Dataset Information

The Transportal Graft Passage in Transtibial Posterior Cruciate Ligament Reconstruction With a Bone-Patellar Tendon-Bone Graft.

Publications

The Transportal Graft Passage in Transtibial Posterior Cruciate Ligament Reconstruction With a Bone-Patellar Tendon-Bone Graft.

Similar Datasets

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