Final Grant Proposal Presentation 2
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Transcript of Final Grant Proposal Presentation 2
ACL graft comparison between patellar autograft, hamstring autograft and allographs
By: David T. Payne IV
ACL • Anterior translation of the tibia, and
secondary to varus/valgus stress. • Age, knee joint laxity, activity level,
biomechanics, may lead to ACL tear• Most frequently repaired ligament in
the knee joint.
Patellar Tendon Graft • Most widely used graft source and is
considered the gold standard.• Most popular choice due to the
strength, ease of harvest, quick healing, and good patient outcomes.
• Patella infera, patellar fractures, patellar tendon ruptures, tendonitis, anterior knee pain, synovitis
Hamstrings Autograft• Semitendinosus muscle is most often
used.• Recreational athletes, low demand
patients, or youth• Should not be used in competitive
sprinters, those with generalized ligamentous laxity, or those with previous hamstring injury
Allografts• Eliminates the donor morbidity and no
weakening of muscles • There is a shorter operating time, less
pain, smaller incisions, and better cosmetic result.
• Host immune response against donor tissue and an increase in cost.
PurposePatients need to know the differences
between the choices for the repair graft.College athletes are highly active and
will want to know how each graft will handle long-term stress
HypothesisResearch shows that patellar autografts
(BPTB) work best for highly active persons, including our college athletes
Comparing data groups such as success rate, rupture rate, pain levels, ect.
Inclusion Criteria College aged athletesUndergone patellar autograft, allograft
or hamstring autograft to repair ACL injury
Within the past 3 years
Exclusion Criteria College aged individuals that are not
athletes that have had one of the procedures.
Greater than 3 years since reconstruction
Any athlete with other surgeries
Data Collection Initial selection Email contactQuestionnaire
Data AnalysisANOVANO T-testPost Hoc Alpha level 0.05
References 1. ElAttrache, S. N., Harner, D. C., Mizayan, R. (December 4, 2006) Surgical
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2. Shelbourne, K. D., Gray, T. (Dec, 1997). Anterior Cruciate Ligament Reconstruction with Autogenous Patellar Tendon Graft Followed by Accelerated Rehabilitation: A Two- to Nine-Year Followup. American Journal of Sports Medicine, 25(6): 786-95.
3. Marder, R. A., Raskind, J. R., Carroll, M. (Sept, 1991). Prospective evaluation of arthroscopically assisted anterior cruciate ligament reconstruction: Patellar tendon versus semitendinosus and gracilis tendons. American Journal of Sports Medicine, 19(5): 478-84.
4. Rosenberg, T. D., Franklin, J. L., Baldwin, G. N., Nelson, K. A. (Sept-Oct, 1992) Extensor mechanism function after patellar tendon graft harvest for anterior cruciate ligament reconstruction. American Journal of Sports Medicine, 20(5): 519-526.
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7. Sajovic, M., Strahovnik, A., Dernovsek, M. Z., Skaza, K. (June, 2011). Quality of Life and Clinical Outcome Comparison of Semitendinosus and Gracilis Tendon Versus Patellar Tendon Autografts for Anterior Cruciate Ligament Reconstruction: An 11 Year Follow-up of a Randomized Controlled Trial. American Journal of Sports Medicine, 39(10): 2161-2169
8. Kurosaka, M., Yoshiya, S., Andrish, J. T. (June, 1987). A biomechanical comparison of different surgical techniques of graft fixation in anterior cruciate ligament reconstruction. American Journal of Sports Medicine, 15(3): 225-229.
9. Kraeutler, M. J., Bravman, J. T., McCarty, E. C. (Oct, 2013). Bone-Patellar Tendon-Bone Autograft Versus Allograft in Outcomes of Anterior Cruciate Ligament Reconstruction: A Meta-Analysis of 5182 Patients. American Journal of Sports Medicine, 41(10): 2439-2448.
10. Yasuda, K., Kondo, E., Ichiyama, H., Kitamura, N., Tanebe, Y., Tohyama, H., et al. (Dec, 2004). Anatomic reconstruction of the anteromedial and pasteriolateral bundles of the anterior cruciate ligament using hamstring tendon grafts. Journal of Arthroscopic & Related Surgery, 20(10): 1015-1025.
11. Yasuda, K., Kodo, E., Ichiyama, H., Tanebe, Y., Tohyama, H. (Mar, 2006). Clinical Evaluation of Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction Procedure using Hamstring Tendon Grafts: Comparisons Among 3 Different Procedures. Journal of Arthroscopy & Related Surgery, 22(3): 240-251.
12. Heijne, A., & Werner, S. (2010). A 2-year follow-up of rehabilitation after ACL reconstruction using patellar tendon or hamstring tendon grafts: a prospective randomised outcome study. Knee Surgery, Sports Traumatology, Arthroscopy, 18(6), 805-813.
13. Xergia, S. A., McClelland, J. A., Kvist, J., Vasiliadis, H. S., & Georgoulis, A. D. (2011). The influence of graft choice on isokinetic muscle strength 4-24 months after anterior cruciate ligament reconstruction. Knee Surgery, Sports Traumatology, Arthroscopy, 19(5), 768-780.
14. Magnussen, R. A., Carey, J. L., & Spindler, K. P. (2011). Does autograft choice determine intermediate-term outcome of ACL reconstruction? Knee Surgery, Sports Traumatology, Arthroscopy,19(3), 462-472.
15. Landes, S., Nyland, J., Elmlinger, B., Tillett, E., & Caborn, D. (2010). Knee flexor strength after ACL reconstruction: comparison between hamstring autograft, tibialis anterior allograft, and non-injured controls. Knee Surgery, Sports Traumatology, Arthroscopy,18(3), 317-324.
16. Zamarra, G., Fisher, M. B., Woo, S. Y., & Cerulli, G. (2010). Biomechanical evaluation of using one hamstrings tendon for ACL reconstruction: a human cadaveric study. Knee Surgery, Sports Traumatology, Arthroscopy, 18(1), 11-19.
17. Petersen, W., Zantop, T. (June, 2012). Return to play following ACL reconstruction: survey among experienced arthroscopic surgeons (AGA
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cruciate ligament reconstruction with BPTB autograft, irradiated versus non-irradiated allograft: a prospective randomized clinical study. Knee Surgery, Sports Traumatology, Arthroscopy, 17(5), 464-474.
19. Mehran, N., Skendzel, J. G., Lesniak, B. P., Bedi, A. (2013). Contemporary Graft Options in Anterior Cruciate Ligament Reconstruction. Operative Techniques in Sports Medicine, 21: 10-18.
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21. Magnussen, R., Spindler, K. P. (2013). Anterior Cruciate Ligament Reconstruction: Two Incision-Technique. Operative Techniques in Sports Medicine, 21: 34-39.
22. Goldsmith, M. T., Jansson, K. S., Smith, S. D., Engebretson, L., LaPrade, R. F., Wijdicks, C. A. (2013). Biomechanical Comparison of Anatomic Single- and Double- Bundle Anterior Cruciate Ligament Reconstructions. American Journal of of Sports Medicine, 41(7): 1595-1604. 23. Viskontas, D. G., Giuffre, B. M., Duggal, N., Graham, D., Parker, D., Coolican, M. (2008). Bone Bruises Associated with ACL Rupture. American Journal of Sports Medicine, 36(5): 927-933.24. Mulford, J. S., Hutchinson, S. E., Hang, J. R. (Sept, 2012). Outcomes for primary anterior cruciate reconstruction with the quadriceps autograft: a systematic review. Knee Surgerons Sports Traumatol Arthroscopy, 21: 1882-1888. 25. Ghodadra, N. S, Mall, N. A., Grumet, R., Sherman, S. L, Kirk, S., Provencher, M. T., & Bach, B. R.(2012). Interval Arthrometric Comparison of Anterior Cruciate Ligament Reconstruction Using Bone-Patellar Tendon- Bone Autograft Versus Allograft: Do Grafts Attenuate Within the First Year Postoperatively? American Journal of Sports Medicine, 40(6), 1347-1354. 26. Mascarenhas, R., Tranovich, M., Kropf, E., Fu, F., & Harner, C. (2012). Bone-patellar tendon-bone autograft versus hamstring autograft anterior cruciate ligament reconstruction in the young athlete: a retrospective matched analysis with 2-10 year follow-up. Knee Surgery, Sports Traumatology, Arthroscopy, 20(8), 1520-1527. 27. Sun, K., Tian, S., Zhang, J., Xia, C., Zhang, C., & Yu, T. (2009). Anterior cruciate ligament reconstruction with BPTB autograft, irradiated versus non-irradiated allograft: a prospective randomized clinical study. Knee Surgery, Sports Traumatology, Arthroscopy, 17(5), 464-474.