Abstract
BackgroundTo improve tendon-to-bone healing in anterior cruciate ligament (ACL) reconstruction, a novel technique via calcium phosphate (CaP)-hybridized tendon graft using an alternate soaking process was developed. The purpose of this study was to evaluate the clinical results of anatomic single-bundle ACL reconstruction using the CaP-hybridized tendon graft with up to 2 years follow-up, and compare the outcome with conventional ACL reconstruction and preoperative data.MethodsNinety patients who required anatomic single-bundle ACL reconstruction were randomized to undergo either the CaP-hybridized tendon graft method (CaP group, n = 45) or the conventional method (conventional group, n = 45). At 1 and 2 years postoperatively, all patients were evaluated using KT-1000 arthrometry, pivot-shift test, International Knee Documentation Committee (IKDC) grade, Lysholm scale, and Tegner scale; at the same timepoints, bone tunnel enlargement was evaluated using computed tomography, and the tendon graft intensity was evaluated on magnetic resonance imaging. Tendon graft appearance was evaluated arthroscopically once after a period of up to 2 years postoperatively. Cases of re-rupture and adverse events were recorded in both groups.ResultsIn both groups, the KT-1000 arthrometry, pivot-shift test, IKDC grade, and Lysholm scale results at 1 and 2 years postoperatively were superior to preoperative data; these results did not significantly differ between groups at either timepoint. The rate of increase of the cross-sectional area of the femoral bone tunnel in the CaP group was smaller than that in the conventional group at 1 year postoperatively. The other results did not significantly differ between the two groups at any timepoint. There were two cases of re-rupture in the CaP group, and six cases of re-rupture in the conventional group. There were no adverse events during follow-up in either group.ConclusionsAnatomic single-bundle ACL reconstruction using a CaP-hybridized tendon graft was safe, and resulted in improved clinical outcomes at 2 years postoperatively compared with preoperative data; the outcomes were comparable with the conventional method. A longer follow-up is needed to clarify the clinical effects of the CaP-hybridized tendon graft in anatomic single-bundle ACL reconstruction.Trial registrationUMIN, UMIN000019788 Registered 14 November 2015—Retrospectively registered.
Highlights
To improve tendon-to-bone healing in anterior cruciate ligament (ACL) reconstruction, a novel technique via calcium phosphate (CaP)-hybridized tendon graft using an alternate soaking process was developed
In the CaP group, better anterior knee stability and greater in situ forces in the graft under applied anterior tibial loads were found at 1 year after non-anatomic ACL reconstruction in goats compared with an untreated tendon graft [3]
There were two cases of re-rupture in the CaP group, and six cases of re-rupture in the conventional group in 2 years of follow-up
Summary
To improve tendon-to-bone healing in anterior cruciate ligament (ACL) reconstruction, a novel technique via calcium phosphate (CaP)-hybridized tendon graft using an alternate soaking process was developed. To improve tendon-to-bone healing, a novel technique via calcium phosphate (CaP)-hybridized tendon graft using an alternate soaking process was developed [4]. In the CaP group, better anterior knee stability and greater in situ forces in the graft under applied anterior tibial loads were found at 1 year after non-anatomic ACL reconstruction in goats compared with an untreated tendon graft [3]. The CaP-hybridized tendon graft in non-anatomic single-bundle ACL reconstruction improved anterior knee stability at 1 and 2 years postoperatively, and reduced the bone tunnel enlargement in both tunnels at 1 year postoperatively compared with the conventional method [7]
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