Tags

Type your tag names separated by a space and hit enter

Superior graft maturation after anatomical double-bundle anterior cruciate ligament reconstruction using the transtibial drilling technique compared to the transportal technique.
Knee Surg Sports Traumatol Arthrosc. 2019 Aug; 27(8):2468-2477.KS

Abstract

PURPOSE

To evaluate and compare the femoral tunnel aperture position, graft bending angle and the magnetic resonance imaging (MRI) graft signal intensity after anatomical double-bundle anterior cruciate ligament (ACL) reconstruction between transtibial and transportal drilling techniques of the femoral tunnel.

METHODS

Eighty-seven patients who underwent anatomic double-bundle ACL reconstruction with hamstring tendon autograft between January 2012 and December 2014 were included in this retrospective study. Forty-one patients underwent reconstruction using a transportal technique (TP group) and 46 patients underwent reconstruction using a transtibial technique (TT group). The anteromedial (AM) femoral aperture position and the graft bending angle were assessed using transparent three-dimensional CT 2 weeks postoperatively. MRI assessment was performed with proton density-weighted images in an oblique coronal plane 6 and 12 months postoperatively. Signal/noise quotient was calculated for two specific graft sites (femoral tunnel site and mid-substance site). Femoral aperture position, the graft bending angle and signal/noise quotient were compared between the TP and TT groups.

RESULTS

There was no significant difference in the aperture position between the two groups. The graft bending angle of the AM tunnel in the axial plane was significantly greater in the TP group (p < 0.001). On the other hand, the TP group had a significantly more acute angle in the coronal plane (p < 0.001). There was no significant difference at either site in the signal/noise quotient of the graft between the two groups at 6 months. However, the TT group had a lower signal/noise quotient at 12 months at both sites (femoral aperture: p = 0.04, mid-substance: p = 0.004).

CONCLUSION

There was a significant difference in signal/noise quotient between the two drilling techniques 12 months postoperatively. There was no significant difference in femoral tunnel aperture position between the two groups. However, graft bending angle at the femoral tunnel aperture was significantly different between the two groups, indicating the possibility that graft bending angle is a factor that influences graft maturation. This indicates that the TT technique has an advantage over the TP technique in terms of graft maturation.

Authors+Show Affiliations

Department of Orthopaedic Surgery, Chiba Medical Center, 1-7-1 Minami-cho, Chuo-ku, Chiba, 260-0842, Japan. masahi1214@hotmail.com.Department of Orthopaedic Surgery, Toho University Sakura Medical Center (Chiba), 564-1 Shimoshizu, Sakura, Chiba, 285-0841, Japan.Department of Orthopaedic Surgery, Toho University Sakura Medical Center (Chiba), 564-1 Shimoshizu, Sakura, Chiba, 285-0841, Japan.Department of Orthopaedic Surgery, Toho University Sakura Medical Center (Chiba), 564-1 Shimoshizu, Sakura, Chiba, 285-0841, Japan.Department of Orthopaedic Surgery, Toho University Sakura Medical Center (Chiba), 564-1 Shimoshizu, Sakura, Chiba, 285-0841, Japan.Department of Radiology, Toho University Sakura Medical Center (Chiba), Chiba, Japan.Department of Orthopaedic Surgery, Chiba Medical Center, 1-7-1 Minami-cho, Chuo-ku, Chiba, 260-0842, Japan.Department of Orthopaedic Surgery, Chiba Medical Center, 1-7-1 Minami-cho, Chuo-ku, Chiba, 260-0842, Japan.Department of Orthopaedic Surgery, Eastern Chiba Medical Center, 3-6-2 Okayamadai, Tougane, Chiba, 283-8686, Japan.Department of Orthopaedic Surgery, Eastern Chiba Medical Center, 3-6-2 Okayamadai, Tougane, Chiba, 283-8686, Japan.Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuou-ku, Chiba, 260-8670, Japan.Department of Radiology, Toho University Sakura Medical Center (Chiba), Chiba, Japan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30374576

Citation

Saito, Masahiko, et al. "Superior Graft Maturation After Anatomical Double-bundle Anterior Cruciate Ligament Reconstruction Using the Transtibial Drilling Technique Compared to the Transportal Technique." Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA, vol. 27, no. 8, 2019, pp. 2468-2477.
Saito M, Nakajima A, Sonobe M, et al. Superior graft maturation after anatomical double-bundle anterior cruciate ligament reconstruction using the transtibial drilling technique compared to the transportal technique. Knee Surg Sports Traumatol Arthrosc. 2019;27(8):2468-2477.
Saito, M., Nakajima, A., Sonobe, M., Takahashi, H., Akatsu, Y., Inaoka, T., Iwasaki, J., Morikawa, T., Watanabe, A., Aoki, Y., Sasho, T., & Nakagawa, K. (2019). Superior graft maturation after anatomical double-bundle anterior cruciate ligament reconstruction using the transtibial drilling technique compared to the transportal technique. Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA, 27(8), 2468-2477. https://doi.org/10.1007/s00167-018-5240-8
Saito M, et al. Superior Graft Maturation After Anatomical Double-bundle Anterior Cruciate Ligament Reconstruction Using the Transtibial Drilling Technique Compared to the Transportal Technique. Knee Surg Sports Traumatol Arthrosc. 2019;27(8):2468-2477. PubMed PMID: 30374576.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Superior graft maturation after anatomical double-bundle anterior cruciate ligament reconstruction using the transtibial drilling technique compared to the transportal technique. AU - Saito,Masahiko, AU - Nakajima,Arata, AU - Sonobe,Masato, AU - Takahashi,Hiroshi, AU - Akatsu,Yorikazu, AU - Inaoka,Tsutomu, AU - Iwasaki,Junichi, AU - Morikawa,Tsuguo, AU - Watanabe,Atsuya, AU - Aoki,Yasuchika, AU - Sasho,Takahisa, AU - Nakagawa,Koichi, Y1 - 2018/10/29/ PY - 2018/03/24/received PY - 2018/10/17/accepted PY - 2018/10/31/pubmed PY - 2019/11/23/medline PY - 2018/10/31/entrez KW - Anterior cruciate ligament KW - Graft bending angle KW - Graft maturation KW - Reconstruction KW - Signal/noise quotient KW - Transportal technique KW - Transtibial technique SP - 2468 EP - 2477 JF - Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA JO - Knee Surg Sports Traumatol Arthrosc VL - 27 IS - 8 N2 - PURPOSE: To evaluate and compare the femoral tunnel aperture position, graft bending angle and the magnetic resonance imaging (MRI) graft signal intensity after anatomical double-bundle anterior cruciate ligament (ACL) reconstruction between transtibial and transportal drilling techniques of the femoral tunnel. METHODS: Eighty-seven patients who underwent anatomic double-bundle ACL reconstruction with hamstring tendon autograft between January 2012 and December 2014 were included in this retrospective study. Forty-one patients underwent reconstruction using a transportal technique (TP group) and 46 patients underwent reconstruction using a transtibial technique (TT group). The anteromedial (AM) femoral aperture position and the graft bending angle were assessed using transparent three-dimensional CT 2 weeks postoperatively. MRI assessment was performed with proton density-weighted images in an oblique coronal plane 6 and 12 months postoperatively. Signal/noise quotient was calculated for two specific graft sites (femoral tunnel site and mid-substance site). Femoral aperture position, the graft bending angle and signal/noise quotient were compared between the TP and TT groups. RESULTS: There was no significant difference in the aperture position between the two groups. The graft bending angle of the AM tunnel in the axial plane was significantly greater in the TP group (p < 0.001). On the other hand, the TP group had a significantly more acute angle in the coronal plane (p < 0.001). There was no significant difference at either site in the signal/noise quotient of the graft between the two groups at 6 months. However, the TT group had a lower signal/noise quotient at 12 months at both sites (femoral aperture: p = 0.04, mid-substance: p = 0.004). CONCLUSION: There was a significant difference in signal/noise quotient between the two drilling techniques 12 months postoperatively. There was no significant difference in femoral tunnel aperture position between the two groups. However, graft bending angle at the femoral tunnel aperture was significantly different between the two groups, indicating the possibility that graft bending angle is a factor that influences graft maturation. This indicates that the TT technique has an advantage over the TP technique in terms of graft maturation. SN - 1433-7347 UR - https://www.unboundmedicine.com/medline/citation/30374576/Superior_graft_maturation_after_anatomical_double_bundle_anterior_cruciate_ligament_reconstruction_using_the_transtibial_drilling_technique_compared_to_the_transportal_technique_ L2 - https://dx.doi.org/10.1007/s00167-018-5240-8 DB - PRIME DP - Unbound Medicine ER -