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Archives of Orthopaedic and Trauma Surgery

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16-05-2024 | Revision Anterior Cruciate Ligament Reconstruction | Arthroscopy and Sports Medicine

A novel surgical technique for revision anterior cruciate ligament reconstruction using an isolated rectus femoris tendon autograft

Authors: Thorsten Huber, Marcel Frühwirth, Florian Hartenbach, Sarah Franzmair, David Ullmann, Björn Rath

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 6/2024

Abstract

Introduction

Only a few anatomic studies have described an isolated rectus femoris tendon autograft for anterior cruciate ligament (ACL) reconstruction. This study aims to demonstrate a new surgical technique utilising the rectus femoris tendon for ACL reconstruction. This study hypothesises that the rectus tendon autograft will yield satisfying postoperative outcomes in terms of stability, with minimal complications at the harvest site.

Methods

This retrospective study investigated the outcomes of 28 revision ACL reconstructions using a rectus tendon autograft with a mean follow-up of 41.7 (range, 24.0-64.8) months. A 3 cm longitudinal incision was used to harvest the rectus tendon with an open tendon stripper. Intraoperative collected data included the length of the tendon and thickness of a 4-fold graft. Further outcome parameters include anterior cruciate ligament stability and range of motion. Additionally, postoperative complications, especially donor site morbidity, were documented in type and frequency.

Results

The mean tendon length measured 32.4 cm (range, 30–35 cm). After preparing a 4-fold graft, the mean diameter was 9.2 mm (range, 8.0-10 mm) at the tibial and 9.0 mm (range, 7.5-10 mm) at the femoral end. Stability evaluated by the Lachman test improved significantly from 2 (Interquartile range (IQR), 2–3) preoperatively to 0 (IQR, 0–1) postoperatively (p < .001). Rerupture of the anterior cruciate ligament graft was observed in 2 patients (7.1%). Four patients showed a persistent extension deficit of about 5 degrees postoperatively. Two of them underwent revision surgery due to a Cyclops lesion. Only one patient complained of prolonged pain at the harvest site (3.6%).

Conclusion

The 4-fold rectus tendon represents a novel autograft technique in revision ACL reconstruction. This study provides evidence of appropriate graft dimensions and satisfying postoperative outcomes regarding stability. The technique is associated with a low complication rate at the harvest site.

Study design

Case series; Level of evidence, IV.

Available only for authorised users

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Title: A novel surgical technique for revision anterior cruciate ligament reconstruction using an isolated rectus femoris tendon autograft
Authors: Thorsten Huber
Marcel Frühwirth
Florian Hartenbach
Sarah Franzmair
David Ullmann
Björn Rath
Publication date: 16-05-2024
Publisher: Springer Berlin Heidelberg
Keyword: Revision Anterior Cruciate Ligament Reconstruction
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 6/2024
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-024-05268-8

EASD 2024

Springer Medicine

A novel surgical technique for revision anterior cruciate ligament reconstruction using an isolated rectus femoris tendon autograft

Abstract

Introduction

Methods

Results

Conclusion

Study design

EASD 2024

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

Study design

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