The purpose of this study is to evaluate the long-term results of various anterior cruciate ligament reconstruction techniques. This assessment is necessary for the current context of anterior cruciate ligament research as several techniques and grafts are used in clinical practice, however, the various studies existing in the literature focus mainly only on the direct comparison of two techniques and usually with short-to-medium term follow-up. Since gonarthrosis is one of the most debated consequences of cruciate ligament reconstruction, a comparison of different long-term procedures would be desirable to have a clearer picture of the risks and benefits associated with different types of intervention.
In the beginning, the Database of our Institute is consulted, all the patients that underwent ACL reconstruction at least 15 years ago are selected. The original group will be divided into subgroups based on the surgical technique adopted, of the different techniques we took into consideration only these three: anatomical ACL reconstruction with patellar tendon, anatomical ACL reconstruction with hamstrings, non-anatomical ACL reconstruction "Over-the-top plus lateral plasty". The patients will be contacted to ask if they are interested to take part in the study; at least 25 patients for each group will be recruited. All the patients recruited will sign an informed consent about the study and the personal data treatment. After consent acquisition, patients will undergo a clinical examination and a questionnaire about pain and knee status will be administered; moreover, a radiographical examination of the operated knee will be performed to assess the osteoarthritis progression. Patients that reported graft rupture will be registered as failures.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
41
Anatomical ACL reconstruction with quadruple-bundle hamstrings graft
Anatomical single bundle ACL reconstruction with patellar tendon
Non-anatomical ACL reconstruction, the hamstrings' tibial insertion is preserved; a double-bundle hamstring graft is passed intra-articularly, fixed in over the top position on the lateral femoral condyle, and then passed extra-articularly deeply to ileo-tibial band up to the tibia, where it is fixed at the level of Gerdy's tubercle.
Istituto Ortopedico Rizzoli
Bologna, Italy
Subjective and objective International Knee Documentation Committee
Clinical scores widely used to assess knee function and symptoms Values: 0 (worst score) to 100 (best score) for subjective IKDC; A (best score)-B-C-D (worst score) for objective IKDC (International Knee Documentation Committee)
Time frame: Two years
VAS pain
Numerical score to quantitatively assess the intensity of pain (0-10)
Time frame: Two years
Kellgreen-Lawrence
Radiographical score that graded knee ostheoarthritis
Time frame: Two years
Knee Laxity
Assessment of knee anterior posterior laxity and quantification of Pivot shift using measurement devices (KT-1000; Kira)
Time frame: Two years
Failure and complications
Failures and complication rate for each arm of the study
Time frame: Two years
Short Form-36 Health Survey
SF-36 is a set of generic, coherent, and easily administered quality-of-life measures. These measures rely upon patient self-reporting and are now widely utilized by managed care organizations and by Medicare for routine monitoring and assessment of care outcomes in adult patients.
Time frame: Two years
Anterior knee pain
The patients will report in dicotomic way (yes/no) the presence/absence of pain referred to patello-femural joint.
Time frame: Two years
Global satisfaction about the surgical procedure
The patients will report in dicotomic way (yes/no) if they are satisfied with the surgical procedure results
Time frame: Two years
Tight circumference
Tight circumference measured 5 cm and 15 cm above the patella; it is a direct measurement of quadriceps trophism and indirectly explore the muscular status of affected limb.
Time frame: Two years
Lysholm knee scoring scale
Clinical score used to assess knee function in context of ligamentary and meniscal lesions Values: 0 (worst score) to 100 (best score)
Time frame: Two years
Tegner activity scale
Score that graded activity based on work and sports referred to knee status Values: 0 (worst score) to 10 (best score)
Time frame: Two years
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.