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Answorth A. Allen - One of the best experts on this subject based on the ideXlab platform.

  • Avoiding Graft-Tunnel Length Mismatch in Anterior Cruciate Ligament Reconstruction: The Single–Bone Plug Technique
    Arthroscopy techniques, 2014
    Co-Authors: Brian M. Grawe, Amber Smerina, Answorth A. Allen
    Abstract:

    Anterior cruciate ligament reconstruction, using autogenous Bone–patellar tendon–Bone (BTB) as a graft material, is commonly performed in the setting of anterior cruciate ligament insufficiency. Although Bone–patellar tendon–Bone autograft has an extensive track record, showing excellent clinical results, donor-site morbidity and graft-tunnel mismatch can still be problematic for a subset of patients. In the setting of a tendon graft that is too long, adequate interference screw fixation cannot be obtained, typically resulting in a tibial-sided Bone Plug that achieves less than 15 to 20 mm of Bone in the distal tibial tunnel. We present an easy and effective technique for avoiding the graft-tunnel mismatch problems that commonly occur in patients who have an excessively long patellar tendons. This technique involves a simple preoperative planning algorithm that ultimately results in a single tibial-sided Plug harvest. Bony interference fixation is then obtained on the femoral side and soft-tissue fixation on the tibial side. This technique allows for satisfactory graft fixation while avoiding the donor-site morbidity associated with patellar Bone Plug harvest.

  • avoiding graft tunnel length mismatch in anterior cruciate ligament reconstruction the single Bone Plug technique
    Arthroscopy techniques, 2014
    Co-Authors: Brian M. Grawe, Amber Smerina, Answorth A. Allen
    Abstract:

    Anterior cruciate ligament reconstruction, using autogenous Bone–patellar tendon–Bone (BTB) as a graft material, is commonly performed in the setting of anterior cruciate ligament insufficiency. Although Bone–patellar tendon–Bone autograft has an extensive track record, showing excellent clinical results, donor-site morbidity and graft-tunnel mismatch can still be problematic for a subset of patients. In the setting of a tendon graft that is too long, adequate interference screw fixation cannot be obtained, typically resulting in a tibial-sided Bone Plug that achieves less than 15 to 20 mm of Bone in the distal tibial tunnel. We present an easy and effective technique for avoiding the graft-tunnel mismatch problems that commonly occur in patients who have an excessively long patellar tendons. This technique involves a simple preoperative planning algorithm that ultimately results in a single tibial-sided Plug harvest. Bony interference fixation is then obtained on the femoral side and soft-tissue fixation on the tibial side. This technique allows for satisfactory graft fixation while avoiding the donor-site morbidity associated with patellar Bone Plug harvest.

A J Cossey - One of the best experts on this subject based on the ideXlab platform.

  • THE BIOMECHANICAL ANALYSIS OF THE TRUFIT Bone Plug
    2018
    Co-Authors: C M Jordan, M C Quaye, K Madi, J Tong, Hsu Y-h., A J Cossey
    Abstract:

    The treatment of acute full thickness chondral damage within the knee is a surgical challenge. Frequently used surgical techniques include chondroplasty, micro-fracture and chondrocyte implantation. These procedures give unpredictable functional outcomes and if the formation of neocartilage is achieved it is predominantly composed of type 1 collagen.The TruFit osteochondral Plug was designed to provide a scaffold for cell proliferation into full thickness chondral defects. It is a composite polymer composed of polylactide co-glycolide, calcium sulphate and poly-glycolide fibres. It is composed of 2 layers, one with a similar trabecular network to cancellous Bone and a superficial layer designed to simulate articular lining.The TruFit Bone Plug was analysed using micro-computed tomography. Its morphology characteristics, granulometry, mechanical performance and image guided failure were tested as well as numerical modelling to assess the permeability of TruFit.Morphological parameters of the TruFit Bone pl...

  • the biomechanical analysis of the trufit Bone Plug
    Journal of Bone and Joint Surgery-british Volume, 2013
    Co-Authors: C M Jordan, M C Quaye, K Madi, Yh Hsu, J Tong, A J Cossey
    Abstract:

    The treatment of acute full thickness chondral damage within the knee is a surgical challenge. Frequently used surgical techniques include chondroplasty, micro-fracture and chondrocyte implantation. These procedures give unpredictable functional outcomes and if the formation of neocartilage is achieved it is predominantly composed of type 1 collagen. The TruFit osteochondral Plug was designed to provide a scaffold for cell proliferation into full thickness chondral defects. It is a composite polymer composed of polylactide co-glycolide, calcium sulphate and poly-glycolide fibres. It is composed of 2 layers, one with a similar trabecular network to cancellous Bone and a superficial layer designed to simulate articular lining. The TruFit Bone Plug was analysed using micro-computed tomography. Its morphology characteristics, granulometry, mechanical performance and image guided failure were tested as well as numerical modelling to assess the permeability of TruFit. Morphological parameters of the TruFit Bone Plug compared favourably with those of human tissue. Under load the scaffold exhibited shear bands throughout the composite leading to a failure mechanism similar to cancellous Bone. Stress relaxation rates of the scaffolds were greatly decreased under wet conditions, likely due to plasticisation of the scaffold by water. The biomechanical properties of the TruFit Bone Plugs are a cause for concern. The Scaffolds mechanical performance under load rapidly deteriorates in wet conditions at body temperature (the natural knee environment). This early failure will lead to defects in the articular surface where the Plug has been inserted. Clinical data is sparse. This study correlates with work performed by Dockery et al & Spalding et al. These clinical studies have shown that the TruFit implant shows no evidence of Bone ingrowth or osteoconductivity. It provides no subchondral support to neocartilage or tissue that was stimulated to form around the defects and surgical sites.

Hiroaki Nakamura - One of the best experts on this subject based on the ideXlab platform.

  • Patients with a quadriceps tendon shorter than 60 mm require a patellar Bone Plug autograft in anterior cruciate ligament reconstruction
    Knee Surgery Sports Traumatology Arthroscopy, 2020
    Co-Authors: Shinya Yamasaki, Yusuke Hashimoto, Changhun Han, Kazuya Nishino, Noriaki Hidaka, Hiroaki Nakamura
    Abstract:

    Purpose To assess the length and thickness of the quadriceps tendon (QT) and anterior cruciate ligament (ACL) to predict the required QT length for individual ACL reconstruction. Methods Thirty patients (9 females, 21 males; mean age 24.5 years; mean height 169.3 cm) who underwent ACL reconstruction using the QT with a Bone Plug autograft were enrolled. The length and thickness of the QT on preoperative magnetic resonance imaging (MRI) were compared with those measured under direct visualization. The ACL length was measured on preoperative MRI and three-dimensional computed tomography after ACL reconstruction. The QT length on MRI was compared with the required graft length, and the factors related to an adequate QT length were assessed. Results The mean QT length on MRI was 60.8 ± 1.3 mm and was significantly positively correlated with the QT length under direct visualization ( P  

  • Patients with a quadriceps tendon shorter than 60 mm require a patellar Bone Plug autograft in anterior cruciate ligament reconstruction.
    Knee surgery sports traumatology arthroscopy : official journal of the ESSKA, 2020
    Co-Authors: Shinya Yamasaki, Yusuke Hashimoto, Changhun Han, Kazuya Nishino, Noriaki Hidaka, Hiroaki Nakamura
    Abstract:

    To assess the length and thickness of the quadriceps tendon (QT) and anterior cruciate ligament (ACL) to predict the required QT length for individual ACL reconstruction. Thirty patients (9 females, 21 males; mean age 24.5 years; mean height 169.3 cm) who underwent ACL reconstruction using the QT with a Bone Plug autograft were enrolled. The length and thickness of the QT on preoperative magnetic resonance imaging (MRI) were compared with those measured under direct visualization. The ACL length was measured on preoperative MRI and three-dimensional computed tomography after ACL reconstruction. The QT length on MRI was compared with the required graft length, and the factors related to an adequate QT length were assessed. The mean QT length on MRI was 60.8 ± 1.3 mm and was significantly positively correlated with the QT length under direct visualization (P 

  • patients with a quadriceps tendon shorter than 60 mm require a patellar Bone Plug autograft in anterior cruciate ligament reconstruction
    Knee Surgery Sports Traumatology Arthroscopy, 2020
    Co-Authors: Shinya Yamasaki, Yusuke Hashimoto, Changhun Han, Kazuya Nishino, Noriaki Hidaka, Hiroaki Nakamura
    Abstract:

    To assess the length and thickness of the quadriceps tendon (QT) and anterior cruciate ligament (ACL) to predict the required QT length for individual ACL reconstruction. Thirty patients (9 females, 21 males; mean age 24.5 years; mean height 169.3 cm) who underwent ACL reconstruction using the QT with a Bone Plug autograft were enrolled. The length and thickness of the QT on preoperative magnetic resonance imaging (MRI) were compared with those measured under direct visualization. The ACL length was measured on preoperative MRI and three-dimensional computed tomography after ACL reconstruction. The QT length on MRI was compared with the required graft length, and the factors related to an adequate QT length were assessed. The mean QT length on MRI was 60.8 ± 1.3 mm and was significantly positively correlated with the QT length under direct visualization (P < 0.01). On MRI, the mean ACL length was 30.8 ± 1.2 mm and the mean QT thickness was 6.3 ± 0.2 mm. Although the mean QT was 0.1 mm longer than the mean required graft length, the QT on MRI was shorter than the required graft length in 37% of patients (11/30). Adequate QT length was related to a QT length of more than 60 mm, but not to age, sex, height, or ACL length. Although preoperative MRI predicted the required QT length for ACL reconstruction, 37% of patients lacked an adequate QT length, and a QT shorter than 60 mm required the addition of patellar Bone. III.

D Kohn - One of the best experts on this subject based on the ideXlab platform.

Jae-young Park - One of the best experts on this subject based on the ideXlab platform.

  • centralized anterior Bone Plug results in less graft extrusion in patients undergoing medial meniscus allograft transplantation following anterior cruciate ligament reconstruction
    Knee, 2020
    Co-Authors: Kyoung Ho Yoon, Hyun Woo Lee, Soo Yeon Park, Jung-suk Kim, Jae-young Park
    Abstract:

    PURPOSE This study was performed to analyze the effect of anterior Bone Plug positioning on clinical and radiological outcomes in patients undergoing medial meniscus allograft transplantation (M-MAT) following anterior cruciate ligament reconstruction (ACLR). METHODS Data from 24 patients who underwent M-MAT following meniscectomy and ACLR from November 2008 to June 2017 were retrospectively investigated. Patients were divided into either the centrally positioned group (group C) or the medially positioned group (group M) based on the location of the anterior Bone Plug for M-MAT. Clinical and radiographic follow-up was performed at two years postoperatively. International Cartilage Repair Society (ICRS) grades of chondral lesion, graft extrusion, and meniscus signal intensity were evaluated by magnetic resonance imaging (MRI) at one year postoperatively. RESULTS There were no significant differences in demographics including follow-up time of two years between the two groups. There were no significant differences in postoperative subjective International Knee Documentation Committee (IKDC), Lysholm, and Tegner scores between groups. Furthermore, there were no significant differences in osteoarthritis progression or ICRS grade on MRI. However, group C showed significantly less absolute graft extrusion (P = .008) and relative graft extrusion (P < .0001) on one-year follow-up MRI, relative to group M. Meniscus signal intensity tended to be better in group C, although this difference was not statistically significant (P = .092). CONCLUSION The centrally positioned group showed significantly less graft extrusion on MRI compared to the medially positioned group; however, there were no statistically significant differences in clinical outcomes between the two groups.

  • Centralized anterior Bone Plug results in less graft extrusion in patients undergoing medial meniscus allograft transplantation following anterior cruciate ligament reconstruction.
    The Knee, 2020
    Co-Authors: Kyoung Ho Yoon, Hyun Woo Lee, Soo Yeon Park, Jung-suk Kim, Jae-young Park
    Abstract:

    PURPOSE This study was performed to analyze the effect of anterior Bone Plug positioning on clinical and radiological outcomes in patients undergoing medial meniscus allograft transplantation (M-MAT) following anterior cruciate ligament reconstruction (ACLR). METHODS Data from 24 patients who underwent M-MAT following meniscectomy and ACLR from November 2008 to June 2017 were retrospectively investigated. Patients were divided into either the centrally positioned group (group C) or the medially positioned group (group M) based on the location of the anterior Bone Plug for M-MAT. Clinical and radiographic follow-up was performed at two years postoperatively. International Cartilage Repair Society (ICRS) grades of chondral lesion, graft extrusion, and meniscus signal intensity were evaluated by magnetic resonance imaging (MRI) at one year postoperatively. RESULTS There were no significant differences in demographics including follow-up time of two years between the two groups. There were no significant differences in postoperative subjective International Knee Documentation Committee (IKDC), Lysholm, and Tegner scores between groups. Furthermore, there were no significant differences in osteoarthritis progression or ICRS grade on MRI. However, group C showed significantly less absolute graft extrusion (P = .008) and relative graft extrusion (P