![]() 7 A 2020 meta-analysis by DeFazio et al showed that during a minimum follow-up of 1 year, hamstring autografts had an overall return-to-sport rate of 70.6%. 6 In an investigation of 314 patients with a mean follow-up of 40 months, Ardern et al showed that only 45% of patients receiving autologous hamstring ACL reconstructions were able to return to sport. 5 Quadruple hamstring grafts preserve extensor mechanism strength but have been shown to lead to significant hamstring weakness. ![]() 4 In addition, an investigation by Novaretti et al showed that only 53.4% of patients with quadriceps tendon autografts returned to their preinjury level of sport during a mean follow-up period of 2.1 years. Quadriceps tendon autografts have been associated with significant postoperative weakness in both males and females, with females experiencing significant weakness at 7-year follow-up. The most common autograft choices are quadriceps tendon, quadruple hamstring, and bone-patellar tendon-bone (BPTB). ![]() Graft selection can lead to various issues postoperatively. 2, 3 The primary goal of ACL reconstruction is to re-create the anatomy and function of the native ACL so that patients can return to their desired activity level without pain or instability. 1 In the United States, more than 200,000 ACL reconstructions are performed annually, costing the health care system approximately $7.6 billion annually. anterior cruciate ligament reconstructionĪrthroscopic anterior cruciate ligament (ACL) reconstruction is a commonly performed procedure, ranking in the top 10 most performed elective orthopedic surgical procedures.This study shows that ACL reconstruction with BPTB autograft was not significantly associated with functional anterior knee pain in our population and that the incidence of postoperative anterior knee pain following BPTB ACL reconstruction may be less than previously reported. At 3 years postoperatively, 94% (63/67) of the patients in this study were not limited by functional anterior knee pain and returned to preoperative levels of activity and sport.Ĭonclusion: To our knowledge, this investigation is the first to define and quantify the relationship between postoperative anterior knee pain and resultant functional limitations. This incidence decreased to 6.0% at 1 year and 7.5% at 3 years postoperatively. The incidence (28.4%) of anterior knee pain was highest at the 3-month time point. Compared to the mean preoperative visual analog scale (VAS) pain score of 6.1, patients reported statistically significant reductions in VAS scores at 1 year and 3 years postoperatively to 0.9 and 1.8, respectively ( P<0.01). Results: Sixty-seven patients met the inclusion criteria. Statistical analyses were performed using paired t tests and binomial test. Patients included in the analysis had a minimum of 1 year of clinical follow-up and 3 years of survey follow-up. Methods: We reviewed BPTB ACL reconstructions from April 2013 to May 2017. This study introduces the concept of functional anterior knee pain, or kneecap pain that limits patients’ ability to return to their prior level of activity or sport. However, previous studies have not evaluated if this anterior knee pain is functionally limiting for patients. doi:10.Background: Bone-patellar tendon-bone (BPTB) anterior cruciate ligament (ACL) reconstruction is a frequently used technique but has been associated with a high incidence of postoperative anterior knee pain. Anatomical double-bundle MPFL reconstruction with an aperture fixation. The newest kits use 3.9 mm BioComposite SwiveLock ® anchors for patellar fixation and either a 6 mm × 20 mm BioComposite FastThread™ interference screw or an ACL TightRope ® implant for femoral fixation.ġ. This position provides a static fixation point that equalizes the tension across the graft in flexion and extension, thus helping minimize stress across the patellofemoral joint.Īrthrex offers 4 MPFL convenience packs to address each patient's unique needs as well as each surgeon's preference for fixation. Our technique incorporates the use of a femoral template to ensure proper placement of the graft in the femur. Successful MPFL reconstruction is dependent on anatomic placement of the graft. The technique, if accomplished directly and anatomically, can also provide for more aggressive rehabilitation protocols and earlier return to activity. The Double-Bundle Technique also effectively limits rotation throughout ROM, helping to minimize postoperative instability. The Arthrex Anatomic Double-Bundle Technique for medial patellofemoral ligament (MPFL) reconstruction replicates the native shape of the MPFL and provides stability in both flexion and extension.
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