Anterior Cruciate Ligament Rupture
Conditions
Keywords
Anterior cruciate ligament rupture, Press-fit fixation, Patellar tendon graft
Brief summary
This study aims to evaluate the clinical and radiological outcomes of patients undergoing anatomical single-bundle anterior cruciate ligament reconstruction with periosteal-patellar tendon-bone autograft and press-fit tibial fixation technique. The study also aims to compare these outcomes with other reconstruction techniques in the literature. The research investigates the results of a novel surgical technique, providing a minimally invasive and faster rehabilitation for patients undergoing surgery due to anterior cruciate ligament rupture. The technique does not use any screws or staples for tibial fixation, but it carries similar risks as existing techniques. The technique, similar to the well-known bone-patellar tendon-bone (BPTB) autograft technique, creates minimal bone defect at the tibial tuberosity. Over time, the defect remodels and causes minimal clinical discomfort. Despite these limitations, the authors expect patients operated with the investigated new technique to experience less postoperative swelling, less pain, faster mobilization, and earlier rehabilitation.
Interventions
PROCEDUREAnterior cruciate ligament (ACL) reconstruction with a periost-patellar-tendon-bone (PPTB) autograft and a tibial press-fit technique
A longitudinal incision will be performed starting from the central part of the patella. A ruler will be used to mark a tendon thickness of 10mm from the middle of the patellar tendon. Superiorly, the patellar periosteum will be marked with a length of 30-40mm and a width of 10mm. Inferiorly, the tibial tubercle will be marked in a trapezoidal shape with a length of approximately 35mm, a superior narrow base of 10mm and an inferior wider base of 12mm. After extraction, the superior part of the graft will be prepared with reinforced sutures in a whipstitch pattern, while the bone block will be shaped according to the planned tunnel width. After adequate preparation, the femoral end of the graft will be shuttled in with an adjusted fixation device, while the tibial end will be hammered in with a small mallet, in a press-fit fashion, stopping short of the joint surface, but tensioned appropriately. The femoral adjustable device will then be tensioned to ensure proper graft sitting.
Sponsors
Konya City Hospital
Baltalimani Bone Diseases Research and Training Hospital
Ataturk University
Karadeniz Technical University
Ankara Etlik City Hospital
Fatih Sultan Mehmet Training and Research Hospital
Kutahya Health Sciences University
Ankara City Hospital Bilkent
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 55 Years
Healthy volunteers
No
Inclusion criteria
* patients who underwent anatomical single-bundle anterior cruciate ligament reconstruction with periosteal - patellar tendon - bone autograft and press-fit tibial fixation technique after anterior cruciate ligament rupture * patients with at least 1 year of clinical and radiological follow-up * patients who did not undergo a revision
Exclusion criteria
* Patients who underwent a secondary arthroscopy for any reason after primary surgery * Patients with a history of septic arthritis (before and after the surgery) * Those with a history of trauma after primary surgery to the operated knee * Patients who have not completed at least 1 year of follow-up
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The Knee injury and Osteoarthritis Outcome Score (KOOS) | Postoperative 1.st year | minimum value:0, maximum value 100, higher values mean better outcome |
| The International Knee Documentation Committee Score (IKDC) | Postoperative 1.st year | minimum value:0, maximum value 100, higher values mean better outcome |
| Tegner-Lysholm Scale | Postoperative 1.st year | minimum value:0, maximum value 100, higher values mean better outcome |
| Graft survival | Postoperative 1.st year | Overall graft survival |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Tunnel widening | Postoperative 1.st year | Tibial and femoral tunnel widening will be measured on direct calibrated Xrays as a distance (in millimeters) and on CT scans taken at the sixth postoperative month. The distance will be measured on the widest point between the sclerotic lines on the Xrays and perpendicular to their longitudinal trajectories. |
Countries
Turkey (Türkiye)
Contacts
Primary ContactEnejd Veizi, MD
Outcome results
None listed