scholarly journals Visualization of torn anterior cruciate ligament using 3-dimensional computed tomography

2013 ◽  
Vol 5 (3) ◽  
pp. 22 ◽  
Author(s):  
Hiroaki Uozumi ◽  
Toshimi Aizawa ◽  
Takehiko Sugita ◽  
Tomonori Kunii ◽  
Shun Abe ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Three Dimensional ◽  
Lateral Wall ◽  
Ct Images ◽  
Reconstruction Technique ◽  
3D Ct ◽  
Anterior Cruciate

Recently, a remnant-preserving anterior cruciate ligament (ACL) reconstruction technique has been developed. However, the pre-operative condition of remnant ACL is occasionally difficult to evaluate by magnetic resonance imaging. The purpose of this study is to evaluate the accuracy of pre-operative visualization of remnant ACL using three-dimensional computed tomography (3D-CT). The remnant ACL in 25 patients was examined by 3D-CT before ACL reconstruction surgery. Findings on 3D-CT images and arthroscopy were compared. The 3D-CT images were classified into 4 groups: Group A, remnant fibers attached to the posterior cruciate ligament (PCL); Group B, those located between the PCL and the lateral wall; Group C, those attached to the lateral wall; and Group D, no identifiable remnant fibers on the tibial side. These groups were made up of 4, 3, 9 and 9 patients, respectively. Findings on 3D-CT images were identical to those during arthroscopy in 20 of 25 cases (80%). Remnant ACL can be accurately evaluated using 3D-CT in 80% of cases of torn ACL. This novel method is a useful technique for pre-operative assessment of remnant ACL.

scholarly journals Computed Tomography Imaging Results of Single Band Anterior Cruciate Ligament Reconstruction: A Retrospective Study Comparing Fixed- and Adjustable-Length Loop Cortical Fixation on the First Day After Surgery

2021 ◽  
Author(s):  
Lifeng Yin ◽  
Hua Zhang ◽  
Junbo Liu ◽  
xingyu zhang ◽  
zhengxing wen ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Femoral Tunnel ◽  
Cruciate Ligament ◽  
Ct Images ◽  
Graft Fixation ◽  
Bone Preservation ◽  
Anterior Cruciate ◽  
Graft Insertion

Abstract Background: Cortical suspensory femoral fixation is commonly performed for graft fixation of the femur in anterior cruciate ligament (ACL) reconstruction using hamstring tendons. This study aimed to compare the morphology of femoral tunnel and graft insertion between fixed-length loop devices (FLD) and adjustable-length loop devices (ALD) using computed tomography (CT) images on the first day after hamstring ACL reconstruction. Methods: Overall, 94 patients who underwent ACL reconstruction from January 2016 to January 2021 were included. For femoral graft fixation, FLD (Smith & Nephew, ENDOBUTTON) and ALD (DePuy Synthes, Mitek sports medicine, RIGIDLOOP Adjustable cortical system) were used in 56 and 38 patients, respectively (FLD and ALD groups). For evaluation of the morphology of the humeral tunnel and graft depth, CT scans were performed immediately on the first postoperative day. The gap distance between the top of the graft and the socket tunnel end, the length of lateral bone preservation, and the depth of graft insertion were measured on the CT images. Results: The gap distance and bone preservation significantly differed between the two groups (1.90±1.81 mm and 14.35±4.67 mm in ALD groups; 7.08±2.63 mm and 7.35±3.62 mm in FLD groups, respectively; both P values < 0.01). The graft insertion depth did not significantly differ between the groups. Conclusion: The ALD group had a smaller gap distance, better bone preservation, and a similar graft insertion length in the femoral tunnel when compared to the FLD group. Based on these findings, ALD might be better for bone preservation and tunnel utilization in patients with short femoral tunnels. Trial registration: retrospectively registered

scholarly journals Anatomıc femoral tunnel drilling in acl reconstruction without using of an accessory medial portal and evaluation of femoral tunnel positioning using 3-d computed tomography

2017 ◽  
Vol 5 (2_suppl2) ◽  
pp. 2325967117S0007
Author(s):  
Fatih Karaaslan ◽  
Sinan Karaoğlu
Keyword(s):  
Computed Tomography ◽  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Femoral Tunnel ◽  
Cruciate Ligament ◽  
3D Ct ◽  
Quadrant Method ◽  
Anterior Cruciate ◽  
Femoral Tunnel Drilling ◽  
Transportal Technique

Background and Purpose: Characterization of the insertion site anatomy in anterior cruciate ligament reconstruction has recently received increased attention in the literature, coinciding with a growing interest in anatomic reconstruction. The purpose of this study is to report a modified novel transportal technique to approach the center of anatomical femoral footprint in anterior cruciate ligament (ACL) reconstruction and to investigate the accurate femoral tunnel position with 3-dimensional computed tomography (3D-CT). Materials-Methods: We evaluated 11 patients who underwent primary ACL reconstruction using a modified transportal technique to approach the center of anatomical femoral footprint in single bundle ACL reconstruction with hamstring autograft. Their femoral tunnel positions were investigated with 3D-CT postoperatively according to the quadrant method by three orthopedic surgeons. Results: According to the quadrant method with 3D-CT, the femoral tunnel was measured at a mean of 33,49% ± 5,59% from the proximal condylar surface (parallel to the Blumensaat line) and 32,93% ± 3,82% from the notch roof (perpendicular to the Blumensaat line) with good interobserver (intraclass correlation coefficients [ICC], 0,991and 0,858, respectively with 0,975 – 0,997%95 CI) and intraobserver reliability (ICC, 0.875 and 0.893, respectively with 0,663 – 0,956%95 CI). Conclusions: Our modified transportal technique is anticipated to provide anatomical placement of the femoral tunnel during ACL reconstruction than the former traditional transtibial techniques. This technique is reproducible and also easier to perform than classic transportal technique does not need extra arthroscopic portal. [Figure: see text]

A Novel Graft Fixation Technique for Anterior Cruciate Ligament Reconstruction Using Hamstring Tendon Grafts

2017 ◽  
Vol 12 (1) ◽  
Author(s):  
Guoan Li ◽  
Ali Hosseini ◽  
Hemanth Gadikota ◽  
Thomas Gill
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Reconstruction Technique ◽  
Tibial Rotation ◽  
Pullout Strength ◽  
Anterior Tibial ◽  
Anterior Cruciate ◽  
Tibial Translation ◽  
Intact Knee

This study evaluated the biomechanical efficacy of single-tunnel double-bundle anterior cruciate ligament (ACL) reconstruction technique. The graft construct is achieved using a novel fixation device that splits an ACL (SPACL) graft into two bundles, recreating the anteromedial (AM) and posterolateral (PL) bundles for ACL reconstruction. A pullout strength test of the SPACL was performed using a 7-mm bovine digital extensor tendon graft. The capability in restoration of knee kinematics after SPACL reconstruction was investigated using cadaveric human knees on a robotic testing system under an anterior tibial load of 134 N and a simulated quadriceps load of 400 N. The data indicated that the SPACL graft has a pullout strength of 823.7±172.3 N. Under the 134 N anterior tibial load, the anteroposterior joint laxity had increased constraint using the SPACL reconstruction but not significantly (p > 0.05) at all selected flexion angles. Under the 400 N quadriceps load, no significant differences were observed between the anterior tibial translation of intact knee and SPACL conditions at all selected flexion angles, but the SPACL graft induced a significant increase in external tibial rotation compared to the intact knee condition at all selected flexion angles with a maximal external rotation of −3.20 deg ±3.6 deg at 90 deg flexion. These data showed that the SPACL technique is equivalent or superior to existing ACL reconstruction techniques in restoration of knee laxity and kinematics. The new SPACL reconstruction technique could provide a valuable alternation to contemporary ACL reconstruction surgery by more closely recreating native ACL kinematics.

scholarly journals Outcomes and Complications After All-Epiphyseal Anterior Cruciate Ligament Reconstruction in Skeletally Immature Patients

2017 ◽  
Vol 5 (3) ◽  
pp. 232596711769360 ◽  
Author(s):  
Eric J. Wall ◽  
Paul J. Ghattas ◽  
Emily A. Eismann ◽  
Gregory D. Myer ◽  
Preston Carr
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Case Series ◽  
Reconstruction Technique ◽  
Skeletally Immature ◽  
Patient Reported ◽  
Ikdc Score ◽  
Anterior Cruciate ◽  
Bone Tunnels

Background: The safest and most effective technique for anterior cruciate ligament (ACL) reconstruction in skeletally immature patients is currently unknown. Purpose: To evaluate the functional and patient-reported outcomes of a specific all-epiphyseal ACL reconstruction technique in which the graft, bone tunnels, and fixation do not cross the knee growth plates. Study Design: Case series; Level of evidence, 4. Methods: Twenty-seven patients (23 boys, 4 girls; mean age, 11 years; range, 8-15 years) underwent an all-epiphyseal ACL reconstruction with a single femoral transverse epiphyseal tunnel and primarily split tibial epiphyseal tunnels. Outcomes were evaluated in terms of the manual Lachman test, range of motion, pain, return to activity, angular or leg-length deformity on imaging, and International Knee Documentation Committee (IKDC) or Pedi-IKDC score an average of 3.8 years postoperatively, with a minimum 2-year follow-up. Results: The mean IKDC score was 94 ± 11. There were no growth arrests, but 3 patients had knee overgrowth, and 2 required a subsequent guided growth procedure. The ACL graft failed in 4 patients (15%), and 2 patients had contralateral ACL tears (7%). There were 5 subsequent ipsilateral meniscal tears, 4 of which were retears of a repaired meniscus. Ipsilateral knee reinjury significantly correlated with the number of associated injuries at the time of index surgery ( P = .040) and the number of sports played ( P = .029). Conclusion: All-epiphyseal ACL reconstruction resulted in excellent long-term functional outcomes, despite a high rate of complications (48%) and secondary procedures (37%) in this highly active cohort. The incidence of graft failure was similar to other standard ACL reconstruction techniques for patients younger than 20 years.

scholarly journals Results of Anterior Cruciate Ligament Injuries by Arthroscopic Reconstruction Using Semitendinosus Tendon

2021 ◽  
pp. 142-148
Author(s):  
Nuresh Kumar Valecha ◽  
Niaz Hussain Keerio ◽  
Masood Ahmed Qureshi ◽  
Syed Sajid Hussain ◽  
Hassan Amir us Saqlain ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Semitendinosus Tendon ◽  
Reconstruction Technique ◽  
Ligament Injuries ◽  
Arthroscopic Reconstruction ◽  
Anterior Cruciate Ligament Injuries ◽  
Anterior Cruciate ◽  
Tendon Autograft

Objectives: This study was designed to evaluate the surgical management of anterior cruciate ligament injuries by arthroscopic reconstruction using semitendinosus grafts. Methodolgy: This study was conducted by Dibba Hospital Fujairah, United Arab Emirates from March 2017- to March 2020. A total of 40 patients were selected for this research.   In our study, we used arthroscopy assisted ACL reconstruction technique with single bundle quadrupled semitendinosus tendon autograft. This autograft was inserted from the ipsilateral limb with the help of endobutton femoral side of graft was fixed and with bioabsorbable screw tibial side of graft was stabilized. A single surgeon performed all the surgeries. Results: In our observations, we reported that the majority of the patients had exposure of ACL injury in their middle adult age (32-38 years old) due to high engagement in physical activities (67.8%) like biking, playing sports and many others. The ratio of right knee injury site was comparatively high (53.5%) than the left one (46.4%). Conclusion: From the results, we concluded that the younger age group is more prone to anterior Cruciate ligament injury. ACL reconstruction with Semitendinosus tendon autograft helps in maintaining knee movement and assist in early knee stability.

scholarly journals Evaluation of a novel lower radiation computed tomography protocol for assessment of tunnel position post anterior cruciate ligament reconstruction

2020 ◽  
Author(s):  
varun vasudeva ◽  
Stephen Key ◽  
Alfred Phillips ◽  
Steve Kahane ◽  
Joseph Stevens ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Anterior Cruciate Ligament ◽  
Radiation Dose ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Tibial Tunnel ◽  
Effective Radiation Dose ◽  
Tunnel Position ◽  
Anterior Cruciate ◽  
Conventional Ct

Abstract Background Anterior cruciate ligament (ACL) reconstruction is a common orthopaedic procedure. We developed a novel, low dose computed tomography (LDCT) protocol to assess tunnel position post-operatively. The effective radiation dose of this protocol is <0.5mSv, which is significantly less than the 2mSv dose for a conventional CT protocol. The aim of this study was to assess the accuracy of the LDCT protocol for determining tunnel position. Methods Twenty-six patients who underwent primary ACL reconstruction were included in the study. A LDCT scan was performed six weeks post-operatively. Femoral and tibial tunnel positions were measured on three dimensional (3D) reconstructions using previously validated techniques. Measurements were performed independently by three observers at two time points, four weeks apart. Results There was excellent intra- and inter-rater reliability for all measurements using the images obtained from the LDCT protocol. Intra-class correlation coefficient (ICC) values were >0.9 for all measurements. Conclusions The LDCT protocol described in this study accurately demonstrates femoral and tibial tunnels post ACL reconstruction, while exposing the patient to a quarter of the radiation dose of a conventional CT. This protocol could be used by orthopaedic surgeons for routine post-operative imaging, in place of plain film radiographs.

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