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      Quadriceps Tendon Autograft Anterior Cruciate Ligament Reconstruction With Independent Suture Tape Reinforcement

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      Author(s): , D.O., A.T.C., C.S.C.S. ∗
      Publication date (Electronic):
      Journal: Arthroscopy Techniques
      Publisher: Elsevier

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          Abstract

          Anterior cruciate ligament (ACL) injuries are common among adolescent athletes and are rising with increased participation in higher level athletics at earlier ages. In these young patients, often with open physes, soft tissue grafts continue to be the primary graft choice for ACL reconstruction. Reinjury continues to be a concern in this high-risk age group, with failure rates 2 to 3 times higher than in adults. Recently, primary ACL reconstruction with suture tape augmentation/reinforcement has been described in both hamstring autografts and allografts. Purported advantages include protection of the graft during the revascularization and remodeling phase of incorporation. This Technical Note details a surgical technique of independent suture tape reinforcement during primary all soft tissue quadriceps tendon autograft ACL reconstruction using an all-inside technique.

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          Risk of Secondary Injury in Younger Athletes After Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis.

          Amelia J Wiggins, Ravi K Grandhi, Daniel Schneider … (2016)
          Injury to the ipsilateral graft used for reconstruction of the anterior cruciate ligament (ACL) or a new injury to the contralateral ACL are disastrous outcomes after successful ACL reconstruction (ACLR), rehabilitation, and return to activity. Studies reporting ACL reinjury rates in younger active populations are emerging in the literature, but these data have not yet been comprehensively synthesized.
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            Knee medial collateral ligament and posteromedial corner anatomic repair with internal bracing.

            James Lubowitz, Gordon MacKay, Brian Gilmer (2014)
            An internal brace is a ligament repair bridging concept using braided ultrahigh-molecular-weight polyethylene/polyester suture tape and knotless bone anchors to reinforce ligament strength as a secondary stabilizer after repair and return to sports, which may help resist injury recurrence. An internal brace may provide augmentation during knee medial and posteromedial corner anatomic repair. In patients with combined, chronic, symptomatic anterior cruciate ligament (ACL)-posteromedial corner laxity, combined ACL reconstruction with posteromedial corner reconstruction is indicated. Our ACL technique was previously published with video illustration in Arthroscopy and Arthroscopy Techniques. The purpose of this article is to describe, with video illustration, knee posteromedial corner reconstruction using anatomic repair with internal brace augmentation.
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              Clinical results of an arthroscopic modified Brostrom operation with and without an internal brace

              Jae-Sung Yoo, Eun Yang (2016)
              Background The concept of utilizing nonabsorbable suture tape fixed directly to bone to augment Brostrom repairs of the anterior talofibular ligament (ATFL) has been proposed. However, no clinical data are currently available regarding the arthroscopic modified Brostrom operation with an internal brace. Materials and methods This study involved 85 consecutive patients (22 in the with internal brace group; 63 in the without internal brace group) who could be followed up for >6 months after undergoing an arthroscopic modified Brostrom operation. The American Orthopaedic Foot & Ankle Society (AOFAS) score was administered to assess the functional status. At preoperation and at 24 weeks after surgery, the anterior drawer test was examined clinically. Results Improvement of mean AOFAS score in the internal brace group from before surgery to two weeks after surgery was statistically significant (p < 0.05). At 24-week follow-up, the anterior drawer test showed grade 0 laxity in 19 patients (86.4 %) and grade 1 in three patients (13.6 %). Improvement of AOFAS score in the group without an internal brace from before surgery to 6 weeks after surgery was not statistically significant (p = 0.001). At 24-week follow-up, the anterior drawer test showed grade 0 laxity in 54 patients (85.7 %) and grade 1 in nine patients (14.3 %). Conclusion Patients in the internal brace group were able to quickly return to activity and sports. We believe this technique could be a viable option for surgically treating chronic lateral ankle instability in patients who need an early return to activity and sports. Level of evidence III.
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                Author and article information

                Contributors
                Michael G. Saper
                Journal
                Journal ID (nlm-ta): Arthrosc Tech
                Journal ID (iso-abbrev): Arthrosc Tech
                Title: Arthroscopy Techniques
                Publisher: Elsevier
                ISSN (Electronic): 2212-6287
                Publication date PMC-release: 29 October 2018
                Publication date Collection: November 2018
                Publication date (Electronic): 29 October 2018
                Volume: 7
                Issue: 11
                Pages: e1221-e1229
                Affiliations
                [1]Department of Orthopedics and Sports Medicine, Seattle Children's Hospital; and Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, Washington, U.S.A.
                Author notes
                [∗ ]Address correspondence to Michael G. Saper, D.O., A.T.C., C.S.C.S., 4800 Sand Point Way NE, Seattle, WA 98105, U.S.A. Michael.Saper@ 123456seattlechildrens.org
                Article
                Publisher ID: S2212-6287(18)30133-6
                DOI: 10.1016/j.eats.2018.08.007
                PMC ID: 6262756
                PubMed ID: 30533372
                SO-VID: 06d4cbbf-c196-44bb-8433-0fe16f398ede
                Copyright © © 2018 by the Arthroscopy Association of North America. Published by Elsevier.
                License:

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                Date received : 25 June 2018
                Date accepted : 2 August 2018
                Categories
                Subject: Technical Note

                Data availability:

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