Background: Anterior cruciate ligament injuries are commonly seen in orthopedic surgery practice. Although anterior cruciate ligament reconstruction (ACLR) has come a long way, the causes of failure have yet to be fully understood.
Objective: The aim of this study was to investigate whether or not the intraoperative 4-strand hamstring autograft diameter does in fact influence the failure rates of ACLR.
Methods: Retrospective intraoperative data were collected from ACLR patients from the only tertiary center available in Kuwait. Patients who underwent ACLR from 2012 to 2018 for isolated ACL injuries were included in this study, allowing for a 24 month follow-up period The cohorts were categorized into 3 groups: patients with graft size≤8mm, 2, patients with graft sizes≥8mm with 4-strands and patients with graft sizes≥8mm with 4-strands or more. ANOVA analysis was applied to address group differences between mean graft size and strand numbers and subsequently the failure rates for each group. In addition, the Mann-Whitney U test was used to investigate the relationship between revision and initial ACL graft size.
Results: Out of the 711 out of 782 patients were included in this study. Only 42.6% of the patients did not need more than 4-strands to achieve an 8mm sized autograft. The patients who had autografts≤8mm in this study accounted for 17.1% of the population. About 7.2% of these patients required revision surgery. Patients with a 4-strand autograft size that was less than 8mm were 7.2 times more at risk for ACLR failure (RR=7.2, 95% CI: 6.02; 8.35, p=0.007).
Conclusions: There is a significant correlation between 4-strand autograft diameter size and the need for ACLR revision surgery.
Level Of Evidence: IV case series.
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http://dx.doi.org/10.1051/sicotj/2021018 | DOI Listing |
J Clin Med
December 2024
Department of Orthopedics, Traumatology and Hand Surgery, Faculty of Medicine, Wroclaw Medical University, 50-556 Wroclaw, Poland.
The number of revision anterior cruciate ligament reconstruction (RACLR) procedures is increasing in proportion to the increase in the number of anterior cruciate ligament reconstruction (ACLR) procedures. Although approximately 50-75% of these procedures can be performed in a single-stage procedure, not all of them can. The choice of graft may influence the results of RACLR.
View Article and Find Full Text PDFKnee
January 2025
Department of Orthopaedics and Traumatology, Haseki Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.
Background: The aim of this study was to predict intraoperative graft diameter with our new method by evaluating the cross-sectional areas (CSAs) of the hamstrings in axial sections of MRI.
Methods: This study included 78 patients who underwent single-bundle ACLR between 2022 and 2023. MRIs of the patients were evaulated preoperatively and four CSAs of the hamstring tendons were measured in two different regions by two participants.
Arthrosc Tech
December 2024
Department of Orthopaedics, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand.
In this article, we explain a simple method to effectively enhance the graft size and maintain the tissue integrity of a hamstring autograft. The triple-fold technique is useful for creating a soft-tissue size and length suitable for anterior cruciate ligament reconstruction.
View Article and Find Full Text PDFPurpose: Using a thin semitendinosus tendon as an autograft is a risk factor for poor clinical outcomes after anterior cruciate ligament reconstruction. Preoperative evaluation of the cross-sectional area of the semitendinosus tendon using magnetic resonance imaging is useful. However, studies comparing the cross-sectional area of the semitendinosus tendon on magnetic resonance imaging and the collagen fibril diameter of the semitendinosus tendon are lacking.
View Article and Find Full Text PDFSkeletal Radiol
December 2024
Department of Orthopaedic Surgery, Tufts Medical Center, Boston, MA, USA.
Objective: Anterior cruciate ligament (ACL) reconstruction using tendon autograft requires imaging to evaluate graft adequacy. Ultrasound (US) offers an efficient adjunct to MRI; however, the utility of US is variable in prior literature and should be investigated. The primary aim of this study is to provide a statistical appraisal of literature assessing correlation of preoperative US measurements with intraoperative size of autografts during ACL reconstruction.
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