Isometric placement of the augmentation braid is not attained reliably in contemporary ACL suture repair

To assess if during arthroscopic braid-augmented ACL suture repair (ACLSR), the actual positions of the augmentation braids' tunnels corresponded with the positions of their intended and targeted isometric points, and to test the hypothesis that there would be no dispersion in actual positions...

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Bibliographic Details
Published in:The knee 2020-01, Vol.27 (1), p.111-123
Main Authors: Hoogeslag, Roy A.G., Brouwer, Reinoud W., Huis in 't Veld, Rianne, Amis, Andrew A.
Format: Article
Language:English
Subjects:
ACL suture repair
Anterior cruciate ligament
Biomechanics
Biomechanics of ligament
Cadavers
Cameras
Femur
Isometric
Knee
Sutures
Tunnels
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Summary:To assess if during arthroscopic braid-augmented ACL suture repair (ACLSR), the actual positions of the augmentation braids' tunnels corresponded with the positions of their intended and targeted isometric points, and to test the hypothesis that there would be no dispersion in actual positions of the augmentation braids' tunnels compared to their intended and targeted isometric points. In 12 human cadaveric knees, the positions of the augmentation braids' tunnels and their intended and targeted isometric points relative to a femoral and tibial grid were analysed. Furthermore, vector length between these positions was calculated to assess the accuracy and precision of the augmentation braids' tunnel placement. There was dispersion for all of the augmentation braids' tunnel positions compared to their intended isometric points. The femoral and tibial vector lengths (mean ± SD (range)) were 2.9 ± 1.0 (1.1–4.1) and 7.1 ± 2.0 (3.2–9.8) mm respectively. In augmented ACLSR, with the ruptured ACL in situ, there was dispersion of the positions of the actual small diameter femoral and tibial augmentation braids' tunnels away from their desired isometric points. The extent of dispersion of the position of both the femoral and tibial tunnels away from their intended isometric positions may cause cyclic length changes with knee motion. An ACLSR with static braid augmentation will thus be vulnerable to cyclic stretching-out. The difficulty of obtaining an isometric tunnel combination for the small diameter augmentation braid may influence the clinician's choice between non-, static or dynamic augmented ACLSR techniques.
ISSN:0968-0160
1873-5800
DOI:10.1016/j.knee.2019.10.013