Manual and Device-Assisted Hamstring Autograft Tensioning Yield Similar Outcomes following ACL Reconstruction.

Autor: Piskopakis A; Department of Orthopaedics and Traumatology, KAT General Hospital, 14561 Kifissia, Greece.; Department of Orthopaedics and Sports Injuries, Medical Center of Athens, 15125 Marousi, Greece., Totlis T; Thessaloniki Minimally Invasive Surgery (TheMIS) Orthopaedic Center, St. Luke's Hospital, 55236 Thessaloniki, Greece.; Department of Anatomy and Surgical Anatomy, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece., Achlatis V; Department of Anatomy and Surgical Anatomy, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece., Zampeli F; Department of Orthopaedics and Traumatology, KAT General Hospital, 14561 Kifissia, Greece., Georgoulis JD; First Department of Orthopaedics, School of Medicine, National and Kapodistrian University of Athens, 10679 Athens, Greece., Hantes M; Department of Orthopaedic Surgery and Musculoskeletal Trauma, University Hospital of Larissa, 41334 Larissa, Greece., Piskopakis N; Department of Orthopaedics and Traumatology, KAT General Hospital, 14561 Kifissia, Greece.; Department of Orthopaedics and Sports Injuries, Medical Center of Athens, 15125 Marousi, Greece., Vekris M; Department of Orthopaedic Surgery, School of Medicine, University of Ioannina, 45110 Ioannina, Greece.
Jazyk: angličtina
Zdroj: Journal of clinical medicine [J Clin Med] 2023 Jul 11; Vol. 12 (14). Date of Electronic Publication: 2023 Jul 11.
DOI: 10.3390/jcm12144623
Abstrakt: The optimal initial graft tension during ACL reconstruction is still a matter of debate. Manual tension is commonly applied to the graft during tibial fixation. However, this has been associated with a greater graft failure rate than that associated with device-assisted tensioning. This study aims to compare the clinical outcomes between the application of manual tension and the use of the ConMed Linvatec SE™ Graft Tensioning System during graft fixation while performing anatomic single-bundle ACL reconstruction.
Methods: A prospective comparative study was conducted between September 2015 and May 2017. Sixty-four patients (mean age 29.3 years, range 14-45) with isolated ACL injuries (and who would be subjected to ACL reconstruction with a quadruple hamstring tendon graft) were divided into two groups. In Group A ( n = 29), common tension was applied manually to both grafts. In Group B ( n = 35), specific tension was applied to the grafts with the use of a tensioner device (ConMed Linvatec SE™ (Stress Equalization) Graft Tensioning System). A total of 60 N was applied to the semitendinosus, and 40 N was applied to the gracilis. Clinical outcomes were assessed at 6, 12, and 24 months.
Results: There were no significant differences between the baseline demographic and clinical data among the patients of the two groups (all p > 0.05). The patients were followed up for a minimum of 24 months (mean ± SD). There were no significant differences in the side-to-side anterior knee laxity, the IKDC, the Lysholm Knee, and the Tegner Activity Scale scores for up to 24 months after operation. The pivot shift test was negative in all cases, and no graft failure was reported at a 2-year follow-up.
Conclusion: No significant differences were found with respect to postoperative anterior knee laxity, clinical outcomes, activity level, and patient satisfaction between the application of manual tension and the use of the graft-tensioning system during tibial fixation while performing anatomic single-bundle ACL reconstruction with a quadruple hamstring tendon graft. Further high-quality clinical studies are required to elucidate whether device-assisted tension is superior to manual tension.
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje