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Leo A Pinczewski - One of the best experts on this subject based on the ideXlab platform.
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20 year outcomes of anterior cruciate ligament reconstruction with Hamstring Tendon autograft the catastrophic effect of age and posterior tibial slope
American Journal of Sports Medicine, 2018Co-Authors: Lucy J Salmon, Justin P Roe, James Linklater, Emma Heath, Hawar Akrawi, Leo A PinczewskiAbstract:Background:No well-controlled studies have compared the long-term outcome of anterior cruciate ligament (ACL) reconstruction with Hamstring Tendon autograft between adolescents and adults. Increase...
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the outcome at 15 years of endoscopic anterior cruciate ligament reconstruction using Hamstring Tendon autograft for isolated anterior cruciate ligament rupture
Journal of Bone and Joint Surgery-british Volume, 2012Co-Authors: Henry E Bourke, Lucy J Salmon, James Linklater, D J Gordon, Alison Waller, Leo A PinczewskiAbstract:The purpose of this study was to report the outcome of ‘isolated’ anterior cruciate ligament (ACL) ruptures treated with anatomical endoscopic reconstruction using Hamstring Tendon autograft at a mean of 15 years (14.25 to 16.9). A total of 100 consecutive men and 100 consecutive women with ‘isolated’ ACL rupture underwent four-strand Hamstring Tendon reconstruction with anteromedial portal femoral tunnel drilling and interference screw fixation by a single surgeon. Details were recorded pre-operatively and at one, two, seven and 15 years post-operatively. Outcomes included clinical examination, subjective and objective scoring systems, and radiological assessment. At 15 years only eight of 118 patients (7%) had moderate or severe osteo-arthritic changes (International Knee Documentation Committee Grades C and D), and 79 of 152 patients (52%) still performed very strenuous activities. Overall graft survival at 15 years was 83% (1.1% failure per year). Patients aged 2 mm of laxity at one year had a threefold increase in the risk of suffering a rupture of the graft (p = 0.002 and p = 0.001, respectively). There was no increase in laxity of the graft over time. ACL reconstructive surgery in patients with an ‘isolated’ rupture using this technique shows good results 15 years post-operatively with respect to ligamentous stability, objective and subjective outcomes, and does not appear to cause osteoarthritis.
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a 10 year comparison of anterior cruciate ligament reconstructions with Hamstring Tendon and patellar Tendon autograft a controlled prospective trial
Scandinavian Journal of Medicine & Science in Sports, 2007Co-Authors: Leo A Pinczewski, Lucy J Salmon, Vivianne J Russell, Jeffrey Lyman, James LinklaterAbstract:BACKGROUND: There are no controlled, prospective studies comparing the 10-year outcomes of anterior cruciate ligament (ACL) reconstruction using patellar Tendon (PT) and four-strand Hamstring Tendon (HT) autografts. HYPOTHESIS: Comparable results are possible with HT and PT autografts. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: One hundred and eighty ACL-deficient knees that met inclusion criteria underwent ACL reconstruction (90 HT autograft, 90 PT autograft) by one surgeon and were treated with an accelerated rehabilitation program. All knees were observed in a prospective fashion with subjective, objective, and radiographic evaluation at 2-, 5-, 7-, and 10-year intervals. RESULTS: At 10 years, there were no differences in graft rupture rates (7/90 PT vs 12/90 HT, P=0.24). There were 20 contralateral ACL ruptures in the PT group, compared with nine in the HT group (P=0.02). In all patients, graft rupture was associated with instrumented laxity >2 mm at 2 years (P=0.001). Normal or near-normal function of the knee was reported in 97% of patients in both groups. In the PT group, harvest-site symptoms (P=0.001) and kneeling pain (P=0.01) were more common than in the HT group. More patients reported pain with strenuous activities in PT knees than in HT knees (P=0.05). Radiographic osteoarthritis was more common in PT knees than the HT-reconstructed knees (P=0.04). The difference, however, was composed of patients with mild osteoarthritis. Other predictors of radiographic osteoarthritis were <90% single-legged hop test at 1 year and the need for further knee surgery. An “ideal” outcome, defined as an overall International Knee Documentation Committee grade of A or B and a radiographic grade of A at 10 years after ACL reconstruction, was associated with <3 mm of instrumented laxity at 2 years, the absence of additional surgery in the knee, and HT grafts. CONCLUSIONS: It is possible to obtain excellent results with both HT and PT autografts. We recommend HT reconstructions to our patients because of decreased harvest-site symptoms and radiographic osteoarthritis.
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a 10 year comparison of anterior cruciate ligament reconstructions with Hamstring Tendon and patellar Tendon autograft a controlled prospective trial
American Journal of Sports Medicine, 2007Co-Authors: Leo A Pinczewski, Lucy J Salmon, Vivianne J Russell, Jeffrey Lyman, James LinklaterAbstract:BackgroundThere are no controlled, prospective studies comparing the 10-year outcomes of anterior cruciate ligament (ACL) reconstruction using patellar Tendon (PT) and 4-strand Hamstring Tendon (HT) autografts.HypothesisComparable results are possible with HT and PT autografts.Study DesignCohort study; Level of evidence, 2.MethodsOne hundred eighty ACL-deficient knees that met inclusion criteria underwent ACL reconstruction (90 HT autograft, 90 PT autograft) by one surgeon and were treated with an accelerated rehabilitation program. All knees were observed in a prospective fashion with subjective, objective, and radiographic evaluation at 2, 5, 7, and 10-year intervals.ResultsAt 10 years, there were no differences in graft rupture rates (7/90 PT vs. 12/90 HT, P = .24). There were 20 contralateral ACL ruptures in the PT group, compared with 9 in the HT group (P = .02). In all patients, graft rupture was associated with instrumented laxity >2 mm at 2 years (P = .001). Normal or near-normal function of the k...
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revision anterior cruciate ligament reconstruction with Hamstring Tendon autograft 5 to 9 year follow up
American Journal of Sports Medicine, 2006Co-Authors: Lucy J Salmon, Vivianne J Russell, Leo A Pinczewski, Kathryn M RefshaugeAbstract:BackgroundThe results of revision anterior cruciate ligament reconstruction are limited in the current literature, and no studies have previously documented the outcome of revision anterior cruciate ligament reconstruction using solely Hamstring Tendon grafts.HypothesisRevision anterior cruciate ligament reconstruction with 4-strand Hamstring Tendon graft affords acceptable results and is comparable to reported outcomes with the bone–patellar Tendon–bone graft.Study DesignCase series; Level of evidence, 4.MethodsFifty-seven consecutive revision anterior cruciate ligament reconstructions with the Hamstring Tendon graft and interference screw fixation were assessed a mean time of 89 months (range, 60-109 months) after surgery. Assessment included the International Knee Documentation Committee knee ligament evaluation, instrumented laxity testing, and radiologic examination.ResultsOf the 50 knees reviewed, 5 (10%) had objective failure of the revision anterior cruciate ligament reconstruction. Of the 45 pati...
Lucy J Salmon - One of the best experts on this subject based on the ideXlab platform.
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20 year outcomes of anterior cruciate ligament reconstruction with Hamstring Tendon autograft the catastrophic effect of age and posterior tibial slope
American Journal of Sports Medicine, 2018Co-Authors: Lucy J Salmon, Justin P Roe, James Linklater, Emma Heath, Hawar Akrawi, Leo A PinczewskiAbstract:Background:No well-controlled studies have compared the long-term outcome of anterior cruciate ligament (ACL) reconstruction with Hamstring Tendon autograft between adolescents and adults. Increase...
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the outcome at 15 years of endoscopic anterior cruciate ligament reconstruction using Hamstring Tendon autograft for isolated anterior cruciate ligament rupture
Journal of Bone and Joint Surgery-british Volume, 2012Co-Authors: Henry E Bourke, Lucy J Salmon, James Linklater, D J Gordon, Alison Waller, Leo A PinczewskiAbstract:The purpose of this study was to report the outcome of ‘isolated’ anterior cruciate ligament (ACL) ruptures treated with anatomical endoscopic reconstruction using Hamstring Tendon autograft at a mean of 15 years (14.25 to 16.9). A total of 100 consecutive men and 100 consecutive women with ‘isolated’ ACL rupture underwent four-strand Hamstring Tendon reconstruction with anteromedial portal femoral tunnel drilling and interference screw fixation by a single surgeon. Details were recorded pre-operatively and at one, two, seven and 15 years post-operatively. Outcomes included clinical examination, subjective and objective scoring systems, and radiological assessment. At 15 years only eight of 118 patients (7%) had moderate or severe osteo-arthritic changes (International Knee Documentation Committee Grades C and D), and 79 of 152 patients (52%) still performed very strenuous activities. Overall graft survival at 15 years was 83% (1.1% failure per year). Patients aged 2 mm of laxity at one year had a threefold increase in the risk of suffering a rupture of the graft (p = 0.002 and p = 0.001, respectively). There was no increase in laxity of the graft over time. ACL reconstructive surgery in patients with an ‘isolated’ rupture using this technique shows good results 15 years post-operatively with respect to ligamentous stability, objective and subjective outcomes, and does not appear to cause osteoarthritis.
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a 10 year comparison of anterior cruciate ligament reconstructions with Hamstring Tendon and patellar Tendon autograft a controlled prospective trial
Scandinavian Journal of Medicine & Science in Sports, 2007Co-Authors: Leo A Pinczewski, Lucy J Salmon, Vivianne J Russell, Jeffrey Lyman, James LinklaterAbstract:BACKGROUND: There are no controlled, prospective studies comparing the 10-year outcomes of anterior cruciate ligament (ACL) reconstruction using patellar Tendon (PT) and four-strand Hamstring Tendon (HT) autografts. HYPOTHESIS: Comparable results are possible with HT and PT autografts. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: One hundred and eighty ACL-deficient knees that met inclusion criteria underwent ACL reconstruction (90 HT autograft, 90 PT autograft) by one surgeon and were treated with an accelerated rehabilitation program. All knees were observed in a prospective fashion with subjective, objective, and radiographic evaluation at 2-, 5-, 7-, and 10-year intervals. RESULTS: At 10 years, there were no differences in graft rupture rates (7/90 PT vs 12/90 HT, P=0.24). There were 20 contralateral ACL ruptures in the PT group, compared with nine in the HT group (P=0.02). In all patients, graft rupture was associated with instrumented laxity >2 mm at 2 years (P=0.001). Normal or near-normal function of the knee was reported in 97% of patients in both groups. In the PT group, harvest-site symptoms (P=0.001) and kneeling pain (P=0.01) were more common than in the HT group. More patients reported pain with strenuous activities in PT knees than in HT knees (P=0.05). Radiographic osteoarthritis was more common in PT knees than the HT-reconstructed knees (P=0.04). The difference, however, was composed of patients with mild osteoarthritis. Other predictors of radiographic osteoarthritis were <90% single-legged hop test at 1 year and the need for further knee surgery. An “ideal” outcome, defined as an overall International Knee Documentation Committee grade of A or B and a radiographic grade of A at 10 years after ACL reconstruction, was associated with <3 mm of instrumented laxity at 2 years, the absence of additional surgery in the knee, and HT grafts. CONCLUSIONS: It is possible to obtain excellent results with both HT and PT autografts. We recommend HT reconstructions to our patients because of decreased harvest-site symptoms and radiographic osteoarthritis.
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a 10 year comparison of anterior cruciate ligament reconstructions with Hamstring Tendon and patellar Tendon autograft a controlled prospective trial
American Journal of Sports Medicine, 2007Co-Authors: Leo A Pinczewski, Lucy J Salmon, Vivianne J Russell, Jeffrey Lyman, James LinklaterAbstract:BackgroundThere are no controlled, prospective studies comparing the 10-year outcomes of anterior cruciate ligament (ACL) reconstruction using patellar Tendon (PT) and 4-strand Hamstring Tendon (HT) autografts.HypothesisComparable results are possible with HT and PT autografts.Study DesignCohort study; Level of evidence, 2.MethodsOne hundred eighty ACL-deficient knees that met inclusion criteria underwent ACL reconstruction (90 HT autograft, 90 PT autograft) by one surgeon and were treated with an accelerated rehabilitation program. All knees were observed in a prospective fashion with subjective, objective, and radiographic evaluation at 2, 5, 7, and 10-year intervals.ResultsAt 10 years, there were no differences in graft rupture rates (7/90 PT vs. 12/90 HT, P = .24). There were 20 contralateral ACL ruptures in the PT group, compared with 9 in the HT group (P = .02). In all patients, graft rupture was associated with instrumented laxity >2 mm at 2 years (P = .001). Normal or near-normal function of the k...
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revision anterior cruciate ligament reconstruction with Hamstring Tendon autograft 5 to 9 year follow up
American Journal of Sports Medicine, 2006Co-Authors: Lucy J Salmon, Vivianne J Russell, Leo A Pinczewski, Kathryn M RefshaugeAbstract:BackgroundThe results of revision anterior cruciate ligament reconstruction are limited in the current literature, and no studies have previously documented the outcome of revision anterior cruciate ligament reconstruction using solely Hamstring Tendon grafts.HypothesisRevision anterior cruciate ligament reconstruction with 4-strand Hamstring Tendon graft affords acceptable results and is comparable to reported outcomes with the bone–patellar Tendon–bone graft.Study DesignCase series; Level of evidence, 4.MethodsFifty-seven consecutive revision anterior cruciate ligament reconstructions with the Hamstring Tendon graft and interference screw fixation were assessed a mean time of 89 months (range, 60-109 months) after surgery. Assessment included the International Knee Documentation Committee knee ligament evaluation, instrumented laxity testing, and radiologic examination.ResultsOf the 50 knees reviewed, 5 (10%) had objective failure of the revision anterior cruciate ligament reconstruction. Of the 45 pati...
Andreas Weiler - One of the best experts on this subject based on the ideXlab platform.
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primary versus single stage revision anterior cruciate ligament reconstruction using autologous Hamstring Tendon grafts a prospective matched group analysis
American Journal of Sports Medicine, 2007Co-Authors: Andreas Weiler, Max J Kaab, Arno Schmeling, Ivonne Stohr, Michael WagnerAbstract:BackgroundThere is a low level of evidence about clinical results after anterior cruciate ligament (ACL) revision reconstruction using autologous Hamstring Tendon grafts.HypothesisAnterior cruciate ligament revision reconstruction improves knee stability but shows inferior results for functional and subjective outcome and knee stability compared with primary reconstruction.Study DesignCohort study; Level of evidence, 2.MethodsBetween October 1997 and July 2005, 166 single-stage or 2-stage revision ACL reconstructions were done using different graft types. One hundred twenty-four cases underwent a single-stage revision reconstruction with autologous Hamstring Tendon grafts. At the time of data analysis, 67 cases fulfilled the criteria of minimum 2-year follow-up. Five patients were lost to follow-up (follow-up rate, 91%). Four patients (6%) who experienced graft rupture were counted as failures but not subjected to further detailed analysis. Because of loss to follow-up and exclusion criteria (n = 12), 50 ...
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Hamstring Tendon versus patellar Tendon anterior cruciate ligament reconstruction using biodegradable interference fit fixation a prospective matched group analysis
American Journal of Sports Medicine, 2005Co-Authors: Michael Wagner, Max J Kaab, Jessica Schallock, Norbert Haas, Andreas WeilerAbstract:BackgroundThere are still controversies about graft selection for primary anterior cruciate ligament reconstruction, especially with respect to knee stability and functional outcome.HypothesisBiodegradable interference screw fixation of Hamstring Tendon grafts provides clinical results similar to those achieved with identical fixation of bone-patellar Tendon-bone grafts.Study DesignCohort study; Level of evidence, 2.MethodsIn 1996 and 1997, primary isolated anterior cruciate ligament reconstruction using a bone-patellar Tendon-bone autograft was performed in 72 patients. Since 1998, Hamstring Tendons were used as routine grafts. Matched patients with a Hamstring Tendon graft were selected from a database (n = 284). All patients were followed prospectively for a minimum of 2 years with KT-1000 arthrometer testing, International Knee Documentation Committee score, and Lysholm score.ResultsIn the bone-patellar Tendon-bone group, 9 patients were excluded because of bilateral rupture of the anterior cruciate l...
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the endopearl device increases fixation strength and eliminates construct slippage of Hamstring Tendon grafts with interference screw fixation
Arthroscopy, 2001Co-Authors: Andreas Weiler, Manuel Richter, Gerhard Schmidmaier, F Kandziora, Norbert P. SüdkampAbstract:Abstract Purpose: The EndoPearl (Linvatec, Largo, FL), a biodegradable device to augment the femoral interference screw fixation of Hamstring Tendon grafts has been developed. The first objective of this study was to compare the initial fixation strength of quadrupled Hamstring Tendons and biodegradable interference screw fixation with and without the application of the EndoPearl device. The second objective was to determine the influence of the EndoPearl device on the fatigue behavior under incremental cyclic loading conditions in a simulation of critical fixation conditions. Type of Study: Biomechanical study. Methods: Fresh human Hamstring Tendons were harvested and grafts were fixed with biodegradable poly-L-lactide interference screws. Twenty proximal calf tibias were used to compare the initial fixation strength of the study and the control group. In the study group, the EndoPearl device was secured to the graft using two No. 5 Ethibond sutures (Ethicon, Somerville, NJ). Specimens were loaded until failure in a materials testing machine. For cyclic testing, human Hamstring Tendons and 20 distal porcine femurs were used. Critical graft fixation conditions were simulated by increasing tunnel diameter 2 mm over the graft diameter. Grafts were loaded progressively in increments of 100 N until failure; 100 cycles were applied per load increment. Results: Graft fixation with the additional EndoPearl device had a significantly higher maximum load to failure (658.9 ± 118.1 N v 385.9 ± 185.6 N, P =.003) and stiffness (41.7 ± 11 N/mm v 25.7 ± 8.5 N/mm). Graft fixation with the EndoPearl device sustained a significant higher total number of cycles (388.5 ± 125.6) compared with the control group (152.8 ± 144.9, P =.002). Conclusions: We demonstrated that the augmentation of a Hamstring Tendon graft with the EndoPearl device increases interference screw fixation strength significantly. Under dynamic loading conditions, specimens of the study group sustained substantially higher loads and a larger number of cycles, which indicates a greater resistance to graft slippage. The application of the EndoPearl device may also allow for a secure soft-tissue graft fixation with interference screws in cases of critical fixation conditions. Arthroscopy: The Journal of Arthroscopic and Related Surgery, Vol 17, No 4 (April), 2001: pp 353–359
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the influence of screw geometry on Hamstring Tendon interference fit fixation
American Journal of Sports Medicine, 2000Co-Authors: Andreas Weiler, C. J. Siepe, R Hoffmann, S Kolbeck, Norbert P. SüdkampAbstract:We used a standardized model of calf tibial bone to investigate the influence of screw diameter and length on interference fit fixation of a three-stranded semitendinosus Tendon graft for anterior cruciate ligament reconstruction. Biodegradable poly-(L-lactide) interference screws with a diameter of 7, 8, and 9 mm and a length of 23 and 28 mm were used. We examined results in three groups of 10 specimens each: group 1, screw diameter equaled graft diameter and screw length was 23 mm; group 2, screw diameter equaled graft diameter plus 1 mm and screw length was 23 mm; group 3, screw diameter equaled graft diameter and screw length was 28 mm. The mean pull-out forces in groups 1, 2, and 3 were 367.2+/-78 N, 479.1+/-111.1 N, and 537.4+/-139.1 N, respectively. The force data from groups 2 and 3 were significantly higher than those from group 1. These results indicate that screw geometry has a significant influence on Hamstring Tendon interference fit fixation. Increasing screw length improves fixation strength more than oversizing the screw diameter. This is important, especially for increasing tibial fixation strength because the tibial graft fixation site has been considered to be the weak link of such a reconstruction.
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Hamstring Tendon Fixation Using Interference Screws: A Biomechanical Study in Calf Tibial Bone
Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the Internation, 1998Co-Authors: Andreas Weiler, Reinhard F.g. Hoffmann, Andreas C. Stähelin, Hermann J. Bail, C. J. Siepe, Norbert P. SüdkampAbstract:Summary: It has recently been shown that graft fixation close to the ACL insertion site is optimal in order to increase anterior knee stability. Hamstring Tendon fixation using interference screws offers this possibility and a round threaded titanium interference screw has been previously developed. The use of a round threaded biodegradable interference screw may be equivalent. In addition, to increase initial fixation strength, graft harvest with a distally attached bone plug may be advantageous, but biomechanical data do not exist. This study compares the initial pullout force, stiffness of fixation, and failure modes of three strand semitendinosus grafts in 36 proximal calf tibiae using either biodegradable
Vivianne J Russell - One of the best experts on this subject based on the ideXlab platform.
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a 10 year comparison of anterior cruciate ligament reconstructions with Hamstring Tendon and patellar Tendon autograft a controlled prospective trial
Scandinavian Journal of Medicine & Science in Sports, 2007Co-Authors: Leo A Pinczewski, Lucy J Salmon, Vivianne J Russell, Jeffrey Lyman, James LinklaterAbstract:BACKGROUND: There are no controlled, prospective studies comparing the 10-year outcomes of anterior cruciate ligament (ACL) reconstruction using patellar Tendon (PT) and four-strand Hamstring Tendon (HT) autografts. HYPOTHESIS: Comparable results are possible with HT and PT autografts. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: One hundred and eighty ACL-deficient knees that met inclusion criteria underwent ACL reconstruction (90 HT autograft, 90 PT autograft) by one surgeon and were treated with an accelerated rehabilitation program. All knees were observed in a prospective fashion with subjective, objective, and radiographic evaluation at 2-, 5-, 7-, and 10-year intervals. RESULTS: At 10 years, there were no differences in graft rupture rates (7/90 PT vs 12/90 HT, P=0.24). There were 20 contralateral ACL ruptures in the PT group, compared with nine in the HT group (P=0.02). In all patients, graft rupture was associated with instrumented laxity >2 mm at 2 years (P=0.001). Normal or near-normal function of the knee was reported in 97% of patients in both groups. In the PT group, harvest-site symptoms (P=0.001) and kneeling pain (P=0.01) were more common than in the HT group. More patients reported pain with strenuous activities in PT knees than in HT knees (P=0.05). Radiographic osteoarthritis was more common in PT knees than the HT-reconstructed knees (P=0.04). The difference, however, was composed of patients with mild osteoarthritis. Other predictors of radiographic osteoarthritis were <90% single-legged hop test at 1 year and the need for further knee surgery. An “ideal” outcome, defined as an overall International Knee Documentation Committee grade of A or B and a radiographic grade of A at 10 years after ACL reconstruction, was associated with <3 mm of instrumented laxity at 2 years, the absence of additional surgery in the knee, and HT grafts. CONCLUSIONS: It is possible to obtain excellent results with both HT and PT autografts. We recommend HT reconstructions to our patients because of decreased harvest-site symptoms and radiographic osteoarthritis.
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a 10 year comparison of anterior cruciate ligament reconstructions with Hamstring Tendon and patellar Tendon autograft a controlled prospective trial
American Journal of Sports Medicine, 2007Co-Authors: Leo A Pinczewski, Lucy J Salmon, Vivianne J Russell, Jeffrey Lyman, James LinklaterAbstract:BackgroundThere are no controlled, prospective studies comparing the 10-year outcomes of anterior cruciate ligament (ACL) reconstruction using patellar Tendon (PT) and 4-strand Hamstring Tendon (HT) autografts.HypothesisComparable results are possible with HT and PT autografts.Study DesignCohort study; Level of evidence, 2.MethodsOne hundred eighty ACL-deficient knees that met inclusion criteria underwent ACL reconstruction (90 HT autograft, 90 PT autograft) by one surgeon and were treated with an accelerated rehabilitation program. All knees were observed in a prospective fashion with subjective, objective, and radiographic evaluation at 2, 5, 7, and 10-year intervals.ResultsAt 10 years, there were no differences in graft rupture rates (7/90 PT vs. 12/90 HT, P = .24). There were 20 contralateral ACL ruptures in the PT group, compared with 9 in the HT group (P = .02). In all patients, graft rupture was associated with instrumented laxity >2 mm at 2 years (P = .001). Normal or near-normal function of the k...
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revision anterior cruciate ligament reconstruction with Hamstring Tendon autograft 5 to 9 year follow up
American Journal of Sports Medicine, 2006Co-Authors: Lucy J Salmon, Vivianne J Russell, Leo A Pinczewski, Kathryn M RefshaugeAbstract:BackgroundThe results of revision anterior cruciate ligament reconstruction are limited in the current literature, and no studies have previously documented the outcome of revision anterior cruciate ligament reconstruction using solely Hamstring Tendon grafts.HypothesisRevision anterior cruciate ligament reconstruction with 4-strand Hamstring Tendon graft affords acceptable results and is comparable to reported outcomes with the bone–patellar Tendon–bone graft.Study DesignCase series; Level of evidence, 4.MethodsFifty-seven consecutive revision anterior cruciate ligament reconstructions with the Hamstring Tendon graft and interference screw fixation were assessed a mean time of 89 months (range, 60-109 months) after surgery. Assessment included the International Knee Documentation Committee knee ligament evaluation, instrumented laxity testing, and radiologic examination.ResultsOf the 50 knees reviewed, 5 (10%) had objective failure of the revision anterior cruciate ligament reconstruction. Of the 45 pati...
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gender differences in outcome after anterior cruciate ligament reconstruction with Hamstring Tendon autograft
American Journal of Sports Medicine, 2006Co-Authors: Lucy J Salmon, Kathryn M Refshauge, Vivianne J Russell, Justin P Roe, James Linklater, Leo A PinczewskiAbstract:BackgroundIt is now well documented that women are more likely to suffer anterior cruciate ligament injuries than are men. A few studies have examined gender differences in the outcome of anterior cruciate ligament reconstruction with patellar Tendon graft and Hamstring Tendon with Endo Button fixation, but no well-controlled studies have specifically compared men and women after anterior cruciate ligament reconstruction with Hamstring Tendon graft and interference screw fixation.HypothesisThere is no difference in outcome between men and women after anterior cruciate ligament reconstruction with Hamstring Tendon autograft and interference screw fixation.Study DesignCohort study; Level of evidence, 3.MethodsThere were 100 men and 100 women who underwent isolated anterior cruciate ligament reconstruction by a single surgeon. Patients were assessed preoperatively and at 1, 2, and 7 years after surgery. Variables were compared between female and male patients.ResultsLaxity on physical evaluation was greater ...
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a 7 year follow up of patellar Tendon and Hamstring Tendon grafts for arthroscopic anterior cruciate ligament reconstruction differences and similarities
American Journal of Sports Medicine, 2005Co-Authors: Justin P Roe, Lucy J Salmon, Vivianne J Russell, Leo A Pinczewski, Tomomaro Kawamata, Melvin ChewAbstract:BackgroundFor arthroscopic anterior cruciate ligament reconstruction, the most commonly used graft constructs are either the Hamstring Tendon or patellar Tendon. Well-controlled, long-term studies are needed to determine the differences between the 2 materials.HypothesisThere is a difference between Hamstring and patellar Tendon grafts in the clinical results of anterior cruciate ligament reconstructions at 7 years.Study DesignCohort study; Level of evidence, 2.MethodsTwo groups of 90 patients each, consecutively treated with Hamstring or patellar Tendon grafts, were followed and assessed at 1, 2, 5, and 7 years after surgery.ResultsAt the 7-year review, abnormal radiographic findings were seen in 45% (24/53) of the patellar Tendon group and in 14% (7/51) of the Hamstring Tendon group (P = .002). Although there was no significant difference between the groups in extension deficit (P= .22), the percentage of patients with an extension deficit increased significantly in the patellar Tendon group from 8% at ...
Arsi Harilainen - One of the best experts on this subject based on the ideXlab platform.
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patellar Tendon versus Hamstring Tendon autografts for reconstructing the anterior cruciate ligament a meta analysis based on individual patient data
American Journal of Sports Medicine, 2009Co-Authors: David Biau, Sandrine Katsahian, Juri Kartus, Arsi Harilainen, Julian A Feller, Matjaz Sajovic, Lars Ejerhed, Stefano Zaffagnini, Martin Ropke, Remy NizardAbstract:BackgroundThe best means of ensuring knee stability after anterior cruciate ligament (ACL) reconstruction remains a core debate in sports medicine.HypothesisThere is no difference between ACL reconstruction with patellar Tendon or Hamstring Tendon autografts with regard to postoperative knee laxity and instability.Study DesignMeta-analysis of individual patient data.MethodsPooled analysis of individual patient data from 6 published randomized clinical trials included 423 patients with symptomatic unilateral anterior cruciate ligament injury randomly assigned to reconstruction with patellar Tendon or Hamstring Tendon autograft. Knee instability, defined as a positive pivot-shift test result, was the primary outcome, and knee laxity, defined as a positive Lachman test result, was the secondary outcome. Odds ratios were computed before and after adjustment for potential confounders and trial effect. Regression analyses were performed to look for effects of covariates on outcomes, and mixed-effects models wer...
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randomized prospective study of acl reconstruction with interference screw fixation in patellar Tendon autografts versus femoral metal plate suspension and tibial post fixation in Hamstring Tendon autografts 5 year clinical and radiological follow up
Knee Surgery Sports Traumatology Arthroscopy, 2006Co-Authors: Arsi Harilainen, Eric Linko, Jerker SandelinAbstract:Patellar Tendon graft has been the most frequently used material in anterior cruciate ligament (ACL) reconstruction, but the Hamstring Tendons have been increasingly used as well; however, which graft is to be preferred is not adequately supported by existing clinical studies. In this prospective randomized clinical trial, the study hypothesis was that the Hamstring Tendons are equally good graft material as the patellar Tendon in ACL reconstruction. Ninety-nine patients with laxity due to a torn ACL underwent arthroscopically assisted reconstruction with graft randomization according to their birth year to either patellar Tendon with metal interference screw fixation or double looped semitendinosus and gracilis Tendons with fixation similar to the Endobutton technique using a titanium metal plate suspension proximally and screw-washer postdistally. Excluding preoperative Lysholm knee score, there were no significant differences between the two groups in the preoperative and operative data. A standard rehabilitation regimen was used for all the patients, including immediate postoperative mobilization without a knee brace, protected weight bearing for 2 weeks, and return to full activity at 6–12 months postoperatively. Forty patients in the patellar Tendon group and 39 patients in the Hamstring Tendon group were available for clinical evaluation at median 5 years after surgery (ranges 3 years 11 months–6 years 7 months). The results revealed no statistically significant differences with respect to clinical and instrumented laxity testing, isokinetic muscle torque measurements, International Knee Documentation Committee ratings, Lysholm (knee score), Tegner (activity level) and Kujala patellofemoral knee scores. There was an enlargement of the drill tunnels, statistically more in the Hamstring Tendon group, but no increase from 2 to 5 years in either group. Narrowing of the joint spaces (IKDC measurement method) from 2 to 5 years postoperatively was seen in both the groups, however, without difference between the two groups.
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a prospective randomized study of patellar versus Hamstring Tendon autografts for anterior cruciate ligament reconstruction
American Journal of Sports Medicine, 2003Co-Authors: Kim A Jansson, Eric Linko, Jerker Sandelin, Arsi HarilainenAbstract:BackgroundBone-patellar Tendon-bone graft has been the most commonly used graft material in anterior cruciate reconstructions, but there has been increasing use of Hamstring Tendon grafts. However,...
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a prospective randomized study of patellar versus Hamstring Tendon autografts for anterior cruciate ligament reconstruction
American Journal of Sports Medicine, 2003Co-Authors: Kim A Jansson, Eric Linko, Jerker Sandelin, Arsi HarilainenAbstract:Background: Bone-patellar Tendon-bone graft has been the most commonly used graft material in anterior cruciate reconstructions, but there has been increasing use of Hamstring Tendon grafts. However, no existing clinical studies show adequate support for the choice of one graft over the other.Hypothesis: Hamstring Tendons are equally as good as patellar Tendon in anterior cruciate ligament reconstructions.Study Design: Prospective randomized clinical trial.Methods: Ninety-nine patients with laxity caused by a torn anterior cruciate ligament underwent arthroscopically assisted reconstruction with graft randomization according to their birth year. Grafts were either bone-patellar Tendon-bone with metal interference screw fixation or double-looped Hamstring Tendons with metal plate fixation. There were no significant differences between the two groups preoperatively or at operation. Standard rehabilitation included immediate postoperative mobilization without a knee brace, protected weightbearing for 2 weeks...
