Comparison of "ligamentization" process between preserved insertion hamstring tendon autograft and bone-patellar tendon-bone autograft.

ACL BPTB Hamstring tendon graft with preserved insertion Ligamentization Lysholm score

Journal

Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association
ISSN: 1436-2023
Titre abrégé: J Orthop Sci
Pays: Japan
ID NLM: 9604934

Informations de publication

Date de publication:
27 Jul 2023
Historique:
received: 16 10 2022
revised: 07 06 2023
accepted: 24 06 2023
medline: 30 7 2023
pubmed: 30 7 2023
entrez: 29 7 2023
Statut: aheadofprint

Résumé

Ligamentization is a complex process and effect of preservation of hamstring tendon graft insertion on this process is not well studied. Present study was conducted to analyze and compare the ligamentization of semitendinosus gracilis graft with preserved tibial insertion (STGPI) and bone-patellar tendon-bone (BPTB) autografts. A total of 50 sportspeople who underwent ACL reconstruction using either BPTB (group A; n = 25) or STGPI (group B; n = 25) autografts were included in the study. Contrast enhanced MRI was done at 8 months and 14 months post-ACL reconstruction to evaluate the ligamentization using Signal noise quotient (SNQ), graft intensity and enhancement index. Clinical outcomes (Lysholm score) and knee laxity were also assessed at 8 months and 14 months. 18/23 (78%) patients in group A and 14/23 (61%) patients in group B had hyperintense graft signal at 8 months (n.s.) and at 14 months, 1/23 patients in group A and none of the patients in group B had hyperintense graft. SNQ at 8 months was 3.6 ± 2 and 3.7 ± 2 in group A and B respectively (n.s.) and at 14 months, SNQ was 2.5 ± 1.5 in group A and 2.4 ± 1.3 in group B (n.s.). Enhancement index at 8 months was 1.5 ± 0.3 and 1.2 ± 0.3 in group A and B respectively (p = 0.0001). Enhancement index at 14 months was 1.21 ± 0.2 in group A and 1.07 ± 0.2 in group B (p = 0.003). Functional outcomes and knee laxity were comparable in both the groups at 8 and 14 months (n.s.). Both the grafts i.e. BPTB and STGPI are similar in terms of rate and extent of ligamentization. Clinical outcomes and knee laxity are also comparable between two grafts.

Sections du résumé

BACKGROUND BACKGROUND
Ligamentization is a complex process and effect of preservation of hamstring tendon graft insertion on this process is not well studied. Present study was conducted to analyze and compare the ligamentization of semitendinosus gracilis graft with preserved tibial insertion (STGPI) and bone-patellar tendon-bone (BPTB) autografts.
METHODS METHODS
A total of 50 sportspeople who underwent ACL reconstruction using either BPTB (group A; n = 25) or STGPI (group B; n = 25) autografts were included in the study. Contrast enhanced MRI was done at 8 months and 14 months post-ACL reconstruction to evaluate the ligamentization using Signal noise quotient (SNQ), graft intensity and enhancement index. Clinical outcomes (Lysholm score) and knee laxity were also assessed at 8 months and 14 months.
RESULTS RESULTS
18/23 (78%) patients in group A and 14/23 (61%) patients in group B had hyperintense graft signal at 8 months (n.s.) and at 14 months, 1/23 patients in group A and none of the patients in group B had hyperintense graft. SNQ at 8 months was 3.6 ± 2 and 3.7 ± 2 in group A and B respectively (n.s.) and at 14 months, SNQ was 2.5 ± 1.5 in group A and 2.4 ± 1.3 in group B (n.s.). Enhancement index at 8 months was 1.5 ± 0.3 and 1.2 ± 0.3 in group A and B respectively (p = 0.0001). Enhancement index at 14 months was 1.21 ± 0.2 in group A and 1.07 ± 0.2 in group B (p = 0.003). Functional outcomes and knee laxity were comparable in both the groups at 8 and 14 months (n.s.).
CONCLUSION CONCLUSIONS
Both the grafts i.e. BPTB and STGPI are similar in terms of rate and extent of ligamentization. Clinical outcomes and knee laxity are also comparable between two grafts.

Identifiants

pubmed: 37516643
pii: S0949-2658(23)00191-4
doi: 10.1016/j.jos.2023.06.014
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2023 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest The authors had no conflict of interest related to research and authorship is granted to only those individuals who have contributed substantially to the manuscript.

Auteurs

Ravi Gupta (R)

Director Orthopaedics, Fortis Hospital, Mohali, Punjab, India. Electronic address: ravikgupta2000@yahoo.com.

Sandeep Singh (S)

Department of Orthopaedics, Government Medical College Hospital, Chandigarh, India. Electronic address: mailsandy28@gmail.com.

Anil Kapoor (A)

Department of Orthopaedics, Government Medical College Hospital, Chandigarh, India. Electronic address: anil88gmch@gmail.com.

Ashwani Soni (A)

Department of Orthopaedics, Government Medical College Hospital, Chandigarh, India. Electronic address: asoniortho@gmail.com.

Rohil Mehta (R)

Department of Orthopaedics, Government Medical College Hospital, Chandigarh, India. Electronic address: rohil.mart11@gmail.com.

Ravinder Kaur (R)

Department of Radio-Diagnosis, Government Medical College Hospital, Chandigarh, India. Electronic address: drravinder19@gmail.com.

Gladson David Masih (GD)

Department of Orthopaedics, Government Medical College Hospital, Chandigarh, India. Electronic address: gladsondavid32@gmail.com.

Classifications MeSH