Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
International Orthopaedics
Published in: International Orthopaedics 2/2013

01-02-2013 | Original Paper

Comparative study between mono-bundle bone-patellar tendon-bone, double-bundle hamstring and mono-bundle bone-patellar tendon-bone combined with a modified Lemaire extra-articular procedure in anterior cruciate ligament reconstruction

Authors: David Dejour, Wilson Vanconcelos, Nicolas Bonin, Paulo Renato Fernandes Saggin

Published in: International Orthopaedics | Issue 2/2013

Login to get access

Abstract

Purpose

The aim of the study was to compare three different procedures performed by the same surgeon: mono-bundle patellar tendon reconstruction (bone-patellar tendon-bone, BPTB), double-bundle hamstring reconstruction (DBH) and mono-bundle patellar tendon combined with extra-articular reconstruction (Lemaire) (BPTB + L).

Methods

A total of 75 patients (25 in each group) were evaluated at a mean follow-up of 25 months. Laxity was assessed pre- and post-operatively with Telos™ stress radiographs (15 kg). The amount of anterior tibial translation (ATT) corrected by the surgery was quantified. Secondary outcomes were International Knee Documentation Committee (IKDC) scores, pivot shift grading, pain complaints, sensory deficits, subsequent surgical procedures, return to sports and patients’ ability to kneel or squat on their affected knee.

Results

Absolute correction of ATT for the internal compartment was not statistically significant [analysis of variance (ANOVA), p = 0.377]. For the external compartment BPTB + L (8.2 mm) showed superiority over DBH (5.6 mm) and BPTB (4.1 mm) (ANOVA, p = 0.0001, Tukey’s test). Kneeling was better in the DBH group (ANOVA, p = 0.0001, Tukey’s test). In 22 patients it felt normal, while only in seven in the BPTB and eight in the BPTB + L groups. Sensory deficits were present in 11 patients from the DBH group, while in 17 in the BPTB and 19 in the BPTB + L groups (ANOVA, p = 0.052). Mean IKDC values, presence of anterior knee pain, subsequent operations, ability to squat and return to sports were not statistically different between groups.

Conclusions

Absolute correction of ATT was not statistically different for the medial compartment, but the patellar tendon reconstruction combined with the extra-articular procedure achieved the best lateral compartment ATT correction. Sensory deficits and kneeling seem to be worse in the groups where the patellar tendon is harvested.
Literature
1.
Yasuda K, Tanabe Y, Kondo E, Kitamura N, Tohyama H (2010) Anatomic double-bundle anterior cruciate ligament reconstruction. Arthroscopy 26(9 Suppl):S21–S34PubMed
2.
Aglietti P, Giron F, Losco M, Cuomo P, Ciardullo A, Mondanelli N (2010) Comparison between single- and double-bundle anterior cruciate ligament reconstruction: a prospective, randomized, single-blinded clinical trial. Am J Sports Med 38(1):25–34PubMedCrossRef
3.
Järvelä T (2007) Double-bundle versus single-bundle anterior cruciate ligament reconstruction: a prospective, randomize clinical study. Knee Surg Sports Traumatol Arthrosc 15(5):500–507PubMedCrossRef
4.
Siebold R, Dehler C, Ellert T (2008) Prospective randomized comparison of double-bundle versus single-bundle anterior cruciate ligament reconstruction. Arthroscopy 24(2):137–145PubMedCrossRef
5.
Aglietti P, Giron F, Buzzi R, Biddau F, Sasso F (2004) Anterior cruciate ligament reconstruction: bone-patellar tendon-bone compared with double semitendinosus and gracilis tendon grafts. A prospective, randomized clinical trial. J Bone Joint Surg Am 86-A(10):2143–2155PubMed
6.
Aune AK, Holm I, Risberg MA, Jensen HK, Steen H (2001) Four-strand hamstring tendon autograft compared with patellar tendon-bone autograft for anterior cruciate ligament reconstruction. A randomized study with two-year follow-up. Am J Sports Med 29(6):722–728PubMed
7.
Shaieb MD, Kan DM, Chang SK, Marumoto JM, Richardson AB (2002) A prospective randomized comparison of patellar tendon versus semitendinosus and gracilis tendon autografts for anterior cruciate ligament reconstruction. Am J Sports Med 30(2):214–220PubMed
8.
Anderson AF, Snyder RB, Lipscomb AB Jr (2001) Anterior cruciate ligament reconstruction. A prospective randomized study of three surgical methods. Am J Sports Med 29(3):272–279PubMed
9.
Webster KE, Feller JA, Hameister KA (2001) Bone tunnel enlargement following anterior cruciate ligament reconstruction: a randomised comparison of hamstring and patellar tendon grafts with 2-year follow-up. Knee Surg Sports Traumatol Arthrosc 9(2):86–91PubMedCrossRef
10.
Feller JA, Webster KE (2003) A randomized comparison of patellar tendon and hamstring tendon anterior cruciate ligament reconstruction. Am J Sports Med 31(4):564–573PubMed
11.
Samuelsson K, Andersson D, Karlsson J (2009) Treatment of anterior cruciate ligament injuries with special reference to graft type and surgical technique: an assessment of randomized controlled trials. Arthroscopy 25(10):1139–1174PubMedCrossRef
12.
Marcacci M, Zaffagnini S, Giordano G, Iacono F, Presti ML (2009) Anterior cruciate ligament reconstruction associated with extra-articular tenodesis: a prospective clinical and radiographic evaluation with 10- to 13-year follow-up. Am J Sports Med 37(4):707–714PubMedCrossRef
13.
Lerat JL, Mandrino A, Besse JL, Moyen B, Brunet-Guedj E (1997) Effect of external extra-articular ligament plasty on the results of anterior cruciate ligament reconstruction with patellar tendon, a 4 years follow-up. Rev Chir Orthop Reparatrice Appar Mot 83(7):591–601PubMed
14.
Noyes FR, Barber SD (1991) The effect of an extra-articular procedure on allograft reconstructions for chronic ruptures of the anterior cruciate ligament. J Bone Joint Surg Am 73(6):882–892PubMed
15.
van Eck CF, Schreiber VM, Mejia HA, Samuelsson K, van Dijk CN, Karlsson J, Fu FH (2010) “Anatomic” anterior cruciate ligament reconstruction: a systematic review of surgical techniques and reporting of surgical data. Arthroscopy 26(9 Suppl):S2–S12PubMed
16.
Condouret J, Cohn J, Ferret J-M, Lemonsu A, Vasconcelos W, Dejour D, Potel J-F et al (2008) Isokinetic assessment with two years follow-up of anterior cruciate ligament reconstruction with patellar tendon or hamstring tendons. Rev Chir Orthop Reparatrice Appar Mot 94(8 Suppl):375–382PubMedCrossRef
17.
Prado RK, Ntagiopoulos PG, Fucs PMB, Severino NR, Dejour D (2012) A new technique in double-bundle anterior cruciate ligament reconstruction using implant-free femoral fixation. Int Orthop 36(7):1479–1485, discussion 1539–1541PubMedCrossRef
18.
Dejour H, Dejour D, Aït Si Selmi T (1999) Chronic anterior laxity of the knee treated with free patellar graft and extra-articular lateral plasty: 10-year follow-up of 148 cases. Rev Chir Orthop Reparatrice Appar Mot 85(8):777–789, 85PubMed
19.
Lemaire M (1967) Rupture ancienne du ligament croisé antérieur du genou; fréquence, clinique, traitement (46 cas). J Chirurgie 311–320
20.
Beldame J, Bertiaux S, Roussignol X, Lefebvre B, Adam J-M, Mouilhade F, Dujardin F (2011) Laxity measurements using stress radiography to assess anterior cruciate ligament tears. Orthop Traumatol Surg Res 97(1):34–43PubMedCrossRef
21.
Jacobsen K (1976) Stress radiographical measurement of the anteroposterior, medial and lateral stability of the knee joint. Acta Orthop Scand 47(3):335–334PubMedCrossRef
22.
Kartus J, Magnusson L, Stener S, Brandsson S, Eriksson BI, Karlsson J (1999) Complications following arthroscopic anterior cruciate ligament reconstruction. A 2-5-year follow-up of 604 patients with special emphasis on anterior knee pain. Knee Surg Sports Traumatol Arthrosc 7(1):2–8PubMedCrossRef
23.
Laxdal G, Sernert N, Ejerhed L, Karlsson J, Kartus JT (2007) A prospective comparison of bone-patellar tendon-bone and hamstring tendon grafts for anterior cruciate ligament reconstruction in male patients. Knee Surg Sports Traumatol Arthrosc 15(2):115–125PubMedCrossRef
Metadata
Title
Comparative study between mono-bundle bone-patellar tendon-bone, double-bundle hamstring and mono-bundle bone-patellar tendon-bone combined with a modified Lemaire extra-articular procedure in anterior cruciate ligament reconstruction
Authors
David Dejour
Wilson Vanconcelos
Nicolas Bonin
Paulo Renato Fernandes Saggin
Publication date
01-02-2013
Publisher
Springer-Verlag
Published in
International Orthopaedics / Issue 2/2013
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-012-1718-z

Other articles of this Issue 2/2013

International Orthopaedics 2/2013 Go to the issue

Original Paper

Long-term outcomes following single-bundle transtibial arthroscopic posterior cruciate ligament reconstruction

Original Paper

Hamstring tendon anterior cruciate ligament reconstruction: does gracilis tendon harvest matter?

Original Paper

Second-look arthroscopic findings and clinical results after polyethylene terephthalate augmented anterior cruciate ligament reconstruction

Original Paper

Long-term outcome of anterior cruciate ligament reconstruction with an autologous four-strand semitendinosus tendon autograft

Review Article

Synthetic meniscus replacement: a review

Original Paper

An extra-articular procedure improves the clinical outcome in anterior cruciate ligament reconstruction with hamstrings in female athletes