Abstract
Anterior cruciate ligament (ACL) reconstruction with bone-patellar tendon-bone (BTB) autograft is a very common surgical procedure for patients with ACL deficient knees; however, itcan be a technically challenging operation with possible intra-operative complications. Graft-tunnel mismatch (GTMM) is a condition in which the ACL BTB autograft does not match the intra-articular and tunnel length.
Highlights
Anterior cruciate ligament (ACL) rupture is a very common injury in active and athletic patients, and ACL reconstruciton is the prefered surgical option for the ACL-deficient knee with funcitonal instability
Using BTB autografts have been reported to have greater tensile strength compared to the native ACL,to have significatinly less anterior knee laxity and more stability compared to hamstring autografts [3,4,5]
Et al [8] reported BTB autografts to have superior screw fixation compared to hamstring autografts, which allow for more optimal bone to bone healing and quicker return to rehabiliation
Summary
Anterior cruciate ligament (ACL) rupture is a very common injury in active and athletic patients, and ACL reconstruciton is the prefered surgical option for the ACL-deficient knee with funcitonal instability. Key studies have all concluded that undergiong ACL reconstruction with BTB autografts demonstated significantly lower rates of graft rupture, decreased levels of knee laxity, improved single-legged hop test results and increaed satisfaction postoperatively [10,11,12,13]. When the ACL graft is too long, it results in protrusion of the graft out of the tibial bone tunnel and necessitates removel of excess bone This can result in compromised graft fixation and loss of optimal bone to bone healing. It is important to check the length and tension of the graft prior to fixing it into place Due to these increased risks, numerous bailout method options creating longer operative times, higher financial costs, and greater risks to each operative case- many orthopaedic surgeons will opt to use soft tissue grafts instead of BTB grafts
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