Pullout strength of tibial graft fixation in ACL-replacement with a patellar tendon graft: Interference screw versus staple fixation in human knees

1998 ◽  
Vol 101 (3) ◽  
pp. 204-208 ◽  
Author(s):  
T. G. Gerich ◽  
A. Cassim ◽  
C. Lattermann ◽  
H. P. Lobenhoffer ◽  
H. Tscherne
Keyword(s):  
Patellar Tendon ◽  
Tendon Graft ◽  
Interference Screw ◽  
Graft Fixation ◽  
Pullout Strength ◽  
Patellar Tendon Graft ◽  
Acl Replacement ◽  
Staple Fixation

Graft Fixation Strength with Arthroscopic Anterior Cruciate Ligament Reconstruction

1998 ◽  
Vol 26 (3) ◽  
pp. 442-445 ◽  
Author(s):  
Timothy R. Stapleton ◽  
John I. Waldrop ◽  
Craig R. Ruder ◽  
Todd A. Parrish ◽  
Thomas E. Kuivila
Keyword(s):  
Patellar Tendon ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Tendon Graft ◽  
Interference Screw ◽  
Patellar Tendon Graft ◽  
Anterior Cruciate ◽  
Incision Technique ◽  
The One ◽  
Bone Plug

To compare the fixation strengths of two arthroscopic anterior cruciate ligament reconstruction techniques, we harvested 10-mm bone-patellar tendon-bone grafts with 25-mm bone plugs from 12 fresh-frozen cadaveric knees. One knee of each pair was fixed using Acufex instruments and the two-incision technique; one knee was fixed using Arthrotek instruments and the one-incision technique. We used cannulated 9 25 mm Kurosaka screws for femoral and tibial tunnel fixation. All knees were mounted on the Instron Test System and were stressed to failure by recreating a pivot shift maneuver. The one-incision technique graft fixation was significantly stronger (mean failure, 695 N) than that with the two-incision technique (mean failure, 593 N). In all one-incision technique knees, either the patellar tendon graft avulsed off a bone plug or the plug broke. In five of six two-incision technique knees, the tibial bone plug pulled out around the interference screw. Patellar tendon graft length ranges from 90 to 105 mm, and the average two-incision technique tunnel length is 120 mm. The interference screw compressed the femoral bone plug into cortical bone but compressed the tibial bone plug into cancellous bone in the two-incision technique, while in the one-incision technique the bone plug was compressed into cortical bone on both sides.

scholarly journals MRI Evaluation of Patella Alignment Before and After Anatomical Reconstruction of ACL Undergoing Unified Rehabilitation Programme Introduced by CMC Physical Therapy Team

2014 ◽  
Vol 2 (11_suppl3) ◽  
pp. 2325967114S0014
Author(s):  
Dariusz Straszewski ◽  
Marcin Plenzler ◽  
Joanna Szczepaniak ◽  
Robert Śmigielski ◽  
Beata Ciszkowska-Łysoń ◽  
...  
Keyword(s):  
Patellar Tendon ◽  
Muscle Activation ◽  
Weight Bearing ◽  
Tendon Graft ◽  
Rehabilitation Programme ◽  
Anatomical Reconstruction ◽  
Patella Baja ◽  
Functional Rehabilitation ◽  
Patellar Tendon Graft ◽  
The Impact

Objectives: The aim of the study was to asses the impact of the functional rehabilitation on patella alignment with MRI imaging in patients who underwent the ACL reconstruction. The surgical approach with the use of patellar tendon graft is known to carry the risk of lowering patella height (patella baja), which, in turn, may lead to accelerated cartilage wear in patellofemoral joint. Methods: 30 patients after the anatomical reconstruction of ACL took part in this study (23 male, and 7 female, mean age = 28 ± 10,6 years). During the procedure a patellar tendon graft was used. The Insali-Salvati ratio measured with MRI (images taken pre-procedural, and 9 months after the surgery) was used for the assessment of patellar alignment. The measurements were taken by one radiology specialist on MRI scans in sagittal view in PD sequence. During the examination, patellar joint was in flexion (approx.10 degrees). As the point of reference for patella’s position ISR ratio was in the range of 0.8 - 1.2. All patients were operated on by the same team of surgeons and underwent an unified rehabilitation programme led by a team of selected physiotherapists. The main features of the programme were: an early muscle activation (second day after the procedure); mobilisation of the patella and tissues of the anterior compartment of the knee; weight bearing co-contraction exercises, and the sensomotoric training of the entire kinetic chain of the lower limb. The data recorded was statistically analysed using the Wilcoxon signed-rank test in order to establish parameters’ changes within the study group.. Results: The mean ISR value before the procedure was 0.84 (± 0,1), whereas 9 months after the surgery it was 0.85 (± 0,1). The results’ analysis did not show any statistically significant changes between ISR values. Nine months after the procedure patella baja has not been observed in any of the evaluated patients. Conclusion: The functional rehabilitation programme designed by the CMC team had no negative impact on patella alignment, as no patella baja, which is a common complication after these kinds of surgeries, has been observed. The applied functional rehabilitation programme enabled patients to keep the proper patella alignment, similar to the alignment recorded before the surgery.

Reconstruction of the Lateral Ankle Ligaments with Bone-Patellar Tendon Graft in Patients with Chronic Ankle Instability

2002 ◽  
Vol 30 (3) ◽  
pp. 340-346 ◽  
Author(s):  
Kazuya Sugimoto ◽  
Yoshinori Takakura ◽  
Tsukasa Kumai ◽  
Makoto Iwai ◽  
Yasuhito Tanaka
Keyword(s):  
Patellar Tendon ◽  
Clinical Condition ◽  
Case Series ◽  
Tendon Graft ◽  
Long Term Results ◽  
Patellar Tendon Graft ◽  
Chronic Instability ◽  
Lateral Ankle Ligaments ◽  
Bone Patellar Tendon

Background Unsatisfactory long-term results have been reported after use of a Broström repair for patients with chronic ankle ligament insufficiency. Hypothesis Repair or reconstruction of both the anterior talofibular and calcaneofibular ligaments is essential for normal kinematics of the ankle-hindfoot. Study Design Case series. Methods Thirteen patients with chronic instability of the ankle were found at operation to have injuries of both the anterior talofibular and calcaneofibular ligaments, with a lack of healthy ligament margins suitable for suturing. Reconstruction of the ligaments was performed with bone-patellar tendon graft. The score devised by Good et al. was used to assess the patients’ clinical condition before the operation and at final follow-up. Results Before the operation, six patients had a grade 3 clinical condition and seven had a grade 4 condition. At a mean follow-up of 26.5 months, all patients had a grade 1 condition. The average talar tilt of the patients was improved from 18.4° ± 5.5° to 4.9° ± 2.6°, and the average anterior drawer sign was improved from 9.1 ± 2.6 mm to 5.8 ± 1.6 mm. Conclusion In cases of combined injuries, short-term results of reconstruction of the anterior talofibular and calcaneofibular ligaments using bone-split patellar tendon graft were good, with a low frequency of complications.

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