Revision of anterior cruciate ligament reconstruction presents various challenges not encountered in the primary settings, including malpositioned tunnels, tunnel widening, and the lack of consensus on the ideal graft to be used. This Technical Note describes a one-stage anterior cruciate ligament reconstruction revision using a bone-patellar tendon-bone autograft combined with lateral extra-articular tenodesis. This technique represents the ideal approach to tackle complex revision cases primarily characterized by tibial and femoral tunnel osteolysis and rotational knee instability. The bone-patellar tendon-bone autograft offers numerous advantages mainly providing a double bone plug, which is critical when encountering cases with tibial and femoral tunnel widening. In addition, a lateral extra-articular tenodesis alongside the revision enhances rotational knee stability reducing stress on the graft and ensuring better graft survival.
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http://dx.doi.org/10.1016/j.eats.2024.103149 | DOI Listing |
This study was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta- Analyses) guidelines. PubMed and Medline databases were searched in October 2023 for studies reporting outcomes of arthroscopic anterior cruciate ligament (ACL) reconstruction and stable medial meniscal ramp lesion treatment. Studies focused on diagnostic approaches, biomechanical properties, unstable ramp lesions, isolated ramp lesions, and concomitant intraarticular/extraarticular pathologies other than ACL rupture are excluded.
View Article and Find Full Text PDFActa Orthop Belg
September 2024
Reconstruction of the anterior cruciate ligament (ACL) using hamstring autograft presents a greater risk of surgical site infection than other transplants (0.5% to 1.5%).
View Article and Find Full Text PDFFront Physiol
January 2025
Department of Orthopaedics, Sports Medical Research Group, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
Competitive alpine skiing requires a high level of physical fitness to perform sport-specific manoeuvres and to minimise the risk of injury. The aim of this study was to establish reference values for the maximal anatomical cross-sectional area (ACSA) of the individual hamstrings (HAM) and quadriceps (QUAD) muscles as well as for the maximal voluntary torque (MVT) during knee flexion (KF) and knee extension (KE) of female and male elite competitive alpine skiers. Ultrasound and dynamometer data were obtained from a largely overlapping but not identical dataset.
View Article and Find Full Text PDFWorld J Orthop
January 2025
Department of Trauma and Orthopaedics, AOSP Terni, Terni 05100, Umbria, Italy.
Platelet rich plasma (PRP) is an autologous blood product rich in platelets, showing promise in reducing inflammation and accelerating healing. While extensively utilized in plastic surgery, dermatology, and osteoarthritis treatment, its application in anterior cruciate ligament (ACL) injuries is limited. This article examines PRP's potential in ACL reconstruction (ACLR), exploring its history, current usage, controversies and future directions.
View Article and Find Full Text PDFAm J Sports Med
January 2025
Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Background: Anterior cruciate ligament reconstruction (ACLR) is one of the most common orthopaedic procedures and one of the most well studied. Despite extensive research dedicated to ACLR, there is limited understanding of how chronic inflammatory systemic diseases (CIDs) such as rheumatoid arthritis and systemic lupus erythematosus affect outcomes.
Purpose: To compare the outcomes of ACLR in cohorts of patients with and without CID.
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