Comparison of anterior knee laxity immediately after anatomic double-bundle anterior cruciate ligament reconstruction: Manual tensioning vs tensioning boot techniques
Purpose: Tensioning technique at graft fixation is one of key factors for successful outcomes in ACL reconstruction. The tensioning boot, which had two tensioners and was fixed to the tibia with a bandage, was developed for precise graft tensioning. The purpose was to compare the anterior knee laxit...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-04-01
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| Series: | Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilitation and Technology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214687322000048 |
| _version_ | 1828280458275717120 |
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| author | Tatsuo Mae Yukiyoshi Toritsuka Hiroyuki Nakamura Ryohei Uchida Shigeto Nakagawa Konsei Shino |
| author_facet | Tatsuo Mae Yukiyoshi Toritsuka Hiroyuki Nakamura Ryohei Uchida Shigeto Nakagawa Konsei Shino |
| author_sort | Tatsuo Mae |
| collection | DOAJ |
| description | Purpose: Tensioning technique at graft fixation is one of key factors for successful outcomes in ACL reconstruction. The tensioning boot, which had two tensioners and was fixed to the tibia with a bandage, was developed for precise graft tensioning. The purpose was to compare the anterior knee laxity between the manual tensioning and the tensioning boot techniques immediately after ACL reconstruction under anesthesia in order to elucidate the effectiveness of using the tensioning boot. Methods: 33 patients had anatomic double-bundle ACL reconstruction with semitendinosus tendon graft. After grafts were fixed with EndoButton-CL on lateral femoral cortex, grafts were tied to Double Spike Plate (DSP). Each graft was pre-tensioning with 20 N (totally 40 N) at 20 degree of flexion for 3 minutes using manually-held tensioner in 11 patients and using tensioner installed to tensioning boot in the remaining 22 patients before graft fixation, and were then fixed in the same manner. Tibial displacement under 67 and 89 N of tibial anterior load was measured by KT-2000 Knee Arthrometer under anesthesia before and immediately after operation. Results: The anterior knee laxity in the operated knee was 4.5 ± 1.0 mm in the manual tensioning group and 2.9 ± 0.9 mm in the tensioning boot group at 89 N of anterior load, showing a significant difference. (P < .0001) The side-to-side difference in the manual tensioning group was significantly less than that in the tensioning boot group. (P = .002) Conclusions: Anterior laxity of the operated knees as well as KT side-to-side difference immediately after ACL reconstruction was larger in the tensioning boot technique than the manual tensioning technique, when the graft was fixed in the same manner. Thus, the initial tension at graft fixation with the tensioning boot can be smaller than 40 N. |
| first_indexed | 2024-04-13T07:59:57Z |
| format | Article |
| id | doaj.art-4ea31577838c42ddad05f2d5d901b644 |
| institution | Directory Open Access Journal |
| issn | 2214-6873 |
| language | English |
| last_indexed | 2024-04-13T07:59:57Z |
| publishDate | 2022-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilitation and Technology |
| spelling | doaj.art-4ea31577838c42ddad05f2d5d901b6442022-12-22T02:55:18ZengElsevierAsia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilitation and Technology2214-68732022-04-01282124Comparison of anterior knee laxity immediately after anatomic double-bundle anterior cruciate ligament reconstruction: Manual tensioning vs tensioning boot techniquesTatsuo Mae0Yukiyoshi Toritsuka1Hiroyuki Nakamura2Ryohei Uchida3Shigeto Nakagawa4Konsei Shino5Department of Sports Medical Biomechanics, Osaka University Graduate School of Medicine, 2-2, Yamada-oka, Suita, Osaka, 565-0871, Japan; Department of Orthopaedic Surgery, Kansai Rosai Hospital, 3-1-69, Inabaso, Amagasaki, Hyogo, 660-0064, Japan; Corresponding author. Dept. of Sports Medical Biomechanics, Osaka Univ. Graduate School of Medicine, 2-2, Yamada-oka, Suita, Osaka, 565-0871, Japan.School of Health and Sports Sciences, Mukogawa Women's University, 6-46, Ikebiraki, Nishinomiya, Hyogo, 663-8558, Japan; Department of Sports Orthopaedic Surgery, Kansai Rosai Hospital, 3-1-69, Inabaso, Amagasaki, Hyogo, 660-0064, JapanSoai Orthopedic Surgery, 2-8, Suehiro-cho, Takarazuka, Hyogo, 665-0031, JapanDepartment of Sports Orthopaedic Surgery, Kansai Rosai Hospital, 3-1-69, Inabaso, Amagasaki, Hyogo, 660-0064, JapanDepartment of Sports Orthopaedic Surgery, Yukioka Hospital, 2-2-3, Ukita, Kita-ku, Osaka, 530-0021, JapanSports Orthopaedic Center, Yukioka Hospital, 2-2-3, Ukita, Kita-ku, Osaka, 530-0021, JapanPurpose: Tensioning technique at graft fixation is one of key factors for successful outcomes in ACL reconstruction. The tensioning boot, which had two tensioners and was fixed to the tibia with a bandage, was developed for precise graft tensioning. The purpose was to compare the anterior knee laxity between the manual tensioning and the tensioning boot techniques immediately after ACL reconstruction under anesthesia in order to elucidate the effectiveness of using the tensioning boot. Methods: 33 patients had anatomic double-bundle ACL reconstruction with semitendinosus tendon graft. After grafts were fixed with EndoButton-CL on lateral femoral cortex, grafts were tied to Double Spike Plate (DSP). Each graft was pre-tensioning with 20 N (totally 40 N) at 20 degree of flexion for 3 minutes using manually-held tensioner in 11 patients and using tensioner installed to tensioning boot in the remaining 22 patients before graft fixation, and were then fixed in the same manner. Tibial displacement under 67 and 89 N of tibial anterior load was measured by KT-2000 Knee Arthrometer under anesthesia before and immediately after operation. Results: The anterior knee laxity in the operated knee was 4.5 ± 1.0 mm in the manual tensioning group and 2.9 ± 0.9 mm in the tensioning boot group at 89 N of anterior load, showing a significant difference. (P < .0001) The side-to-side difference in the manual tensioning group was significantly less than that in the tensioning boot group. (P = .002) Conclusions: Anterior laxity of the operated knees as well as KT side-to-side difference immediately after ACL reconstruction was larger in the tensioning boot technique than the manual tensioning technique, when the graft was fixed in the same manner. Thus, the initial tension at graft fixation with the tensioning boot can be smaller than 40 N.http://www.sciencedirect.com/science/article/pii/S2214687322000048ACLLaxityTensioningGraftFixationInitial tension |
| spellingShingle | Tatsuo Mae Yukiyoshi Toritsuka Hiroyuki Nakamura Ryohei Uchida Shigeto Nakagawa Konsei Shino Comparison of anterior knee laxity immediately after anatomic double-bundle anterior cruciate ligament reconstruction: Manual tensioning vs tensioning boot techniques Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilitation and Technology ACL Laxity Tensioning Graft Fixation Initial tension |
| title | Comparison of anterior knee laxity immediately after anatomic double-bundle anterior cruciate ligament reconstruction: Manual tensioning vs tensioning boot techniques |
| title_full | Comparison of anterior knee laxity immediately after anatomic double-bundle anterior cruciate ligament reconstruction: Manual tensioning vs tensioning boot techniques |
| title_fullStr | Comparison of anterior knee laxity immediately after anatomic double-bundle anterior cruciate ligament reconstruction: Manual tensioning vs tensioning boot techniques |
| title_full_unstemmed | Comparison of anterior knee laxity immediately after anatomic double-bundle anterior cruciate ligament reconstruction: Manual tensioning vs tensioning boot techniques |
| title_short | Comparison of anterior knee laxity immediately after anatomic double-bundle anterior cruciate ligament reconstruction: Manual tensioning vs tensioning boot techniques |
| title_sort | comparison of anterior knee laxity immediately after anatomic double bundle anterior cruciate ligament reconstruction manual tensioning vs tensioning boot techniques |
| topic | ACL Laxity Tensioning Graft Fixation Initial tension |
| url | http://www.sciencedirect.com/science/article/pii/S2214687322000048 |
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