Clinical outcomes of primary anatomic all-inside Anterior Cruciate Ligament reconstruction using the TransLateral technique: A minimum one-year follow-up study.


Journal

The Knee
ISSN: 1873-5800
Titre abrégé: Knee
Pays: Netherlands
ID NLM: 9430798

Informations de publication

Date de publication:
Dec 2020
Historique:
received: 16 09 2019
revised: 14 07 2020
accepted: 14 09 2020
pubmed: 17 11 2020
medline: 6 5 2021
entrez: 16 11 2020
Statut: ppublish

Résumé

Anatomic all-inside Anterior Cruciate Ligament (ACL) reconstruction using the TransLateral technique is relatively new. This technique utilises single tendon autograft and instruments permitting inside-to-out drilling to create retrograde sockets. Few studies have investigated clinical outcomes following this technique. We investigate clinical outcomes in patients who underwent primary anatomic all-inside ACL reconstruction using the TransLateral technique with a minimum one-year follow-up. Interrogation of our prospectively maintained database identified patients who underwent surgery from June 2013 to December 2017. Patients were followed up clinically and using patient-reported outcome measures (PROMS) including EQ-5D, KOOS, IKDC and Tegner scores from the National Ligament Registry. Paired two-tailed Student t-test was used to assess for clinical significance. One hundred forty-one cases with a mean age of 30 years (range 16.0-60.2) and mean follow-up of 17.4 months (12.1-75.2) were included. Grafts included isolated quadrupled semitendinosus (n = 115) and both quadrupled semitendinosus and gracilis (n = 26). One hundred and two patients (72.3%) had complete peri-operative PROMS. Mean increases in EQ-5D VAS and IKDC scores were 18.9 and 29.2 points (p < 0.001). Significant peri-operative improvements were observed for all KOOS domains (p < 0.001). Median Tegner activity score increased by two levels (p < 0.001). Incidence of graft re-rupture was 5.7% (n = 8), all were following significant knee trauma and seven cases were mid-bundle femoral tunnel placements. All-inside ACL reconstruction using the TransLateral technique demonstrates good clinical and functional outcomes with low complication and failure rate. Mid-bundle femoral tunnel placements have been abandoned in favour of placement deep within the anteromedial bundle footprint.

Sections du résumé

BACKGROUND BACKGROUND
Anatomic all-inside Anterior Cruciate Ligament (ACL) reconstruction using the TransLateral technique is relatively new. This technique utilises single tendon autograft and instruments permitting inside-to-out drilling to create retrograde sockets. Few studies have investigated clinical outcomes following this technique. We investigate clinical outcomes in patients who underwent primary anatomic all-inside ACL reconstruction using the TransLateral technique with a minimum one-year follow-up.
METHODS METHODS
Interrogation of our prospectively maintained database identified patients who underwent surgery from June 2013 to December 2017. Patients were followed up clinically and using patient-reported outcome measures (PROMS) including EQ-5D, KOOS, IKDC and Tegner scores from the National Ligament Registry. Paired two-tailed Student t-test was used to assess for clinical significance.
RESULTS RESULTS
One hundred forty-one cases with a mean age of 30 years (range 16.0-60.2) and mean follow-up of 17.4 months (12.1-75.2) were included. Grafts included isolated quadrupled semitendinosus (n = 115) and both quadrupled semitendinosus and gracilis (n = 26). One hundred and two patients (72.3%) had complete peri-operative PROMS. Mean increases in EQ-5D VAS and IKDC scores were 18.9 and 29.2 points (p < 0.001). Significant peri-operative improvements were observed for all KOOS domains (p < 0.001). Median Tegner activity score increased by two levels (p < 0.001). Incidence of graft re-rupture was 5.7% (n = 8), all were following significant knee trauma and seven cases were mid-bundle femoral tunnel placements.
CONCLUSIONS CONCLUSIONS
All-inside ACL reconstruction using the TransLateral technique demonstrates good clinical and functional outcomes with low complication and failure rate. Mid-bundle femoral tunnel placements have been abandoned in favour of placement deep within the anteromedial bundle footprint.

Identifiants

pubmed: 33197814
pii: S0968-0160(20)30322-7
doi: 10.1016/j.knee.2020.09.014
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1753-1763

Informations de copyright

Copyright © 2020 Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest We confirm that there are no conflicts of interest.

Auteurs

Wahid Abdul (W)

Department of Trauma & Orthopaedics, Princess of Wales Hospital, Bridgend CF31 1RQ, Wales, United Kingdom. Electronic address: abdulw@cardiff.ac.uk.

Randy Guro (R)

Department of Trauma & Orthopaedics, Princess of Wales Hospital, Bridgend CF31 1RQ, Wales, United Kingdom.

Zayd Jawad (Z)

Department of Trauma & Orthopaedics, Princess of Wales Hospital, Bridgend CF31 1RQ, Wales, United Kingdom.

Rahul Kotwal (R)

Department of Trauma & Orthopaedics, Princess of Wales Hospital, Bridgend CF31 1RQ, Wales, United Kingdom.

Amit Chandratreya (A)

Department of Trauma & Orthopaedics, Princess of Wales Hospital, Bridgend CF31 1RQ, Wales, United Kingdom.

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