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Postoperative outcome is affected by an intraoperative combination of each graft tension change pattern in a double-bundle anterior cruciate ligament reconstruction

BACKGROUND: The purpose of this study is to evaluate the intraoperative tension change pattern of each anteromedial (AM) graft and posterolateral (PL) graft and to investigate the optimal femoral tunnel position in double bundle (DB) anterior cruciate ligament reconstruction (ACLR) by comparing post...

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Autores principales: Nakamura, Tomomasa, Koga, Hideyuki, Horie, Masafumi, Watanabe, Toshifumi, Yagishita, Kazuyoshi, Sekiya, Ichiro, Muneta, Takeshi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Asia-Pacific Knee, Arthroscopy and Sports Medicine Society 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5730699/
https://www.ncbi.nlm.nih.gov/pubmed/29264265
http://dx.doi.org/10.1016/j.asmart.2016.08.002
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author Nakamura, Tomomasa
Koga, Hideyuki
Horie, Masafumi
Watanabe, Toshifumi
Yagishita, Kazuyoshi
Sekiya, Ichiro
Muneta, Takeshi
author_facet Nakamura, Tomomasa
Koga, Hideyuki
Horie, Masafumi
Watanabe, Toshifumi
Yagishita, Kazuyoshi
Sekiya, Ichiro
Muneta, Takeshi
author_sort Nakamura, Tomomasa
collection PubMed
description BACKGROUND: The purpose of this study is to evaluate the intraoperative tension change pattern of each anteromedial (AM) graft and posterolateral (PL) graft and to investigate the optimal femoral tunnel position in double bundle (DB) anterior cruciate ligament reconstruction (ACLR) by comparing postoperative outcomes with each combination of graft tension change pattern. METHODS: Eighty-four unilateral primary DB ACLR cases from 2006 to 2008 with a follow-up of 24 months or more were analysed. The tension change pattern of each AM and PL graft after graft fixation was recorded during DB ACLR, and divided into over-the-top (OTT; tension at 0° > 120°) and reverse OTT (graft tension at 0° < 120°) pattern. The combinations of these patterns were then categorized into four groups and the postoperative results were analysed. The femoral tunnel position was measured by a modified quadrant method. The relationship between the femoral tunnel position and the tension change pattern of each graft was evaluated. RESULTS: The cases that presented reverse tension change pattern of native anterior cruciate ligament (ACL) performed most poorly in postoperative knee laxity among the four groups. In this group, the femoral tunnel of the AM bundle was placed significantly higher in flexion. CONCLUSION: This study suggests that the least effective method for knee stability recovery is for the ACL to be reconstructed with the reverse tension change to the native ACL. It is necessary to refrain from placing the femoral tunnel for the AM bundle in a high position in knee flexion in DB ACLR.
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spelling pubmed-57306992017-12-20 Postoperative outcome is affected by an intraoperative combination of each graft tension change pattern in a double-bundle anterior cruciate ligament reconstruction Nakamura, Tomomasa Koga, Hideyuki Horie, Masafumi Watanabe, Toshifumi Yagishita, Kazuyoshi Sekiya, Ichiro Muneta, Takeshi Asia Pac J Sports Med Arthrosc Rehabil Technol Original Article BACKGROUND: The purpose of this study is to evaluate the intraoperative tension change pattern of each anteromedial (AM) graft and posterolateral (PL) graft and to investigate the optimal femoral tunnel position in double bundle (DB) anterior cruciate ligament reconstruction (ACLR) by comparing postoperative outcomes with each combination of graft tension change pattern. METHODS: Eighty-four unilateral primary DB ACLR cases from 2006 to 2008 with a follow-up of 24 months or more were analysed. The tension change pattern of each AM and PL graft after graft fixation was recorded during DB ACLR, and divided into over-the-top (OTT; tension at 0° > 120°) and reverse OTT (graft tension at 0° < 120°) pattern. The combinations of these patterns were then categorized into four groups and the postoperative results were analysed. The femoral tunnel position was measured by a modified quadrant method. The relationship between the femoral tunnel position and the tension change pattern of each graft was evaluated. RESULTS: The cases that presented reverse tension change pattern of native anterior cruciate ligament (ACL) performed most poorly in postoperative knee laxity among the four groups. In this group, the femoral tunnel of the AM bundle was placed significantly higher in flexion. CONCLUSION: This study suggests that the least effective method for knee stability recovery is for the ACL to be reconstructed with the reverse tension change to the native ACL. It is necessary to refrain from placing the femoral tunnel for the AM bundle in a high position in knee flexion in DB ACLR. Asia-Pacific Knee, Arthroscopy and Sports Medicine Society 2016-09-28 /pmc/articles/PMC5730699/ /pubmed/29264265 http://dx.doi.org/10.1016/j.asmart.2016.08.002 Text en © 2016 Asia Pacific Knee, Arthroscopy and Sports Medicine Society. Published by Elsevier Ltd. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Article
Nakamura, Tomomasa
Koga, Hideyuki
Horie, Masafumi
Watanabe, Toshifumi
Yagishita, Kazuyoshi
Sekiya, Ichiro
Muneta, Takeshi
Postoperative outcome is affected by an intraoperative combination of each graft tension change pattern in a double-bundle anterior cruciate ligament reconstruction
title Postoperative outcome is affected by an intraoperative combination of each graft tension change pattern in a double-bundle anterior cruciate ligament reconstruction
title_full Postoperative outcome is affected by an intraoperative combination of each graft tension change pattern in a double-bundle anterior cruciate ligament reconstruction
title_fullStr Postoperative outcome is affected by an intraoperative combination of each graft tension change pattern in a double-bundle anterior cruciate ligament reconstruction
title_full_unstemmed Postoperative outcome is affected by an intraoperative combination of each graft tension change pattern in a double-bundle anterior cruciate ligament reconstruction
title_short Postoperative outcome is affected by an intraoperative combination of each graft tension change pattern in a double-bundle anterior cruciate ligament reconstruction
title_sort postoperative outcome is affected by an intraoperative combination of each graft tension change pattern in a double-bundle anterior cruciate ligament reconstruction
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5730699/
https://www.ncbi.nlm.nih.gov/pubmed/29264265
http://dx.doi.org/10.1016/j.asmart.2016.08.002
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