Abstract
ABSTRACTObjective:To conduct a systematic review of literature about the use of contralateral patellar tendon autograft in anterior cruciate ligament reconstructions and present the results. Methods:The LILACS, MEDLINE, Cochrane, PubMed, Scielo and Google Scholar databases were searched without date restrictions for the keywords “anterior cruciate ligament reconstruction” combined with “contralateral” in the article title. After the studies were identified, two independent evaluators collected the qualitative characteristics of the studies and classified them according to clinical outcomes of these grafts as positive, neutral, or negative. Results:A total of 755 articles were found initially, and after detailed evaluation of all references, followed by a screening process and assessment of quality, a total of 11 studies were determined to be eligible for inclusion in this systematic review. Of these, 72.72% were level II studies, the most common level of evidence among the results. Positive results for this type of graft were found in 63.63% of the studies. Conclusion:Based on the literature review, most of the included articles (63.63%) presented positive results for the use of contralateral patellar tendon grafts. Level of Evidence III; Systematic review.
Highlights
The anterior cruciate ligament (ACL) plays a very important role in knee biomechanics; it is the primary stabilizer against anterior tibial translation, and acts as a secondary stabilizer in excessive internal rotation and in stress in valgus and varus
An improved surgical technique for reconstructing this ligament has made it less invasive, and when combined with early rehabilitation leads to joint stability and decreases the time patients need to return to their normal activities, which has greatly increased the number of surgical reconstructions in recent years.[3]
The selection criteria for studies included in this review were: a. articles written in English or Portuguese; b. theoretical studies matching the objectives of this analysis; c. cross-sectional studies comparing graft types including contralateral patellar tendon grafts; d. correlation studies involving the use of the contralateral patellar tendon as a graft; e. controlled clinical trials verifying outcomes from the use of the contralateral patellar tendon as a graft
Summary
The anterior cruciate ligament (ACL) plays a very important role in knee biomechanics; it is the primary stabilizer against anterior tibial translation, and acts as a secondary stabilizer in excessive internal rotation and in stress in valgus and varus. Because of the high incidence of ACL injuries in the population, this ligament has been the subject of many contemporary studies. Considering the instability ACL injuries cause, and potential comorbidities resulting from ACL rupture (such as meniscal and chondral injury and possibly early osteoarthrosis), the recommended treatment is surgical and involves ligament reconstruction.[1,2] An improved surgical technique for reconstructing this ligament has made it less invasive, and when combined with early rehabilitation leads to joint stability and decreases the time patients need to return to their normal activities ( professional sports, but to work in ordinary patients), which has greatly increased the number of surgical reconstructions in recent years.[3]. All authors declare no potential conflict of interest related to this article. Article received in 09/21/2017, approved in 10/04/2017
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