دورية أكاديمية
أعرض في EDS

Reduction in Diameter of Hamstring Autograft With Additional Circumferential Preconditioning During ACL Reconstruction in a Pediatric Population.

التفاصيل البيبلوغرافية
العنوان: Reduction in Diameter of Hamstring Autograft With Additional Circumferential Preconditioning During ACL Reconstruction in a Pediatric Population.
المؤلفون: Weltsch D; Division of Orthopaedic Surgery, Children's Hospital of Philadelphia, Pennsylvania, USA.; Department of Orthopedic Surgery, Chaim Sheba Medical Center at Tel Hashomer, Israel.; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel., Chan C; Division of Orthopaedic Surgery, Children's Hospital of Philadelphia, Pennsylvania, USA., Dale KM; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel., Koehler RJ; Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Department of Orthopaedic Surgery and Rehabilitation, University of Nebraska Medical Center, Omaha, Nebraska, USA., Talwar D; Division of Orthopaedic Surgery, Children's Hospital of Philadelphia, Pennsylvania, USA., Ganley TJ; Division of Orthopaedic Surgery, Children's Hospital of Philadelphia, Pennsylvania, USA.; Perelman School of Medicine, University of Pennsylvania, Pennsylvania, USA., Lawrence JTR; Division of Orthopaedic Surgery, Children's Hospital of Philadelphia, Pennsylvania, USA.; Perelman School of Medicine, University of Pennsylvania, Pennsylvania, USA.
المصدر: Orthopaedic journal of sports medicine [Orthop J Sports Med] 2021 Aug 19; Vol. 9 (8), pp. 23259671211025497. Date of Electronic Publication: 2021 Aug 19 (Print Publication: 2021).
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Sage on behalf of: The American Orthopaedic Society for Sports Medicine Country of Publication: United States NLM ID: 101620522 Publication Model: eCollection Cited Medium: Print ISSN: 2325-9671 (Print) Linking ISSN: 23259671 NLM ISO Abbreviation: Orthop J Sports Med Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: [Thousand Oaks, CA] : Sage on behalf of: The American Orthopaedic Society for Sports Medicine, [2013]-
مستخلص: Background: Over 130,000 anterior cruciate ligament (ACL) reconstructions (ACLRs) are performed annually in the United States. Previous studies have shown that circumferential preconditioning reduces the diameter of fresh-frozen allografts, but no studies have described the effect in ACL autografts used during ACLR.
Purpose: To characterize the changes in the hamstring autograft diameter as a result of preparatory circumferential preconditioning.
Study Design: Case series; Level of evidence, 4.
Methods: A total of 135 patients with ACLR, with a median age of 15 years (interquartile range, 14-16 years; 50.4% boys), were identified in 2 pediatric hospitals. Three orthopaedic surgeons recorded hamstring autograft diameters at 2 time points during graft preparation. Hamstring tendons were prepared using a standardized procedure, tensioned to 15 to 20 lbs, and measured using cylindrical sizing guides. The graft was left with passive compression in the smallest initial rigid sizing guide for 10 minutes on both the tibial and femoral sides and then measured again immediately before implantation. Tunnels were drilled based on the second measurement of graft size. Comparisons were made between the graft diameter before and after circumferential preconditioning. A random-effects regression model and a linear regression model were performed to capture any unexplained variance on the linear predictor scale and determine correlations between demographics and graft characteristics.
Results: The median initial diameter for both femoral and tibial sides was 9.5 mm. After longitudinal tension and circumferential preconditioning, the median autograft diameter of both sides decreased by 1 mm ( P < .001) to 8.5 mm. In the random-effects model, decreased patient height was a significant predictor of greater reduction in graft diameter. Increased height was a significant predictor for greater initial graft diameter (average beta coefficient = 3.08; P < .01). No intraoperative complications were noted with implantation of the preconditioned grafts in smaller diameter tunnels.
Conclusion: The median diameter of hamstring ACL autografts decreases by 1 mm after circumferential preconditioning within standard cylindrical sizing guides. This allowed for drilling of tunnels that were an average of 1 mm smaller without any noted intraoperative complications with graft insertion.
Competing Interests: One or more of the authors has declared the following potential conflict of interest or source of funding: K.M.D. has received grant support from Arthrex. T.J.G. has received research support from Vericel, Arthrex, and AlloSource and educational support from Liberty Surgical and is a paid associated editor for The American Journal of Sports Medicine. J.T.R.L. has received educational support from Arthrex and Liberty Surgical and nonconsulting fees from Arthrex. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.
(© The Author(s) 2021.)
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فهرسة مساهمة: Keywords: graft diameter; graft preparation; hamstring; pediatric; sport
تواريخ الأحداث: Date Created: 20210826 Latest Revision: 20220426
رمز التحديث: 20240628
مُعرف محوري في PubMed: PMC8381437
DOI: 10.1177/23259671211025497
PMID: 34435070
قاعدة البيانات: MEDLINE
الوصف
تدمد:2325-9671
DOI:10.1177/23259671211025497