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Can We Predict Quadrupled Hamstring Graft Size from Preoperative MRIs?
ABSTRACTS
reliability, indicating that it takes ten patients to acquire proper technique standardization. Conclusion: Few authors have published their learning curve, but this is the first study to compare arthroscopic Latarjet to the Gold Standard open technique. Although it seems that it takes ten patients to overcome most of the arthroscopic Latarjet learning curve, it takes over the double to achieve comparable results to the open technique, which hence remains the Gold Standard. Second Failure of ACL Graft: Third ACL Reconstruction Combined to Tibial Deflexion Osteotomy, A One Stage Procedure SS-11 Thursday, April 23 at 11:20 AM LAURENT BAVEREL, M.D., PRESENTING AUTHOR GUILLAUME ODRI, M.D. MO SAFFARINI, M.ENJ. DAVID DEJOUR, M.D. Introduction: Anterior cruciate ligament (ACL) revision rate is estimated at 12%. A tibial slope above 7 increases the anterior tibial translation (ATT) and has been identified as a risk factor of iterative rupture. The purpose of this study was to evaluate a third ACL reconstruction combined to tibial deflexion osteotomy in a one-stage procedure. Methods: It is a retrospective study of 11 ACL reconstructions combined to a tibial deflexion osteotomy in one stage procedure. The mean age at surgery was 36,2 years (26-42). The indication was clinical instability in daily life and recreational sport activities combined with tibial slope above 10 . The IKDC score, and Tegner and Lysholm score were used to evaluate the knee preoperatively and postoperatively. Preoperative and postoperative weight bearing X-Rays were done to evaluate the tibial slope correction, bone tunnel position, and development of arthritis. The mean F.U was 78 months one patient was lost at F.U Results: IKDC and Tegner and Lyshom score increased respectively from 45,3 to 76,5 and from 40,8 to 75,6 at final follow-up (p Conclusion: The tibial slope is an important factor to be measured in case of ACL rupture. A pathological tibial slope > 10 could lead to a stress rupture especially in case of meniscectomy. doing combined deflexion osteotomy and ACL reconstruction is an efficient procedure. The one stage procedure does not change the rehab protocol except a none weight bearing period of 21 days. Can We Predict Quadrupled Hamstring Graft Size from Preoperative MRIs? SS-12 Thursday, April 23 at 11:25 AM BRIAN MOSIER, M.D., PRESENTING AUTHOR JASON WALTERS, M.D. GREGORY ALTMAN, M.D. SAM AKHAVAN, M.D. Introduction: Graft size has been shown to be a predictor of early revision after ACL reconstruction with hamstring
e5
autograft sizes less than 8mm.[1] The aim of the current project was to determine whether hamstring size grafts can be predicted from preoperative MRI measurements. Methods: Prior to this study, we obtained 10 semitendinosis (ST) and 10 Gracilis (GT) tendon allografts of various sizes (RTI Biologics, Alchua, FL). This provided us 100 different combinations of ST and GT allografts, which were used to make a predictive chart for quadrupled hamstring (QH) size (Figure 1). We then prospectively evaluated 22 consecutive patients undergoing ACL reconstruction using hamstring autograft. At the time of surgery, the ST and GT were harvested and individually sized, then sized as a QH graft. Preoperative individual ST and GT sizes were determined from the MRI at 3cm above the joint line, using a method previously presented.[2] We then used figure 1 to predict what the size of the QH graft would be and correlated this with the intra-operative measurements. Results: The predicted GT size was within 0.5 millimeters of the actual size in 15/22 (68%) and within 1 mm of the actual graft size in 21/22 (95%) patients. The predicted ST size was within 0.5 millimeters of the actual size in 17/22 (77%) and within 1 mm of the actual graft size in 19/22 (86%) patients. The predicted combined graft size was within 0.5 millimeters of the actual size in 16/22 (73%) and within 1 mm of the actual graft size in 21/22 (95%) patients. Conclusion: The current technique can accurately predict the size of a QH graft within 1mm of final graft size in 95% of cases. We believe this technique would be extremely useful to surgeons concerned with obtaining a small intraoperative QH graft. Anterior Cruciate Ligament Quality of Life (ACL-QOL) Questionnaire: Responsiveness to Change up to 2-years post ACL Reconstruction SS-13 Thursday, April 23 at 11:30 AM S. MARK HEARD, B.P.E., M.D., PRESENTING AUTHOR MARK LAFAVE, M.SC., PH.D. SARAH KERSLAKE, B.PHTY. (HONS), M.SC. LAURIE HIEMSTRA, M.D., PH.D. GREGORY BUCHKO, B.SC., M.D. Introduction: The ACL-QOL was originally published by Mohtadi in 1998, and has been cited in over 130 studies. The responsiveness to change of an instrument is one aspect of its validity. The purpose of this study was to further validate the ACL-QOL by assessing its responsiveness to change up to 2-years post anterior cruciate ligament (ACL) reconstruction surgery. Methods: Five hundred and seventy nine ACL-deficient patients were referred to an orthopaedic surgical practice for consultation. All patients completed the ACL-QOL questionnaire pre-operatively (n ¼ 579). Data was prospectively gathered from this patient cohort 6-months post-operatively (n ¼ 446), 12-months post-operatively (n ¼ 280), and 24-months post-operatively (n¼ 100). Comparison of change in ACL-QOL scores was calculated using a one-way analysis of variance (ANOVA) for each time point. Results: The mean ACL-QOL score for ACL-deficient patients presenting for an orthopaedic surgery
reliability, indicating that it takes ten patients to acquire proper technique standardization. Conclusion: Few authors have published their learning curve, but this is the first study to compare arthroscopic Latarjet to the Gold Standard open technique. Although it seems that it takes ten patients to overcome most of the arthroscopic Latarjet learning curve, it takes over the double to achieve comparable results to the open technique, which hence remains the Gold Standard. Second Failure of ACL Graft: Third ACL Reconstruction Combined to Tibial Deflexion Osteotomy, A One Stage Procedure SS-11 Thursday, April 23 at 11:20 AM LAURENT BAVEREL, M.D., PRESENTING AUTHOR GUILLAUME ODRI, M.D. MO SAFFARINI, M.ENJ. DAVID DEJOUR, M.D. Introduction: Anterior cruciate ligament (ACL) revision rate is estimated at 12%. A tibial slope above 7 increases the anterior tibial translation (ATT) and has been identified as a risk factor of iterative rupture. The purpose of this study was to evaluate a third ACL reconstruction combined to tibial deflexion osteotomy in a one-stage procedure. Methods: It is a retrospective study of 11 ACL reconstructions combined to a tibial deflexion osteotomy in one stage procedure. The mean age at surgery was 36,2 years (26-42). The indication was clinical instability in daily life and recreational sport activities combined with tibial slope above 10 . The IKDC score, and Tegner and Lysholm score were used to evaluate the knee preoperatively and postoperatively. Preoperative and postoperative weight bearing X-Rays were done to evaluate the tibial slope correction, bone tunnel position, and development of arthritis. The mean F.U was 78 months one patient was lost at F.U Results: IKDC and Tegner and Lyshom score increased respectively from 45,3 to 76,5 and from 40,8 to 75,6 at final follow-up (p Conclusion: The tibial slope is an important factor to be measured in case of ACL rupture. A pathological tibial slope > 10 could lead to a stress rupture especially in case of meniscectomy. doing combined deflexion osteotomy and ACL reconstruction is an efficient procedure. The one stage procedure does not change the rehab protocol except a none weight bearing period of 21 days. Can We Predict Quadrupled Hamstring Graft Size from Preoperative MRIs? SS-12 Thursday, April 23 at 11:25 AM BRIAN MOSIER, M.D., PRESENTING AUTHOR JASON WALTERS, M.D. GREGORY ALTMAN, M.D. SAM AKHAVAN, M.D. Introduction: Graft size has been shown to be a predictor of early revision after ACL reconstruction with hamstring
e5
autograft sizes less than 8mm.[1] The aim of the current project was to determine whether hamstring size grafts can be predicted from preoperative MRI measurements. Methods: Prior to this study, we obtained 10 semitendinosis (ST) and 10 Gracilis (GT) tendon allografts of various sizes (RTI Biologics, Alchua, FL). This provided us 100 different combinations of ST and GT allografts, which were used to make a predictive chart for quadrupled hamstring (QH) size (Figure 1). We then prospectively evaluated 22 consecutive patients undergoing ACL reconstruction using hamstring autograft. At the time of surgery, the ST and GT were harvested and individually sized, then sized as a QH graft. Preoperative individual ST and GT sizes were determined from the MRI at 3cm above the joint line, using a method previously presented.[2] We then used figure 1 to predict what the size of the QH graft would be and correlated this with the intra-operative measurements. Results: The predicted GT size was within 0.5 millimeters of the actual size in 15/22 (68%) and within 1 mm of the actual graft size in 21/22 (95%) patients. The predicted ST size was within 0.5 millimeters of the actual size in 17/22 (77%) and within 1 mm of the actual graft size in 19/22 (86%) patients. The predicted combined graft size was within 0.5 millimeters of the actual size in 16/22 (73%) and within 1 mm of the actual graft size in 21/22 (95%) patients. Conclusion: The current technique can accurately predict the size of a QH graft within 1mm of final graft size in 95% of cases. We believe this technique would be extremely useful to surgeons concerned with obtaining a small intraoperative QH graft. Anterior Cruciate Ligament Quality of Life (ACL-QOL) Questionnaire: Responsiveness to Change up to 2-years post ACL Reconstruction SS-13 Thursday, April 23 at 11:30 AM S. MARK HEARD, B.P.E., M.D., PRESENTING AUTHOR MARK LAFAVE, M.SC., PH.D. SARAH KERSLAKE, B.PHTY. (HONS), M.SC. LAURIE HIEMSTRA, M.D., PH.D. GREGORY BUCHKO, B.SC., M.D. Introduction: The ACL-QOL was originally published by Mohtadi in 1998, and has been cited in over 130 studies. The responsiveness to change of an instrument is one aspect of its validity. The purpose of this study was to further validate the ACL-QOL by assessing its responsiveness to change up to 2-years post anterior cruciate ligament (ACL) reconstruction surgery. Methods: Five hundred and seventy nine ACL-deficient patients were referred to an orthopaedic surgical practice for consultation. All patients completed the ACL-QOL questionnaire pre-operatively (n ¼ 579). Data was prospectively gathered from this patient cohort 6-months post-operatively (n ¼ 446), 12-months post-operatively (n ¼ 280), and 24-months post-operatively (n¼ 100). Comparison of change in ACL-QOL scores was calculated using a one-way analysis of variance (ANOVA) for each time point. Results: The mean ACL-QOL score for ACL-deficient patients presenting for an orthopaedic surgery