Comparison of Femoral Tunnel Placement, Geometry and Clinical Outcome Using Two Anterior Cruciate Ligament Reconstruction Technique; Transportal Technique and Outside in Technique With Remnant Preservation. Prospective Randomized Trial
Overview
- Phase
- N/A
- Intervention
- Not specified
- Conditions
- Rupture of Anterior Cruciate Ligament
- Sponsor
- Samsung Medical Center
- Enrollment
- 67
- Locations
- 1
- Primary Endpoint
- Vascularity of Graft Tendon
- Status
- Completed
- Last Updated
- 6 years ago
Overview
Brief Summary
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Purpose :To compare of femoral tunnel placement, tunnel geometry and clinical outcome using two anterior cruciate ligament reconstruction techniques ; transportal technique with flexible reamer and single bundle outside in technique with remnant preservation.
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Subjects: anterior cruciate ligament (ACL) injury 66 patients
- Double bundle transportal technique with flexible reamer: 33
- Single bundle outside in technique with remnant preservation: 33
Detailed Description
Anterior cruciate ligament (ACL) injury patients : Total 66 1. Double bundle transportal technique with flexible reamer: 33 * Advantage: more normal ACL reconstruction than single bundle technique * Disadvantage: to make the two bone tunnel must remove all the residual tissue. 2. Single bundle outside in technique with remnant preservation: 33 * Advantage: good for being synovium and revascularization. Remained proprioception function helps to functional recovery. * Disadvantage: difficult to ensure of visibility and tunnel drilling in the correct position because of remnant tissue.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Lachman test grade II,III and Pivot shift test grade II,III in physical examination
- •ACL rupture in MRI
- •within 6 months after trauma
Exclusion Criteria
- •osteoarthritis (OA) change in X-ray
- •History of other ligament injury or ACL reconstruction in uninjured knee.
- •operation history of either ipsilateral or contralateral knee(fracture, etc)
Outcomes
Primary Outcomes
Vascularity of Graft Tendon
Time Frame: 1yr after surgery
For evaluation of graft vascularity, quantitative parameter of area under the curve (AUC) was measured from DCE-MRI by using an image-processing software (IntelliSpace Portal, version 5.0; Philips Healthcare). A musculoskeletal radiologist manually drew the ROIs for intra-articular portion of the ACL graft including synovial membrane at the proximal, middle and distal zones. The software automatically generated time to signal intensity curves and then calculated the quantitative parameter, area under the time to signal intensity curve values, which were acquired by integrating the area under the time to signal intensity curve. To normalize the AUC (nAUC), we divided the AUC of medial gastrocnemius muscle into that of the ACL graft.
Secondary Outcomes
- Arthroscopy Grading(1yr after surgery)
- Graft Maturity (SNQ)(1 yr after surgery)
- Clinical Knee Scoring(2 yr after surgery)
- Instability(2 yr after surgery)