Over-the-top ACL Reconstruction Plus Extra-articular Lateral Tenodesis With Hamstring Tendon Grafts: Prospective Evaluation With 20-Year Minimum Follow-up
Background: There are few published studies with very long-term follow-up of combined intra- and extra-articular anterior cruciate ligament (ACL) reconstruction. Purpose: To analyze clinical and radiographic outcomes of over-the-top ACL reconstruction plus extra-articular lateral tenodesis with auto...
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| Veröffentlicht in: | The American journal of sports medicine 2017-12, Vol.45 (14), p.3233-3242 |
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| creator | Zaffagnini, Stefano Marcheggiani Muccioli, Giulio Maria Grassi, Alberto Roberti di Sarsina, Tommaso Raggi, Federico Signorelli, Cecilia Urrizola, Francisco Spinnato, Paolo Rimondi, Eugenio Marcacci, Maurilio |
| description | Background:
There are few published studies with very long-term follow-up of combined intra- and extra-articular anterior cruciate ligament (ACL) reconstruction.
Purpose:
To analyze clinical and radiographic outcomes of over-the-top ACL reconstruction plus extra-articular lateral tenodesis with autologous hamstrings at minimum 20-year follow-up.
Study Design:
Case series; Level of evidence, 4.
Methods:
Of 60 originally eligible patients who underwent over-the-top ACL reconstruction with double-stranded hamstring tendon (leaving intact graft tibial insertions) and extra-articular lateral plasty (performed with the remnant part of tendons), 52 were prospectively evaluated at a minimum 20-year follow-up (mean follow-up, 24 years; 41 men, 11 women; mean age at time of surgery, 25.5 ± 7.6 years). Twenty-nine patients were available for prospective evaluations: clinical (Lysholm, Tegner, and objective International Knee Documentation Committee [IKDC]), instrumented (KT-2000), and radiographic (standard, long-standing, and Merchant views). Subjective KOOS (Knee injury and Osteoarthritis Outcome Score) and objective inertial sensor pivot-shift analysis (KiRA) were carried out at final follow-up. Twenty-three patients were investigated by phone interview for subjective Tegner score and documented complications, rerupture, or revision surgery.
Results:
At final follow-up, mean Lysholm score was 85.7 ± 14.6; median Tegner score, 4 (range, 3-5); sport activity resumption, 86.2%; and objective IKDC score, good or excellent in 86% of patients (31%, A; 55%, B). Only 3 of 26 patients (12%) had >5-mm manual maximum KT-2000 side-to-side difference. KiRA system documented positive pivot-shift (>0.9-m/s2 tibial acceleration side-to-side difference) in these 3 of 26 patients (12%). Statistically significant changes were as follows: decrease in Tegner score from 7 (range, 6-8) at 5-year follow-up to 4 (range, 3-5) at 10 years (P < .0001) and decrease in Lysholm score from 96.1 ± 7.3 at 10-year follow-up to 85.7 ± 14.6 at 20 years (P = .0003). Radiographic evaluation demonstrated significant difference of medial joint space between injured and healthy knees in patients with concomitant medial meniscectomy (n = 8, 3.2 ± 0.6 vs 5.0 ± 1.8 mm, P = .0114). No significant differences were reported regarding lateral or patellofemoral joint space. One patient (2%) experienced rerupture, with 3 of 52 (5.8%) having a contralateral ACL injury (excluded from KT-2000 and radiographic evaluat |
| doi_str_mv | 10.1177/0363546517723013 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1940592970</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_0363546517723013</sage_id><sourcerecordid>1979095801</sourcerecordid><originalsourceid>FETCH-LOGICAL-c365t-3ec8afc8e28efdb9abb5ea803a0135fe20b4db670e6bfac625c83e586f76556f3</originalsourceid><addsrcrecordid>eNp1kV9rFDEUxYModrv67pMEfPElmkk2mRnfyrJthZUWqYhPQyZz06ZkJmP-rPpV-mnNdqtIwacEzu-cm5uD0KuKvququn5PueRiJUW5M04r_gQtKiEY4VyKp2ixl8leP0LHMd5SSqtaNs_REWtaxmglFujuYgeBpBsgyc_4ZL3Fn0H7KaaQdbJ-wpcuR7z5mYIiKiSrs1MBb1WCoBy-gskPEG3EX226wedqLEY7Xe-FoZjPgjIpfsCXwccZSuAO8GanXFb32fcmRsk3KJmf7GTHPOJT75z_QfL8Aj0zykV4-XAu0ZfTzdX6nGwvzj6uT7ZEly0T4aAbZXQDrAEz9K3qewGqoVyVDxEGGO1XQy9rCrI3SksmdMNBNNLUUghp-BK9PeTOwX_PEFM32qjBOTWBz7Gr2hUVLWtrWtA3j9Bbn8NUXleouqWtaMrQJaIHSpe1YwDTzcGOKvzqKtrte-se91Ysrx-Ccz_C8Nfwp6gCkAMQ1TX8M_V_gb8BI1ahdg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1979095801</pqid></control><display><type>article</type><title>Over-the-top ACL Reconstruction Plus Extra-articular Lateral Tenodesis With Hamstring Tendon Grafts: Prospective Evaluation With 20-Year Minimum Follow-up</title><source>SAGE Complete A-Z List</source><source>Alma/SFX Local Collection</source><creator>Zaffagnini, Stefano ; Marcheggiani Muccioli, Giulio Maria ; Grassi, Alberto ; Roberti di Sarsina, Tommaso ; Raggi, Federico ; Signorelli, Cecilia ; Urrizola, Francisco ; Spinnato, Paolo ; Rimondi, Eugenio ; Marcacci, Maurilio</creator><creatorcontrib>Zaffagnini, Stefano ; Marcheggiani Muccioli, Giulio Maria ; Grassi, Alberto ; Roberti di Sarsina, Tommaso ; Raggi, Federico ; Signorelli, Cecilia ; Urrizola, Francisco ; Spinnato, Paolo ; Rimondi, Eugenio ; Marcacci, Maurilio</creatorcontrib><description>Background:
There are few published studies with very long-term follow-up of combined intra- and extra-articular anterior cruciate ligament (ACL) reconstruction.
Purpose:
To analyze clinical and radiographic outcomes of over-the-top ACL reconstruction plus extra-articular lateral tenodesis with autologous hamstrings at minimum 20-year follow-up.
Study Design:
Case series; Level of evidence, 4.
Methods:
Of 60 originally eligible patients who underwent over-the-top ACL reconstruction with double-stranded hamstring tendon (leaving intact graft tibial insertions) and extra-articular lateral plasty (performed with the remnant part of tendons), 52 were prospectively evaluated at a minimum 20-year follow-up (mean follow-up, 24 years; 41 men, 11 women; mean age at time of surgery, 25.5 ± 7.6 years). Twenty-nine patients were available for prospective evaluations: clinical (Lysholm, Tegner, and objective International Knee Documentation Committee [IKDC]), instrumented (KT-2000), and radiographic (standard, long-standing, and Merchant views). Subjective KOOS (Knee injury and Osteoarthritis Outcome Score) and objective inertial sensor pivot-shift analysis (KiRA) were carried out at final follow-up. Twenty-three patients were investigated by phone interview for subjective Tegner score and documented complications, rerupture, or revision surgery.
Results:
At final follow-up, mean Lysholm score was 85.7 ± 14.6; median Tegner score, 4 (range, 3-5); sport activity resumption, 86.2%; and objective IKDC score, good or excellent in 86% of patients (31%, A; 55%, B). Only 3 of 26 patients (12%) had >5-mm manual maximum KT-2000 side-to-side difference. KiRA system documented positive pivot-shift (>0.9-m/s2 tibial acceleration side-to-side difference) in these 3 of 26 patients (12%). Statistically significant changes were as follows: decrease in Tegner score from 7 (range, 6-8) at 5-year follow-up to 4 (range, 3-5) at 10 years (P < .0001) and decrease in Lysholm score from 96.1 ± 7.3 at 10-year follow-up to 85.7 ± 14.6 at 20 years (P = .0003). Radiographic evaluation demonstrated significant difference of medial joint space between injured and healthy knees in patients with concomitant medial meniscectomy (n = 8, 3.2 ± 0.6 vs 5.0 ± 1.8 mm, P = .0114). No significant differences were reported regarding lateral or patellofemoral joint space. One patient (2%) experienced rerupture, with 3 of 52 (5.8%) having a contralateral ACL injury (excluded from KT-2000 and radiographic evaluations). Overall, 4 of 29 clinical failures (objective IKDC, KT-2000) and 1 rerupture among 52 patients were registered at final follow-up.
Conclusion:
Studied surgical technique demonstrated good results in laxity control at 20-year minimum follow-up. The lateral extra-articular plasty associated with ACL reconstruction did not generate lateral knee or patellofemoral osteoarthritis. The factor increasing osteoarthritis was meniscectomy.</description><identifier>ISSN: 0363-5465</identifier><identifier>EISSN: 1552-3365</identifier><identifier>DOI: 10.1177/0363546517723013</identifier><identifier>PMID: 28922015</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Arthritis ; Knee ; Skin & tissue grafts ; Sports medicine</subject><ispartof>The American journal of sports medicine, 2017-12, Vol.45 (14), p.3233-3242</ispartof><rights>2017 The Author(s)</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c365t-3ec8afc8e28efdb9abb5ea803a0135fe20b4db670e6bfac625c83e586f76556f3</citedby><cites>FETCH-LOGICAL-c365t-3ec8afc8e28efdb9abb5ea803a0135fe20b4db670e6bfac625c83e586f76556f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/0363546517723013$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/0363546517723013$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,777,781,21800,27905,27906,43602,43603</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28922015$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zaffagnini, Stefano</creatorcontrib><creatorcontrib>Marcheggiani Muccioli, Giulio Maria</creatorcontrib><creatorcontrib>Grassi, Alberto</creatorcontrib><creatorcontrib>Roberti di Sarsina, Tommaso</creatorcontrib><creatorcontrib>Raggi, Federico</creatorcontrib><creatorcontrib>Signorelli, Cecilia</creatorcontrib><creatorcontrib>Urrizola, Francisco</creatorcontrib><creatorcontrib>Spinnato, Paolo</creatorcontrib><creatorcontrib>Rimondi, Eugenio</creatorcontrib><creatorcontrib>Marcacci, Maurilio</creatorcontrib><title>Over-the-top ACL Reconstruction Plus Extra-articular Lateral Tenodesis With Hamstring Tendon Grafts: Prospective Evaluation With 20-Year Minimum Follow-up</title><title>The American journal of sports medicine</title><addtitle>Am J Sports Med</addtitle><description>Background:
There are few published studies with very long-term follow-up of combined intra- and extra-articular anterior cruciate ligament (ACL) reconstruction.
Purpose:
To analyze clinical and radiographic outcomes of over-the-top ACL reconstruction plus extra-articular lateral tenodesis with autologous hamstrings at minimum 20-year follow-up.
Study Design:
Case series; Level of evidence, 4.
Methods:
Of 60 originally eligible patients who underwent over-the-top ACL reconstruction with double-stranded hamstring tendon (leaving intact graft tibial insertions) and extra-articular lateral plasty (performed with the remnant part of tendons), 52 were prospectively evaluated at a minimum 20-year follow-up (mean follow-up, 24 years; 41 men, 11 women; mean age at time of surgery, 25.5 ± 7.6 years). Twenty-nine patients were available for prospective evaluations: clinical (Lysholm, Tegner, and objective International Knee Documentation Committee [IKDC]), instrumented (KT-2000), and radiographic (standard, long-standing, and Merchant views). Subjective KOOS (Knee injury and Osteoarthritis Outcome Score) and objective inertial sensor pivot-shift analysis (KiRA) were carried out at final follow-up. Twenty-three patients were investigated by phone interview for subjective Tegner score and documented complications, rerupture, or revision surgery.
Results:
At final follow-up, mean Lysholm score was 85.7 ± 14.6; median Tegner score, 4 (range, 3-5); sport activity resumption, 86.2%; and objective IKDC score, good or excellent in 86% of patients (31%, A; 55%, B). Only 3 of 26 patients (12%) had >5-mm manual maximum KT-2000 side-to-side difference. KiRA system documented positive pivot-shift (>0.9-m/s2 tibial acceleration side-to-side difference) in these 3 of 26 patients (12%). Statistically significant changes were as follows: decrease in Tegner score from 7 (range, 6-8) at 5-year follow-up to 4 (range, 3-5) at 10 years (P < .0001) and decrease in Lysholm score from 96.1 ± 7.3 at 10-year follow-up to 85.7 ± 14.6 at 20 years (P = .0003). Radiographic evaluation demonstrated significant difference of medial joint space between injured and healthy knees in patients with concomitant medial meniscectomy (n = 8, 3.2 ± 0.6 vs 5.0 ± 1.8 mm, P = .0114). No significant differences were reported regarding lateral or patellofemoral joint space. One patient (2%) experienced rerupture, with 3 of 52 (5.8%) having a contralateral ACL injury (excluded from KT-2000 and radiographic evaluations). Overall, 4 of 29 clinical failures (objective IKDC, KT-2000) and 1 rerupture among 52 patients were registered at final follow-up.
Conclusion:
Studied surgical technique demonstrated good results in laxity control at 20-year minimum follow-up. The lateral extra-articular plasty associated with ACL reconstruction did not generate lateral knee or patellofemoral osteoarthritis. The factor increasing osteoarthritis was meniscectomy.</description><subject>Arthritis</subject><subject>Knee</subject><subject>Skin & tissue grafts</subject><subject>Sports medicine</subject><issn>0363-5465</issn><issn>1552-3365</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><recordid>eNp1kV9rFDEUxYModrv67pMEfPElmkk2mRnfyrJthZUWqYhPQyZz06ZkJmP-rPpV-mnNdqtIwacEzu-cm5uD0KuKvququn5PueRiJUW5M04r_gQtKiEY4VyKp2ixl8leP0LHMd5SSqtaNs_REWtaxmglFujuYgeBpBsgyc_4ZL3Fn0H7KaaQdbJ-wpcuR7z5mYIiKiSrs1MBb1WCoBy-gskPEG3EX226wedqLEY7Xe-FoZjPgjIpfsCXwccZSuAO8GanXFb32fcmRsk3KJmf7GTHPOJT75z_QfL8Aj0zykV4-XAu0ZfTzdX6nGwvzj6uT7ZEly0T4aAbZXQDrAEz9K3qewGqoVyVDxEGGO1XQy9rCrI3SksmdMNBNNLUUghp-BK9PeTOwX_PEFM32qjBOTWBz7Gr2hUVLWtrWtA3j9Bbn8NUXleouqWtaMrQJaIHSpe1YwDTzcGOKvzqKtrte-se91Ysrx-Ccz_C8Nfwp6gCkAMQ1TX8M_V_gb8BI1ahdg</recordid><startdate>201712</startdate><enddate>201712</enddate><creator>Zaffagnini, Stefano</creator><creator>Marcheggiani Muccioli, Giulio Maria</creator><creator>Grassi, Alberto</creator><creator>Roberti di Sarsina, Tommaso</creator><creator>Raggi, Federico</creator><creator>Signorelli, Cecilia</creator><creator>Urrizola, Francisco</creator><creator>Spinnato, Paolo</creator><creator>Rimondi, Eugenio</creator><creator>Marcacci, Maurilio</creator><general>SAGE Publications</general><general>Sage Publications Ltd</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>U9A</scope><scope>7X8</scope></search><sort><creationdate>201712</creationdate><title>Over-the-top ACL Reconstruction Plus Extra-articular Lateral Tenodesis With Hamstring Tendon Grafts: Prospective Evaluation With 20-Year Minimum Follow-up</title><author>Zaffagnini, Stefano ; Marcheggiani Muccioli, Giulio Maria ; Grassi, Alberto ; Roberti di Sarsina, Tommaso ; Raggi, Federico ; Signorelli, Cecilia ; Urrizola, Francisco ; Spinnato, Paolo ; Rimondi, Eugenio ; Marcacci, Maurilio</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c365t-3ec8afc8e28efdb9abb5ea803a0135fe20b4db670e6bfac625c83e586f76556f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Arthritis</topic><topic>Knee</topic><topic>Skin & tissue grafts</topic><topic>Sports medicine</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zaffagnini, Stefano</creatorcontrib><creatorcontrib>Marcheggiani Muccioli, Giulio Maria</creatorcontrib><creatorcontrib>Grassi, Alberto</creatorcontrib><creatorcontrib>Roberti di Sarsina, Tommaso</creatorcontrib><creatorcontrib>Raggi, Federico</creatorcontrib><creatorcontrib>Signorelli, Cecilia</creatorcontrib><creatorcontrib>Urrizola, Francisco</creatorcontrib><creatorcontrib>Spinnato, Paolo</creatorcontrib><creatorcontrib>Rimondi, Eugenio</creatorcontrib><creatorcontrib>Marcacci, Maurilio</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of sports medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zaffagnini, Stefano</au><au>Marcheggiani Muccioli, Giulio Maria</au><au>Grassi, Alberto</au><au>Roberti di Sarsina, Tommaso</au><au>Raggi, Federico</au><au>Signorelli, Cecilia</au><au>Urrizola, Francisco</au><au>Spinnato, Paolo</au><au>Rimondi, Eugenio</au><au>Marcacci, Maurilio</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Over-the-top ACL Reconstruction Plus Extra-articular Lateral Tenodesis With Hamstring Tendon Grafts: Prospective Evaluation With 20-Year Minimum Follow-up</atitle><jtitle>The American journal of sports medicine</jtitle><addtitle>Am J Sports Med</addtitle><date>2017-12</date><risdate>2017</risdate><volume>45</volume><issue>14</issue><spage>3233</spage><epage>3242</epage><pages>3233-3242</pages><issn>0363-5465</issn><eissn>1552-3365</eissn><abstract>Background:
There are few published studies with very long-term follow-up of combined intra- and extra-articular anterior cruciate ligament (ACL) reconstruction.
Purpose:
To analyze clinical and radiographic outcomes of over-the-top ACL reconstruction plus extra-articular lateral tenodesis with autologous hamstrings at minimum 20-year follow-up.
Study Design:
Case series; Level of evidence, 4.
Methods:
Of 60 originally eligible patients who underwent over-the-top ACL reconstruction with double-stranded hamstring tendon (leaving intact graft tibial insertions) and extra-articular lateral plasty (performed with the remnant part of tendons), 52 were prospectively evaluated at a minimum 20-year follow-up (mean follow-up, 24 years; 41 men, 11 women; mean age at time of surgery, 25.5 ± 7.6 years). Twenty-nine patients were available for prospective evaluations: clinical (Lysholm, Tegner, and objective International Knee Documentation Committee [IKDC]), instrumented (KT-2000), and radiographic (standard, long-standing, and Merchant views). Subjective KOOS (Knee injury and Osteoarthritis Outcome Score) and objective inertial sensor pivot-shift analysis (KiRA) were carried out at final follow-up. Twenty-three patients were investigated by phone interview for subjective Tegner score and documented complications, rerupture, or revision surgery.
Results:
At final follow-up, mean Lysholm score was 85.7 ± 14.6; median Tegner score, 4 (range, 3-5); sport activity resumption, 86.2%; and objective IKDC score, good or excellent in 86% of patients (31%, A; 55%, B). Only 3 of 26 patients (12%) had >5-mm manual maximum KT-2000 side-to-side difference. KiRA system documented positive pivot-shift (>0.9-m/s2 tibial acceleration side-to-side difference) in these 3 of 26 patients (12%). Statistically significant changes were as follows: decrease in Tegner score from 7 (range, 6-8) at 5-year follow-up to 4 (range, 3-5) at 10 years (P < .0001) and decrease in Lysholm score from 96.1 ± 7.3 at 10-year follow-up to 85.7 ± 14.6 at 20 years (P = .0003). Radiographic evaluation demonstrated significant difference of medial joint space between injured and healthy knees in patients with concomitant medial meniscectomy (n = 8, 3.2 ± 0.6 vs 5.0 ± 1.8 mm, P = .0114). No significant differences were reported regarding lateral or patellofemoral joint space. One patient (2%) experienced rerupture, with 3 of 52 (5.8%) having a contralateral ACL injury (excluded from KT-2000 and radiographic evaluations). Overall, 4 of 29 clinical failures (objective IKDC, KT-2000) and 1 rerupture among 52 patients were registered at final follow-up.
Conclusion:
Studied surgical technique demonstrated good results in laxity control at 20-year minimum follow-up. The lateral extra-articular plasty associated with ACL reconstruction did not generate lateral knee or patellofemoral osteoarthritis. The factor increasing osteoarthritis was meniscectomy.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>28922015</pmid><doi>10.1177/0363546517723013</doi><tpages>10</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0363-5465 |
| ispartof | The American journal of sports medicine, 2017-12, Vol.45 (14), p.3233-3242 |
| issn | 0363-5465 1552-3365 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1940592970 |
| source | SAGE Complete A-Z List; Alma/SFX Local Collection |
| subjects | Arthritis Knee Skin & tissue grafts Sports medicine |
| title | Over-the-top ACL Reconstruction Plus Extra-articular Lateral Tenodesis With Hamstring Tendon Grafts: Prospective Evaluation With 20-Year Minimum Follow-up |
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