Outcomes of revision anterior cruciate ligament reconstruction secondary to reamer-irrigator-aspirator harvested bone grafting
•RIA harvested bone grafting ensures sufficient tunnel filling rates in two-staged revision ACL surgery.•RIA harvested bone grafting allows for anatomical tunnel positioning in two-staged revision ACL reconstruction.•This study is the first to show good subjective and objective clinical outcomes aft...
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| Veröffentlicht in: | Injury 2019-02, Vol.50 (2), p.467-475 |
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| description | •RIA harvested bone grafting ensures sufficient tunnel filling rates in two-staged revision ACL surgery.•RIA harvested bone grafting allows for anatomical tunnel positioning in two-staged revision ACL reconstruction.•This study is the first to show good subjective and objective clinical outcomes after revision ACL secondary to RIA harvested bone grafting.•RIA harvested bone grafting is shown to be an eligible alternative to autologous iliac crest bone grafting and allogenic bone grafting.
Patients with widened or misplaced tunnels may require bone grafting prior to revision anterior cruciate ligament (ACL) reconstruction. Utilising reamer-irrigator-aspirator (RIA) harvested bone from the femur showed promising filling rates. Nevertheless, the procedure has neither been validated in a larger population nor been assessed with regards to radiological and clinical outcome of the subsequently conducted revision ACL reconstruction. Therefore, the aim of this study was to evaluate tunnel filling rates, positioning of the revision tunnels and outcome parameters of such two-staged revision ACL reconstructions.
A total of 15 consecutive patients were prospectively enrolled in this case series. CT scans were analysed before and after autologous RIA harvested bone grafting. Tunnel volumes and filling rates were calculated based on manual segmentation of axial CT scans. Revision ACL reconstruction was carried out after a mean interval of 6.2 months (±3.7) and positioning of the revision tunnels was assessed by plane radiographs. The mean follow-up was 19.8 months (±8.4) for objective evaluation and 37.1 months (±15.4) for patient reported outcomes. The clinical outcome was assessed by the quantification of the anterior tibial translation, the IKDC objective score, the Tegner activity scale and the Lysholm score.
Initial CT scans revealed mean tunnel volumes of 3.8cm3 (±2.7) femoral and 6.1cm3 (±2.4) tibial. Filling rates of 76.1% (±12.4) femoral and 87.4% (±5.9) tibial were achieved. Postoperative radiographs revealed significantly improved tunnel positioning with anatomical placement in all but one case at the femur and in all cases at the tibia. At follow up, patients showed significantly improved anterior tibial translations with residual side-to-side differences of 1.7 mm (±0.8) and significantly improved IKDC objective scores. Furthermore, significantly higher values were achieved on the Tegner activity scale (5.3 ± 1.4 vs. 2.8 ± 0.5) and the Lysholm score (85.4 ± |
| doi_str_mv | 10.1016/j.injury.2018.12.020 |
| format | Article |
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Patients with widened or misplaced tunnels may require bone grafting prior to revision anterior cruciate ligament (ACL) reconstruction. Utilising reamer-irrigator-aspirator (RIA) harvested bone from the femur showed promising filling rates. Nevertheless, the procedure has neither been validated in a larger population nor been assessed with regards to radiological and clinical outcome of the subsequently conducted revision ACL reconstruction. Therefore, the aim of this study was to evaluate tunnel filling rates, positioning of the revision tunnels and outcome parameters of such two-staged revision ACL reconstructions.
A total of 15 consecutive patients were prospectively enrolled in this case series. CT scans were analysed before and after autologous RIA harvested bone grafting. Tunnel volumes and filling rates were calculated based on manual segmentation of axial CT scans. Revision ACL reconstruction was carried out after a mean interval of 6.2 months (±3.7) and positioning of the revision tunnels was assessed by plane radiographs. The mean follow-up was 19.8 months (±8.4) for objective evaluation and 37.1 months (±15.4) for patient reported outcomes. The clinical outcome was assessed by the quantification of the anterior tibial translation, the IKDC objective score, the Tegner activity scale and the Lysholm score.
Initial CT scans revealed mean tunnel volumes of 3.8cm3 (±2.7) femoral and 6.1cm3 (±2.4) tibial. Filling rates of 76.1% (±12.4) femoral and 87.4% (±5.9) tibial were achieved. Postoperative radiographs revealed significantly improved tunnel positioning with anatomical placement in all but one case at the femur and in all cases at the tibia. At follow up, patients showed significantly improved anterior tibial translations with residual side-to-side differences of 1.7 mm (±0.8) and significantly improved IKDC objective scores. Furthermore, significantly higher values were achieved on the Tegner activity scale (5.3 ± 1.4 vs. 2.8 ± 0.5) and the Lysholm score (85.4 ± 7.9 vs. 62.5 ± 10.5) compared to the preoperative status.
Autologous RIA harvested bone grafting ensures sufficient bone stock consolidation allowing for anatomical tunnel placement of the subsequently conducted revision ACL reconstruction. The two-staged procedure reliably restores stability and provides satisfying subjective and objective outcomes. Thus, RIA harvested bone grafting is an eligible alternative to autologous iliac crest or allogenic bone grafting.</description><identifier>ISSN: 0020-1383</identifier><identifier>EISSN: 1879-0267</identifier><identifier>DOI: 10.1016/j.injury.2018.12.020</identifier><identifier>PMID: 30580931</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Anterior cruciate ligament ; Bone grafting ; Outcome ; Reamer-irrigator-aspirator ; Revision ACL reconstruction ; RIA ; Tunnel positioning ; Two-staged</subject><ispartof>Injury, 2019-02, Vol.50 (2), p.467-475</ispartof><rights>2018 Elsevier Ltd</rights><rights>Copyright © 2018 Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c362t-1d9dcaa73a655266a8a8ec013b94d03beb3b49df18a1aa7b08f522ccf8c99ac03</citedby><cites>FETCH-LOGICAL-c362t-1d9dcaa73a655266a8a8ec013b94d03beb3b49df18a1aa7b08f522ccf8c99ac03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.injury.2018.12.020$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,777,781,3537,27905,27906,45976</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30580931$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Prall, W.C.</creatorcontrib><creatorcontrib>Kusmenkov, T.</creatorcontrib><creatorcontrib>Fürmetz, J.</creatorcontrib><creatorcontrib>Haasters, F.</creatorcontrib><creatorcontrib>Mayr, H.O.</creatorcontrib><creatorcontrib>Böcker, W.</creatorcontrib><creatorcontrib>Grote, S.</creatorcontrib><title>Outcomes of revision anterior cruciate ligament reconstruction secondary to reamer-irrigator-aspirator harvested bone grafting</title><title>Injury</title><addtitle>Injury</addtitle><description>•RIA harvested bone grafting ensures sufficient tunnel filling rates in two-staged revision ACL surgery.•RIA harvested bone grafting allows for anatomical tunnel positioning in two-staged revision ACL reconstruction.•This study is the first to show good subjective and objective clinical outcomes after revision ACL secondary to RIA harvested bone grafting.•RIA harvested bone grafting is shown to be an eligible alternative to autologous iliac crest bone grafting and allogenic bone grafting.
Patients with widened or misplaced tunnels may require bone grafting prior to revision anterior cruciate ligament (ACL) reconstruction. Utilising reamer-irrigator-aspirator (RIA) harvested bone from the femur showed promising filling rates. Nevertheless, the procedure has neither been validated in a larger population nor been assessed with regards to radiological and clinical outcome of the subsequently conducted revision ACL reconstruction. Therefore, the aim of this study was to evaluate tunnel filling rates, positioning of the revision tunnels and outcome parameters of such two-staged revision ACL reconstructions.
A total of 15 consecutive patients were prospectively enrolled in this case series. CT scans were analysed before and after autologous RIA harvested bone grafting. Tunnel volumes and filling rates were calculated based on manual segmentation of axial CT scans. Revision ACL reconstruction was carried out after a mean interval of 6.2 months (±3.7) and positioning of the revision tunnels was assessed by plane radiographs. The mean follow-up was 19.8 months (±8.4) for objective evaluation and 37.1 months (±15.4) for patient reported outcomes. The clinical outcome was assessed by the quantification of the anterior tibial translation, the IKDC objective score, the Tegner activity scale and the Lysholm score.
Initial CT scans revealed mean tunnel volumes of 3.8cm3 (±2.7) femoral and 6.1cm3 (±2.4) tibial. Filling rates of 76.1% (±12.4) femoral and 87.4% (±5.9) tibial were achieved. Postoperative radiographs revealed significantly improved tunnel positioning with anatomical placement in all but one case at the femur and in all cases at the tibia. At follow up, patients showed significantly improved anterior tibial translations with residual side-to-side differences of 1.7 mm (±0.8) and significantly improved IKDC objective scores. Furthermore, significantly higher values were achieved on the Tegner activity scale (5.3 ± 1.4 vs. 2.8 ± 0.5) and the Lysholm score (85.4 ± 7.9 vs. 62.5 ± 10.5) compared to the preoperative status.
Autologous RIA harvested bone grafting ensures sufficient bone stock consolidation allowing for anatomical tunnel placement of the subsequently conducted revision ACL reconstruction. The two-staged procedure reliably restores stability and provides satisfying subjective and objective outcomes. Thus, RIA harvested bone grafting is an eligible alternative to autologous iliac crest or allogenic bone grafting.</description><subject>Anterior cruciate ligament</subject><subject>Bone grafting</subject><subject>Outcome</subject><subject>Reamer-irrigator-aspirator</subject><subject>Revision ACL reconstruction</subject><subject>RIA</subject><subject>Tunnel positioning</subject><subject>Two-staged</subject><issn>0020-1383</issn><issn>1879-0267</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNp9kE1vEzEQQC1ERdPCP0DIRy67zNjJxntBQlVbKlXqBc6W154NjrJ2sL2Reulvx6sUjpxsj998PcY-IrQI2H3Ztz7s5_TcCkDVomhBwBu2QrXtGxDd9i1bQQ01KJW8ZFc57wFwC1K-Y5cSNgp6iSv28jQXGyfKPI480clnHwM3oVDyMXGbZutNIX7wOzNRKJWxMeRS42Uh8_J0Jj3zEutfZVLjU6p0iakx-ejTcuO_TDpRLuT4EAPxXTJj8WH3nl2M5pDpw-t5zX7e3f64-d48Pt0_3Hx7bKzsRGnQ9c4as5Wm22xE1xllFFlAOfRrB3KgQQ7r3o2oDFZsADVuhLB2VLbvjQV5zT6f6x5T_D3XQfTks6XDwQSKc9YCO8ClMlZ0fUZtijknGvUx-aluqBH0Yl7v9dm8XsxrFLpqrmmfXjvMw0TuX9Jf1RX4egao7nnylHS2noIl56vTol30_-_wB-n8m30</recordid><startdate>201902</startdate><enddate>201902</enddate><creator>Prall, W.C.</creator><creator>Kusmenkov, T.</creator><creator>Fürmetz, J.</creator><creator>Haasters, F.</creator><creator>Mayr, H.O.</creator><creator>Böcker, W.</creator><creator>Grote, S.</creator><general>Elsevier Ltd</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201902</creationdate><title>Outcomes of revision anterior cruciate ligament reconstruction secondary to reamer-irrigator-aspirator harvested bone grafting</title><author>Prall, W.C. ; Kusmenkov, T. ; Fürmetz, J. ; Haasters, F. ; Mayr, H.O. ; Böcker, W. ; Grote, S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c362t-1d9dcaa73a655266a8a8ec013b94d03beb3b49df18a1aa7b08f522ccf8c99ac03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Anterior cruciate ligament</topic><topic>Bone grafting</topic><topic>Outcome</topic><topic>Reamer-irrigator-aspirator</topic><topic>Revision ACL reconstruction</topic><topic>RIA</topic><topic>Tunnel positioning</topic><topic>Two-staged</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Prall, W.C.</creatorcontrib><creatorcontrib>Kusmenkov, T.</creatorcontrib><creatorcontrib>Fürmetz, J.</creatorcontrib><creatorcontrib>Haasters, F.</creatorcontrib><creatorcontrib>Mayr, H.O.</creatorcontrib><creatorcontrib>Böcker, W.</creatorcontrib><creatorcontrib>Grote, S.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Injury</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Prall, W.C.</au><au>Kusmenkov, T.</au><au>Fürmetz, J.</au><au>Haasters, F.</au><au>Mayr, H.O.</au><au>Böcker, W.</au><au>Grote, S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcomes of revision anterior cruciate ligament reconstruction secondary to reamer-irrigator-aspirator harvested bone grafting</atitle><jtitle>Injury</jtitle><addtitle>Injury</addtitle><date>2019-02</date><risdate>2019</risdate><volume>50</volume><issue>2</issue><spage>467</spage><epage>475</epage><pages>467-475</pages><issn>0020-1383</issn><eissn>1879-0267</eissn><abstract>•RIA harvested bone grafting ensures sufficient tunnel filling rates in two-staged revision ACL surgery.•RIA harvested bone grafting allows for anatomical tunnel positioning in two-staged revision ACL reconstruction.•This study is the first to show good subjective and objective clinical outcomes after revision ACL secondary to RIA harvested bone grafting.•RIA harvested bone grafting is shown to be an eligible alternative to autologous iliac crest bone grafting and allogenic bone grafting.
Patients with widened or misplaced tunnels may require bone grafting prior to revision anterior cruciate ligament (ACL) reconstruction. Utilising reamer-irrigator-aspirator (RIA) harvested bone from the femur showed promising filling rates. Nevertheless, the procedure has neither been validated in a larger population nor been assessed with regards to radiological and clinical outcome of the subsequently conducted revision ACL reconstruction. Therefore, the aim of this study was to evaluate tunnel filling rates, positioning of the revision tunnels and outcome parameters of such two-staged revision ACL reconstructions.
A total of 15 consecutive patients were prospectively enrolled in this case series. CT scans were analysed before and after autologous RIA harvested bone grafting. Tunnel volumes and filling rates were calculated based on manual segmentation of axial CT scans. Revision ACL reconstruction was carried out after a mean interval of 6.2 months (±3.7) and positioning of the revision tunnels was assessed by plane radiographs. The mean follow-up was 19.8 months (±8.4) for objective evaluation and 37.1 months (±15.4) for patient reported outcomes. The clinical outcome was assessed by the quantification of the anterior tibial translation, the IKDC objective score, the Tegner activity scale and the Lysholm score.
Initial CT scans revealed mean tunnel volumes of 3.8cm3 (±2.7) femoral and 6.1cm3 (±2.4) tibial. Filling rates of 76.1% (±12.4) femoral and 87.4% (±5.9) tibial were achieved. Postoperative radiographs revealed significantly improved tunnel positioning with anatomical placement in all but one case at the femur and in all cases at the tibia. At follow up, patients showed significantly improved anterior tibial translations with residual side-to-side differences of 1.7 mm (±0.8) and significantly improved IKDC objective scores. Furthermore, significantly higher values were achieved on the Tegner activity scale (5.3 ± 1.4 vs. 2.8 ± 0.5) and the Lysholm score (85.4 ± 7.9 vs. 62.5 ± 10.5) compared to the preoperative status.
Autologous RIA harvested bone grafting ensures sufficient bone stock consolidation allowing for anatomical tunnel placement of the subsequently conducted revision ACL reconstruction. The two-staged procedure reliably restores stability and provides satisfying subjective and objective outcomes. Thus, RIA harvested bone grafting is an eligible alternative to autologous iliac crest or allogenic bone grafting.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>30580931</pmid><doi>10.1016/j.injury.2018.12.020</doi><tpages>9</tpages></addata></record> |
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| source | ScienceDirect Journals (5 years ago - present) |
| subjects | Anterior cruciate ligament Bone grafting Outcome Reamer-irrigator-aspirator Revision ACL reconstruction RIA Tunnel positioning Two-staged |
| title | Outcomes of revision anterior cruciate ligament reconstruction secondary to reamer-irrigator-aspirator harvested bone grafting |
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