Purpose: To compare anterior cruciate ligament (ACL) soft-tissue allograft reconstruction using suspensory versus aperture fixation.
Methods: After we performed prospective power analysis and obtained institutional review board approval, as well as patient consent, 64 patients were block randomized among 3 study sites to the aperture fixation group or suspensory fixation group. All patients underwent all-inside ACL reconstruction with soft-tissue allograft using either (1) femoral and tibial joint-line fixation with a femoral cannulated interference screw and a tibial cannulated interference retrograde screw (aperture) or (2) femoral and tibial cortical buttons (suspensory). Our primary outcome measure was knee anteroposterior (AP) stability measured using the KT-1000 device (MEDmetric, San Diego, CA). Secondary outcome measures included change in pain score on a visual analog scale versus preoperatively, narcotic consumption, International Knee Documentation Committee knee examination rating, International Knee Documentation Committee subjective evaluation score, Knee Society Scores, Short Form 12 scores, and radiographic analysis for socket widening.
Results: Ultimately, 6 included patients (9%) were not treated (cancelled surgery), and at 2 years' follow-up, 43 treated patients (74%) completed clinical evaluation. The primary outcome measure, instrumented knee AP stability at 25° of knee flexion, showed no difference between groups (P = .61) at 24 months' follow-up. In addition, no statistically significant difference between groups was observed for secondary measures.
Conclusions: Our results show no significant differences in knee AP stability or other outcomes comparing all-inside ACL allograft reconstruction using aperture fixation and all-inside ACL allograft reconstruction using suspensory fixation.
Level Of Evidence: Level II, lesser-quality randomized controlled trial with follow-up of less than 80% at 2 years.
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http://dx.doi.org/10.1016/j.arthro.2015.03.006 | DOI Listing |
Tech Hand Up Extrem Surg
January 2025
Department of Orthopaedics, Virginia Commonwealth University Health System, Central Virginia Veteran Affairs Health Care System, Richmond, VA.
Managing rerupture of the triceps brachii tendon after surgical repair is challenging due to poor tissue quality, retraction, and adhesions. This clinical scenario often requires augmentation with native tissue or tendon allografts. Traditional techniques include V-Y advancement, reinforced triceps advancement with double row or suture bridge fixation, and allograft tendon augmentation.
View Article and Find Full Text PDFAm J Sports Med
January 2025
Campbell Clinic Orthopedics, Germantown, Tennessee, USA.
Background: While allografts are commonly used for anterior cruciate ligament reconstruction (ACLR), evidence to guide specific allograft selection is lacking.
Purpose: To compare clinical and graft failure rates after ACLR using soft tissue-only allografts and bone-soft tissue allografts in adults.
Study Design: Systematic review and meta-analysis; Level of evidence, 4.
Regen Ther
March 2025
Department of Medical Biotechnology, Iran University of Medical Sciences, Tehran, Iran.
Introduction: Tooth extraction initiates a cascade of homeostatic and structural modifications within the periodontal tissues, culminating in alveolar ridge resorption. To prevent ridge resorption following extraction and facilitate successful placement of an implant-supported prosthesis, alveolar ridge preservation was performed.
Methods: In this study, the biocompatibility of a nanocomposite consisting of self-assembling peptide nanofibers (organic phase) and tri-calcium phosphate-nano hydroxyapatite (mineral phase), was evaluated in rabbits.
JBJS Essent Surg Tech
December 2024
Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut.
Background: For complete disruption of the posterolateral corner (PLC) structures, operative treatment is most commonly advocated, as nonoperative treatment has higher rates of persistent lateral laxity and posttraumatic arthritis. Some studies have shown that acute direct repair results in revision rates upwards of 37% to 40% compared with 6% to 9% for initial reconstruction. In a recent study assessing the outcomes of acute repair of PLC avulsion injuries with 2 to 7 years of follow-up, patients with adequate tissue were shown to have a much lower failure rate than previously documented.
View Article and Find Full Text PDFArthroscopy
January 2025
Department of Orthopaedic Surgery, Northwell, New Hyde Park, New York, U.S.A.; Department of Orthopaedic Surgery at Long Island Jewish Medical Center, New Hyde Park, New York, U.S.A.; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, U.S.A.. Electronic address:
Anterior cruciate ligament reconstruction is one of the most common orthopaedic sports medicine surgeries. Its prevalence in the sports medicine sphere is matched by the numerous options of different techniques. Chief among these is graft selection, which most commonly falls into 1 of 4 options: bone-patellar tendon-bone (BPTB) autograft, hamstring tendon autograft (HT), quadriceps tendon autograft, and allografts.
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