Journal of Clinical Orthopaedics | Vol 5 | Issue 1 |  Jan-Jun 2020 | page:15-20 | Chad Lasceski, Chris Nacca, Sarav S. Shah, John C. Richmond

Author: Chad Lasceski [1], Chris Nacca [1], Sarav S. Shah [1], John C. Richmond [2]

[1] Department of Orthopedics 4th Floor 125 Parker Hill Avenue, Boston, MA 02120
[2] Department of Orthopedics Surgery 4th Floor 125 Parker Hill Avenue, Boston, MA 02120

Address of Correspondence
Dr. John C. Richmond,
Department of Orthopedics Surgery 4th Floor 125 Parker Hill Avenue, Boston, MA 02120
E-mail: jrichmon@nebh.org

Abstract

Surgical treatment of anterior cruciate injury (ACL) has evolved over the last 40 years. Both patient as well as surgeon considerations must be made to optimize the successful treatment of an ACL injured patient. The focus of this paper is to discuss several of the many important issues that continue as topics of discussion in the literature and on the podium. These include graft selection and preparation, the role of anterior cruciate ligament repair, extra-articular tenodesis, and posterior tibial slope (PTS). We will present the current data as it pertains to these topics and include the senior author’s preferences derived from 40 years of personal experience.
Keywords: ACL reconstruction, ACL repair, extra-articular tenodesis, ACL graft choice, posterior tibial slope.

References

1. Gordon MD, Steiner ME. Anterior cruciate ligament injuries. In: Orthopaedic Knowledge Update Sports Medicine III, Garrick JG (Ed), American Academy of Orthopaedic Surgeons, Rosemont 2004. p.169
2. Albright JC, Carpenter JE, Graf BK, et al. Knee and leg: soft tissue trauma. In: Orthopaedic Knowledge Update 6, Beaty JH (Ed), American Academy of Orthopaedic Surgeons, Rosemont 1999. p.533
3. Miyasaka KC, Daniel DM, Stone ML. The incidence of knee ligament injuries in the general population. Am J Knee Surg. 1991; 4:43.
4. Markolf KL, Mensch JS, Amstutz HC. Stiffness and laxity of the knee–the contributions of the supporting structures. A quantitative in vitro study. J Bone Joint Surg Am. 1976;58(5):583-94.
5. Daniel DM, Stone ML, Dobson BE, et al. Fate of the ACL-injured patient. A prospective outcome study. Am J Sports Med. 1994;22(5):632–644.
6. Georgoulis AD, Ristanis S, Moraiti CO, et al. ACL injury and reconstruction: Clinical related in vivo biomechanics. Orthop Traumatol Surg Res. 2010;96(8 Suppl):S119–S128.
7. Loh JC, Fukuda Y, Tsuda E, et al. Knee stability and graft function following anterior cruciate ligament reconstruction: Comparison between 11 o’clock and 10 o’clock femoral tunnel placement. 2002 Richard O’Connor Award paper. Arthroscopy. 2003;19(3):297–304
8. Ajuied A, Wong F, Smith C, et al. Anterior cruciate ligament injury and radiologic progression of knee osteoarthritis: a systematic review and meta-analysis. Am J Sports Med. 2014;42(9):2242–2252.
9. Øiestad BE, Holm I, Risberg MA. Return to pivoting sport after ACL reconstruction: association with osteoarthritis and knee function at the 15-year follow-up. Br J Sports Med. 2018;52(18):1199–1204.
10. Goldblatt J.P., Fitzsimmons S.E., Balk E., Richmond J.C. Reconstruction of the anterior cruciate ligament: Meta-analysis of patellar tendon versus hamstring tendon autograft. Arthroscopy. 2005;21:791–803.
11. Biau DJ, Katsahian S, Kartus J, et al. Patellar tendon versus hamstring tendon autografts for reconstructing the anterior cruciate ligament: a meta-analysis based on individual patient data. Am J Sports Med. 2009;37(12):2470–2478.
12. Gifstad T, Foss OA, Engebretsen L, et al. Lower risk of revision with patellar tendon autografts compared with hamstring autografts: a registry study based on 45,998 primary ACL reconstructions in Scandinavia. Am J Sports Med. 2014;42(10):2319–2328.
13. Rahardja R, Zhu M, Love H, Clatworthy MG, Monk AP, Young SW. Effect of graft choice on revision and contralateral anterior cruciate ligament reconstruction: Results from the New Zealand ACL Registry. Am J Sports Med. 2020;48(1):63–69.
14. MOON Knee Group, Spindler KP, Huston LJ, et al. Anterior cruciate ligament reconstruction in high school and college-aged athletes: Does autograft choice influence anterior cruciate ligament revision rates? Am J Sports Med. 2020;48(2):298–309.
15. Chee MY, Chen Y, Pearce CJ, et al. Outcome of patellar tendon versus 4-strand hamstring tendon autografts for anterior cruciate ligament reconstruction: A systematic review and meta-analysis of prospective randomized trials. Arthroscopy. 2017;33(2):450–463.
16. Mariscalco MW, Flanigan DC, Mitchell J, Pedroza AD, Jones MH, Andrish JT, Parker RD, Kaeding CC, Magnussen RA. The influence of hamstring autograft size on patient-reported outcomes and risk of revision after anterior cruciate ligament reconstruction: A Multicenter Orthopaedic Outcomes Network (MOON) Cohort Study. Arthroscopy. 2013 Dec;29(12):1948-53.
17. Figueroa F, Figueroa, Espregueira-Mendes J. Hamstring autograft size importance in anterior cruciate ligament repair surgery. EFORT Open Rev 2018;3:93-97.
18. Kaeding CC, Pedroza AD, Reinke EK, et al. Risk factors and predictors of subsequent ACL injury in either knee after ACL reconstruction: Prospective analysis of 2488 primary ACL reconstructions from the MOON cohort. Am J Sports Med. 2015;43(7):1583-1590.
19. Vertullo CJ, Quick M, Jones A, Grayson JE. A surgical technique using presoaked vancomycin hamstring grafts to decrease the risk of infection after anterior cruciate ligament reconstruction. Arthroscopy. 2012;28(3):337-342.
20. Baron JE, Shamrock AG, Cates WT, Cates RA, An Q, Wolf BR, et al. Graft preparation with intraoperative vancomycin decreases infection after ACL reconstruction. J Bone Joint Surg Am. 2019;101(24):2187-2193.
21. Nakayama H, Yagi M, Yoshiya S, Takesue Y. Micro-organism colonization and intra-operative contamination in patients undergoing arthroscopic anterior cruciate ligament reconstruction. Arthroscopy. 2012;28(5):667–671.
22. Feagin JA, Abbott HG, Rokous JA. The isolated tear of the anterior cruciate ligament. J Bone Joint Surg Am. 1972;54(6):1340-1341.
23. Feagin JA, Curl WW. Isolated tear of the anterior cruciate ligament: 5-year follow-up study. Am J Sports Med 1976;4(3):95-100.
24. Taylor DC, Posner M, Curl WW, Feagin JA. Isolated tears of the anterior cruciate ligament. Over 30-year follow-up of patients treated with arthrotomy and primary repair. Am J Sports Med. 2009;37(1):65-71.
25. Kaplan N, Wickiewicz TL, Warren RF. Primary surgical treatment of anterior cruciate ligament ruptures. A long-term follow-up study. Am J Sports Med. 1990;18(4):354-358.
26. Jonkergouw A, Van der List JP, DiFelice GS. Arthoroscopic primary repair of proximal anterior cruciate ligament tears: outcomes of the first 56 consecutive patients and the role of additional internal bracing. Knee Surg Sports Traumatol Arthros 2019 Jan; 27(1):21-28.
27. Van der List JP, Jonkergouw A, van Noort A, Kerkhoffs GMMJ, DiFelice GS. Identifying candidates for arthroscopic primary repair of the anterior cruciate ligament: A case-control study. Knee. 2019 Jun;26(3):619-627
28. Nwachukwu BU, Patel BH, Allen AA, Williams RJ. Anterior cruciate ligament repair outcomes: An updated systematic review of recent literature. Arthroscopy. 2019 July;35(7)2233-2247.
29. Waryasz GR, Marcaccio S, Gil JA, Owens BD, Fadale PD. Anterior cruciate ligament repair and biologic innovations. JBJS Rev. 2017;5(5): http://dx.doi.org/10.2106/JBJS.RVW.16.00050
30. Dunn MG, Liesch JB, Tiku ML, Zawadsky JP. Development of fibroblast-seeded ligament analogs for ACL reconstruction. J Biomed Mater Res. 1995;29(11):1363-1371.
31. Murray MM, Kalish LA, Fleming BC, et al. Bridge-enhanced anterior cruciate ligament repair: Two-year results of a first-in-human study. Ortho J Sports Med. 2019;7(3):1-13.
32. Segond P. Recherches cliniques et expérimentales sur les épanchements sanguins du genou par entorse. Progrès Médical 1879; 16: 297–299, 319–321, 340–341
33. Hughston JC, Andrews JR, Cross MJ, Moschi A. Classification of knee ligament instabilities. Part II. The lateral compartment. J Bone Joint Surg Am. 1976;58(2):173–179.
34. Claes S, Vereecke E, Maes M, Victor J, Verdonk P, Bellemans J. Anatomy of the anterolateral ligament of the knee. J Anat. 2013;223(4):321–328. doi:10.1111/joa.12087
35. Song GY, Hong L, Zhang H, Zhang J, et al. Clinical outcomes of combined lateral extra-articular tenodesis and intra-articular anterior cruciate ligament reconstruction in addressing high-grade pivot-shift phenomenon. Arthroscopy. 2016;32(5):898–905.
36. Sonnery-Cottet B, Barbosa NC, Vieira TD, Saithna A. Clinical outcomes of extra-articular tenodesis/anterolateral reconstruction in the ACL injured knee. Knee Surg Sports Traumatol Arthrosc. 2018;26(2):596–604.
37. Sonnery-Cottet B, Saithna A, Frois Temponi E, et al. Anterolateral ligament reconstruction is associated with significantly reduced ACL graft rupture rates at a minimum follow-up of 2 years: A prospective comparative study of 502 patients from the SANTI study group. Am J Sports Med. 2017;45(7):1547-1557.
38. Getgood AMJ, Bryant DM, Litchfield R, et al. Lateral extra-articular tenodesis reduces failure of hamstring tendon autograft anterior cruciate ligament reconstruction: 2-year outcomes from the STABILITY study randomized clinical trial. Am J Sports Med. 2020;48(2):285–297.
39. Ferreira Mde C, Zidan FF, Miduati FB, et al. Reconstruction of anterior cruciate ligament and anterolateral ligament using interlinked hamstrings – technical note. Rev Bras Ortop. 2016;51(4):466–470.
40. Todd MS, Laliss S, Garcia E, et al. The relationship between posterior tibial slope and anterior cruciate ligament injuries. Am J Sports Med. 2010;38(1):63-67.
41. Webb JM, Salmon LJ, Leclerc E, Pinczewski LA, et al. Posterior tibial slope and further anterior cruciate ligament injuries in the anterior cruciate ligament-reconstructed patient. Am J Sports Med. 2013;41(12):2800-2804.
42. Dejour D, Saffarini M, Demey G, Baverel L. Tibial slope correction combined with second revision ACL produces good knee stability and prevents graft rupture. Knee Surg Sports Traumatol Arthrosc. 2015;23(10):2846-2852.

(Abstract    Full Text HTML)   (Download PDF)