Anterior Cruciate Ligament Reconstruction With Bone–Patellar Tendon–Bone Autograft With Concomitant Meniscal Allograft Transplantation
Background: Primary arthroscopic-assisted anterior cruciate ligament (ACL) reconstruction using a bone–patellar tendon–bone (BTB) graft offers excellent long-term results for patients with ACL tears. When concurrent meniscal damage is present, the preferred treatment is repair of the meniscus. Howev...
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2025-02-01
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| Series: | Video Journal of Sports Medicine |
| Online Access: | https://doi.org/10.1177/26350254241299456 |
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| author | Jonathan D. Groothoff MA Richard S. Villa BS Mark A. Glover BS Thomas W. Mason BS Anthony P. Fiegen MD Jelle P. van der List MD, PhD Brian R. Waterman MD |
| author_facet | Jonathan D. Groothoff MA Richard S. Villa BS Mark A. Glover BS Thomas W. Mason BS Anthony P. Fiegen MD Jelle P. van der List MD, PhD Brian R. Waterman MD |
| author_sort | Jonathan D. Groothoff MA |
| collection | DOAJ |
| description | Background: Primary arthroscopic-assisted anterior cruciate ligament (ACL) reconstruction using a bone–patellar tendon–bone (BTB) graft offers excellent long-term results for patients with ACL tears. When concurrent meniscal damage is present, the preferred treatment is repair of the meniscus. However, meniscectomy may be needed, which can result in insufficient meniscal function. Indications: ACL reconstruction performed concomitantly with meniscal allograft transplantation (MAT) is indicated for patients with ACL tears and meniscal insufficiency. This procedure is typically reserved for younger, active patients, such as the 38-year-old woman in this presentation. Technique Description: The patient was placed in the supine position. The BTB graft was harvested first using a standard medial midline incision. A posterior meniscus root tunnel was drilled, followed by drilling of the femoral tunnel for ACL reconstruction. The tibial tunnel for ACL reconstruction was subsequently created, after which tapping was performed for anterior meniscus root fixation. The meniscal allograft was secured using alternating vertical mattress inside-out sutures. Finally, the BTB graft was passed through the tibial and femoral tunnels. Results: Outcomes following ACL reconstruction with BTB autograft and MAT are positive, with a 5-year survival between 84% and 91%. ACL reinjury and long-term development of osteoarthritis are the most common complications. In this case, the patient returned to work within 7 months and reported 0 out of 10 pain. Discussion/Conclusion: ACL reconstruction with BTB autograft and concomitant MAT is a viable treatment option for patients with ACL tears in the context of meniscal deficiency. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication. |
| format | Article |
| id | doaj-art-e832c4c25eb74fd5862cc6496e2e7b78 |
| institution | DOAJ |
| issn | 2635-0254 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Video Journal of Sports Medicine |
| spelling | doaj-art-e832c4c25eb74fd5862cc6496e2e7b782025-08-20T03:12:24ZengSAGE PublishingVideo Journal of Sports Medicine2635-02542025-02-01510.1177/26350254241299456Anterior Cruciate Ligament Reconstruction With Bone–Patellar Tendon–Bone Autograft With Concomitant Meniscal Allograft TransplantationJonathan D. Groothoff MA0Richard S. Villa BS1Mark A. Glover BS2Thomas W. Mason BS3Anthony P. Fiegen MD4Jelle P. van der List MD, PhD5Brian R. Waterman MD6Wake Forest University School of Medicine, Winston-Salem, North Carolina, USAWake Forest University School of Medicine, Winston-Salem, North Carolina, USAWake Forest University School of Medicine, Winston-Salem, North Carolina, USAWake Forest University School of Medicine, Winston-Salem, North Carolina, USADepartment of Orthopaedic Surgery and Rehabilitation, Atrium Health Wake Forest Baptist, Winston-Salem, North Carolina, USADepartment of Orthopaedic Surgery and Rehabilitation, Atrium Health Wake Forest Baptist, Winston-Salem, North Carolina, USADepartment of Orthopaedic Surgery and Rehabilitation, Atrium Health Wake Forest Baptist, Winston-Salem, North Carolina, USABackground: Primary arthroscopic-assisted anterior cruciate ligament (ACL) reconstruction using a bone–patellar tendon–bone (BTB) graft offers excellent long-term results for patients with ACL tears. When concurrent meniscal damage is present, the preferred treatment is repair of the meniscus. However, meniscectomy may be needed, which can result in insufficient meniscal function. Indications: ACL reconstruction performed concomitantly with meniscal allograft transplantation (MAT) is indicated for patients with ACL tears and meniscal insufficiency. This procedure is typically reserved for younger, active patients, such as the 38-year-old woman in this presentation. Technique Description: The patient was placed in the supine position. The BTB graft was harvested first using a standard medial midline incision. A posterior meniscus root tunnel was drilled, followed by drilling of the femoral tunnel for ACL reconstruction. The tibial tunnel for ACL reconstruction was subsequently created, after which tapping was performed for anterior meniscus root fixation. The meniscal allograft was secured using alternating vertical mattress inside-out sutures. Finally, the BTB graft was passed through the tibial and femoral tunnels. Results: Outcomes following ACL reconstruction with BTB autograft and MAT are positive, with a 5-year survival between 84% and 91%. ACL reinjury and long-term development of osteoarthritis are the most common complications. In this case, the patient returned to work within 7 months and reported 0 out of 10 pain. Discussion/Conclusion: ACL reconstruction with BTB autograft and concomitant MAT is a viable treatment option for patients with ACL tears in the context of meniscal deficiency. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.https://doi.org/10.1177/26350254241299456 |
| spellingShingle | Jonathan D. Groothoff MA Richard S. Villa BS Mark A. Glover BS Thomas W. Mason BS Anthony P. Fiegen MD Jelle P. van der List MD, PhD Brian R. Waterman MD Anterior Cruciate Ligament Reconstruction With Bone–Patellar Tendon–Bone Autograft With Concomitant Meniscal Allograft Transplantation Video Journal of Sports Medicine |
| title | Anterior Cruciate Ligament Reconstruction With Bone–Patellar Tendon–Bone Autograft With Concomitant Meniscal Allograft Transplantation |
| title_full | Anterior Cruciate Ligament Reconstruction With Bone–Patellar Tendon–Bone Autograft With Concomitant Meniscal Allograft Transplantation |
| title_fullStr | Anterior Cruciate Ligament Reconstruction With Bone–Patellar Tendon–Bone Autograft With Concomitant Meniscal Allograft Transplantation |
| title_full_unstemmed | Anterior Cruciate Ligament Reconstruction With Bone–Patellar Tendon–Bone Autograft With Concomitant Meniscal Allograft Transplantation |
| title_short | Anterior Cruciate Ligament Reconstruction With Bone–Patellar Tendon–Bone Autograft With Concomitant Meniscal Allograft Transplantation |
| title_sort | anterior cruciate ligament reconstruction with bone patellar tendon bone autograft with concomitant meniscal allograft transplantation |
| url | https://doi.org/10.1177/26350254241299456 |
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