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Graft isometry during anatomical ACL reconstruction has little effect on surgical outcomes

Authors
 Hyun-Soo Moon  ;  Chong-Hyuk Choi  ;  Je-Hyun Yoo  ;  Min Jung  ;  Tae-Ho Lee  ;  Kee-Bum Hong  ;  Sung-Hwan Kim 
Citation
 KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, Vol.30(5) : 1594-1604, 2022-05 
Journal Title
KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY
ISSN
 0942-2056 
Issue Date
2022-05
MeSH
Anterior Cruciate Ligament Injuries* / surgery ; Anterior Cruciate Ligament Reconstruction* / methods ; Hamstring Tendons* / transplantation ; Humans ; Knee Joint / diagnostic imaging ; Knee Joint / surgery ; Retrospective Studies ; Treatment Outcome
Keywords
ACL ; Anatomical ACL reconstruction ; Anterior cruciate ligament ; Graft isometry ; Graft tunnel placement
Abstract
Purpose: To investigate the surgical outcomes of anatomical anterior cruciate ligament (ACL) reconstruction according to the graft isometry measured during surgery.

Methods: Electrical medical records of patients who underwent an arthroscopic ACL reconstruction through the transportal technique using hamstring tendon autograft between 2012 and 2016 were retrospectively reviewed. The patients were classified into two groups based on the graft length change throughout the knee range of motion measured just before graft fixation (Group 1, graft length change ≤ 2 mm; Group 2, graft length change > 2 mm). Comparative analyses, including a non-inferiority trial, were performed regarding the clinical scores, knee laxity, and radiographic parameters between the groups.

Results: A total of 67 patients were included in the study. The total change in the length of ACL graft throughout the knee range of motion was 1.4 ± 0.4 mm in Group 1 (range, 0.2-2.0 mm), and 3.0 ± 0.7 mm in Group 2 (range, 2.2-5.0 mm). Group 1 showed a relatively high (proximal) femoral tunnel and shallow (anterior) tibial tunnel compared to Group 2 (P < 0.001 and P = 0.028, respectively), but there were no apparent differences in the macroscopic view. There were no statistically significant differences in the clinical outcomes between groups at 2 years after surgery, which satisfied the non-inferiority criterion of Group 1 in terms of clinical scores and knee laxity compared to Group 2.

Conclusion: The surgical outcomes of anatomical ACL reconstruction in patients with non-isometric ACL graft were not inferior in terms of clinical scores and knee laxity, compared to those with nearly-isometric ACL graft. The graft tunnel placement in the isometric position during anatomical ACL reconstruction, which is technically challenging in the clinical setting, is not a crucial factor in terms of clinical outcomes.

Level of evidence: Level IV.
Full Text
https://link.springer.com/article/10.1007/s00167-021-06654-0
DOI
10.1007/s00167-021-06654-0
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Sung Hwan(김성환) ORCID logo https://orcid.org/0000-0001-5743-6241
Moon, Hyun-Soo(문현수)
Jung, Min(정민) ORCID logo https://orcid.org/0000-0002-7527-4802
Choi, Chong Hyuk(최종혁) ORCID logo https://orcid.org/0000-0002-9080-4904
Hong, Kee-Bum(홍기범)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/188510
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