Clin Orthop Surg.  2017 Dec;9(4):424-431. 10.4055/cios.2017.9.4.424.

A Comparative Study of Clinical Outcomes and Second-Look Arthroscopic Findings between Remnant-Preserving Tibialis Tendon Allograft and Hamstring Tendon Autograft in Anterior Cruciate Ligament Reconstruction: Matched-Pair Design

• Kim YK
• Ahn JH
• Yoo JD

• KMID: 2412243
• DOI: http://doi.org/10.4055/cios.2017.9.4.424

Abstract

BACKGROUND
This study aimed to compare stability, functional outcome, and second-look arthroscopic findings after anterior cruciate ligament reconstruction between remnant-preserving tibialis tendon allograft and remnant-sacrificing hamstring tendon autograft.
METHODS
We matched two groups (remnant-preserving tibialis tendon allograft group and hamstring tendon autograft group) in terms of demographic characteristics, associated injury, and knee characteristics. Each group consisted of 25 patients.
RESULTS
Operation time was longer in the remnant-preserving tibialis tendon allograft group, but there was no significant intergroup difference in stability, clinical outcome, and second-look arthroscopic findings.
CONCLUSIONS
When an autograft is not feasible in anterior cruciate ligament reconstruction, the remnant-preserving technique can produce comparable results in terms of restoration of function, stability of the knee, and degree of synovium coverage at second-look arthroscopy compared to remnant-sacrificing hamstring autograft.

Keyword

Anterior cruciate ligament; Hamstring autograft; Tibialis allograft; Remnant-preserving technique; Outcome

MeSH Terms

Adolescent
Adult
Allografts
Anterior Cruciate Ligament Injuries/complications/*surgery
Anterior Cruciate Ligament Reconstruction/adverse effects/*methods
Arthroscopy
Autografts
Female
Humans
Imaging, Three-Dimensional
Joint Instability/diagnostic imaging/*etiology
Knee Joint/diagnostic imaging/physiopathology/*surgery
Lysholm Knee Score
Male
Matched-Pair Analysis
Middle Aged
Operative Time
Retrospective Studies
Second-Look Surgery
Tendons/*transplantation
Tomography, X-Ray Computed
Treatment Outcome
Young Adult

Figure

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  Fig. 1 A suture hook with Maxon monofilament absorbable suture was inserted through the anteromedial portal and passed through the remnant anterior cruciate ligament tissue.

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  Fig. 2 Two or three more stitches of the remnant anterior cruciate ligament tissue were performed and pulled out through the anterior portal.

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  Fig. 3 After confirmation of the graft passage, the suture was tied with a TightRope device over the button. Then, the sutures were tied with each other.

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  Fig. 4 (A) Synovial coverage less than 50%. (B) Synovial coverage more than 50%. (C) Nearly entire synovial coverage.

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  Fig. 5 The location of the femoral tunnel was calculated as a percentage of the distance from the most posterior contour with respect to the total length of the lateral condyle parallel to the Blumensaat's line and a percentage of the distance from the intercondylar roof with respect to the total depth of the intercondylar notch perpendicular to the Blumensaat's line. H: perpendicular to the Blumensaat's line, D: parallel to the Blumensaat's line.

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  Fig. 6 The location of the tibial tunnel was calculated as a percentage of the distance from the most medial contour with respect to the mediolateral (ML) width of the tibial plateau and a percentage of the distance from the most anterior contour with respect to the anteroposterior (AP) length of the tibial plateau.

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