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Venosa M, Cerciello S, Zoubi M, Petralia G, Vespasiani A, Angelozzi M, Romanini E, Logroscino G. Readability and Quality of Online Patient Education Materials Concerning Posterior Cruciate Ligament Reconstruction. Cureus 2024; 16:e58618. [PMID: 38770469 PMCID: PMC11103262 DOI: 10.7759/cureus.58618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2024] [Indexed: 05/22/2024] Open
Abstract
Objective This study aimed to assess the quality of online patient educational materials regarding posterior cruciate ligament (PCL) reconstruction. Methods We performed a search of the top-50 results on Google® (terms: "posterior cruciate ligament reconstruction," "PCL reconstruction," "posterior cruciate ligament surgery," and "PCL surgery") and subsequently filtered to rule out duplicated/inaccessible websites or those containing only videos (67 websites included). Readability was assessed using six formulas: Flesch-Kincaid Reading Ease (FRE), Flesch-Kincaid Grade Level (FKG), Gunning Fog Score (GF), Simple Measure of Gobbledygook (SMOG) Index, Coleman-Liau Index (CLI), Automated Readability Index (ARI); quality was assessed using the JAMA benchmark criteria and recording the presence of the HONcode seal. Results The mean FRE was 49.3 (SD 11.2) and the mean FKG level was 8.09. These results were confirmed by the other readability formulae (average: GF 8.9; SMOG Index 7.3; CLI 14.7; ARI 6.5). A HONcode seal was available for 7.4 % of websites. The average JAMA score was 1.3. Conclusion The reading level of online patient materials concerning PCL reconstruction is too high for the average reader, requiring high comprehension skills. Practice implications Online medical information has been shown to influence patient healthcare decision processes. Patient-oriented educational materials should be clear and easy to understand.
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Affiliation(s)
- Michele Venosa
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, ITA
- Department of Orthopaedics, RomaPro, Polo Sanitario San Feliciano, Rome, ITA
| | - Simone Cerciello
- Department of Orthopaedics and Traumatology, Fondazione Policlinico Universitario Agostino Gemelli, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, ITA
- Orthopaedic Department, Casa di Cura Villa Betania, Rome, ITA
| | - Mohammad Zoubi
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, ITA
| | - Giuseppe Petralia
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, ITA
| | - Andrea Vespasiani
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, ITA
| | - Massimo Angelozzi
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, ITA
| | - Emilio Romanini
- Department of Orthopaedics, RomaPro, Polo Sanitario San Feliciano, Rome, ITA
- Department of Orthopaedics, Italian Working Group on Evidence-Based Orthopaedics (GLOBE), Rome, ITA
| | - Giandomenico Logroscino
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, ITA
- Department of Minimally Invasive and Computer-Assisted Orthopaedic Surgery, San Salvatore Hospital, L'Aquila, ITA
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Venosa M, Romanini E, Ciminello E, Cerciello S, Angelozzi M, Calvisi V. Telerehabilitation Is a Valid Option for Total Knee Arthroplasty Patients: A Retrospective Pilot Study Based on Our Experience during the COVID-19 Pandemic. Healthcare (Basel) 2023; 11:2489. [PMID: 37761686 PMCID: PMC10530780 DOI: 10.3390/healthcare11182489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 09/03/2023] [Accepted: 09/06/2023] [Indexed: 09/29/2023] Open
Abstract
INTRODUCTION Total knee arthroplasty is an effective operation. Post-surgery rehabilitation, based on early and intensive progressive exercise programs, plays a substantial role and telerehabilitation can be an effective safe option. This retrospective study aimed to compare traditional in-presence rehabilitation and telerehabilitation for total knee arthroplasty, based on our experience during the Italian COVID-19 lockdown. MATERIALS AND METHODS We retrospectively analyzed 164 patients (94 females and 70 males) enrolled in 2020 within 2 weeks after total knee replacement to perform post-operative outpatient rehabilitation. The clinical results of 82 patients (mean age 66.8 ± 10.2 years) performing telerehabilitation with those obtained from a similar cohort of 82 patients (mean age 65.4 ± 11.8 years) performing traditional in-presence outpatient rehabilitation were compared. Clinical outcomes were examined by comparing the gait speed (Time Up and Go-TUG test), the range of motion, the pain intensity (VAS), the functional status (Oxford Knee Score-OKS and Knee injury and Osteoarthritis Outcome Score-KOOS) and the overall satisfaction (Self-administered patient satisfaction scale) 12 weeks after the beginning of the physiotherapeutic protocol. RESULTS Telerehabilitation was non-inferior to traditional in-presence rehabilitation in all of the investigated areas and no statistical difference in terms of effectiveness was detected at 12 weeks, as confirmed by the respective patient-reported outcome scores such as TUG test (reduced from 20 ± 2 s to 12 ± 1.5 s for the telerehab cohort and from 18 ± 1.5 s to 13.1 ± 2 s for the in-presence rehabilitation one), pain VAS, OKS (improved from 22 ± 1.3 to 36 ± 2.7 for the telerehab cohort and from 23 ± 2.1 to 35.1 ± 4.2 for the in-presence group), KOOS (improved from 46.2 ± 10.2 to 67.4 ± 3.8 for the telerehabilitation cohort and from 48.4 ± 8.4 to 68.3 ± 6.6 for the other group), and the Self-administered patient satisfaction scale (more than two-thirds of patients globally satisfied with the results of their surgery in both groups). CONCLUSION The telerehabilitation program was effective after total knee replacement and yielded clinical outcomes that were not inferior to conventional outpatient protocols.
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Affiliation(s)
- Michele Venosa
- Department of Life, Health and Environmental Sciences, University of L’Aquila, Via Vetoio, Coppito 2, 67100 L’Aquila, Italy; (M.A.); (V.C.)
- RomaPro, Polo Sanitario San Feliciano, Via Mattia Battistini 44, 00167 Rome, Italy;
| | - Emilio Romanini
- RomaPro, Polo Sanitario San Feliciano, Via Mattia Battistini 44, 00167 Rome, Italy;
- GLOBE, Italian Working Group on Evidence-Based Orthopaedics, Via Nicola Martelli 3, 00197 Rome, Italy
| | - Enrico Ciminello
- Italian Implantable Prostheses Registry (RIPI), Italian National Institute of Health, Viale Regina Elena 299, 00161 Rome, Italy;
| | - Simone Cerciello
- Department of Orthopaedics and Traumatology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy;
- Orthopaedic Department, Casa di Cura Villa Betania, Via Pio IV 42, 00165 Rome, Italy
| | - Massimo Angelozzi
- Department of Life, Health and Environmental Sciences, University of L’Aquila, Via Vetoio, Coppito 2, 67100 L’Aquila, Italy; (M.A.); (V.C.)
| | - Vittorio Calvisi
- Department of Life, Health and Environmental Sciences, University of L’Aquila, Via Vetoio, Coppito 2, 67100 L’Aquila, Italy; (M.A.); (V.C.)
- UOSD, Department of Mini-Invasive and Computer-Assisting Orthopedic Surgery, San Salvatore Hospital, Via L. Natali 1, 67100 L’Aquila, Italy
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Calvisi V, Romanini E, Staniscia D, Di Brigida G, Venosa M. Technical Note: Tibial Spine Avulsion Treatment with Arthroscopic Reduction and Internal Fixation with Kirschner Wires in Skeletally Immature Patients. Healthcare (Basel) 2023; 11:2404. [PMID: 37685438 PMCID: PMC10486765 DOI: 10.3390/healthcare11172404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 08/23/2023] [Accepted: 08/25/2023] [Indexed: 09/10/2023] Open
Abstract
INTRODUCTION Tibial spine avulsion injury, tibial eminence injury, tibial spine fracture, and anterior cruciate ligament (ACL) avulsion are multiple terms that express the same pathological condition. It can be encountered both in the pediatric and adult population. A wide array of surgical techniques have been proposed to manage displaced tibial spine avulsions. Anyway, insufficient evidence is currently available to prefer one fixation technique over another, and a gold-standard arthroscopy-based technique is still missing. In this article, we describe a mini-invasive, safe and user-friendly technique for arthroscopic reduction and internal fixation of displaced tibial eminence fractures. MATERIALS AND METHODS Standard and patient-specific accessory arthroscopic portals allow for full access to knee visualization and management of concomitant intraarticular lesions. After performing the debridement of the inflammatory tissue and the release of eventual interposed tissues in the fracture site, the tibial eminence avulsion can be reduced by using a less-invasive bone impactor. With the knee flexed to 90°, the fracture fragments are then synthesized (under fluoroscopic control) with three thin Kirschner wires inserted in a proximal-distal direction in a cross-shaped geometry. RESULTS This technique allows a fast surgical and hospitalization time, a punctiform arthrotomy, proximal tibial physis preservation, and an early rehabilitation program. CONCLUSIONS This novel technique seems attractive and very promising since it is respectful of the epiphyseal growth plates and is thus suitable for children and adolescents.
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Affiliation(s)
- Vittorio Calvisi
- Department of Life, Health and Environmental Sciences, University of L’Aquila, Via Vetoio Coppito 2, 67100 L’Aquila, Italy; (V.C.)
- UOSD, Department of Mini-Invasive and Computer-Assisting Orthopedic Surgery, San Salvatore Hospital, Via L. Natali 1, 67100 L’Aquila, Italy
| | - Emilio Romanini
- RomaPro, Polo Sanitario San Feliciano, Via Mattia Battistini, 44, 00167 Rome, Italy
- GLOBE, Italian Working Group on Evidence-Based Orthopedics, Via Nicola Martelli, 3, 00197 Rome, Italy
| | - Donato Staniscia
- Department of Life, Health and Environmental Sciences, University of L’Aquila, Via Vetoio Coppito 2, 67100 L’Aquila, Italy; (V.C.)
| | - Giovanni Di Brigida
- UOSD, Department of Mini-Invasive and Computer-Assisting Orthopedic Surgery, San Salvatore Hospital, Via L. Natali 1, 67100 L’Aquila, Italy
| | - Michele Venosa
- Department of Life, Health and Environmental Sciences, University of L’Aquila, Via Vetoio Coppito 2, 67100 L’Aquila, Italy; (V.C.)
- RomaPro, Polo Sanitario San Feliciano, Via Mattia Battistini, 44, 00167 Rome, Italy
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Calafiore F, Fidanza A, Venosa M, Fabiani R, Logroscino G. Hip joint osteochondroma treated with short stem total hip arthroplasty: a case report. Acta Biomed 2023; 94:e2023188. [PMID: 37486596 DOI: 10.23750/abm.v94is1.14671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 05/25/2023] [Indexed: 07/25/2023]
Abstract
The purpose of this report is to present the clinical and radiological findings of a young patient affected by proximal femoral and acetabular osteochondroma. This benign primary tumor of the long bones occurs in childhood and is localized in the proximal femur only with low incidence. As far as we know, there are only 30 other cases in the literature of an osteochondroma involving the entire hip joint. Out of these 30, only 17 patients were treated with lesion excision and joint replacement. However this is the first patient treated with a short stem total hip replacement. The innovative short stems allow the bone saving of the proximal femur, a necessary condition to have a good bone stock in the event of a future prosthetic revision in a highly demanding young patient. Preoperative planning and specific rehabilitation are mandatory to achieve good outcomes.
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Venosa M, Tarantino A, Schettini I, Padua R, Cifone MG, Calvisi V, Romanini E. Stem Cells in Orthopedic Web Information: An Assessment with the DISCERN Tool. Cartilage 2021; 13:519S-525S. [PMID: 34425692 PMCID: PMC8808862 DOI: 10.1177/19476035211040161] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Regenerative medicine is experiencing a strong expansion worldwide, including the treatment of some common orthopedic pathologies, with an increase in physicians adopting these technologies. This growing interest has been associated with an equally significant spread of websites dedicated to public information on this topic, often lacking scientific bases. This study aims to evaluate the quality of information on the World Wide Web about stem cells for cartilage disorders in orthopedic practice. DESIGN On February 19, 2021 we performed a search on Google using as keywords "cartilage stem cells," considering only the freely accessible sites in Italian, English, French, and Spanish. We selected the first 50 valid results for each language and evaluated them using the DISCERN scale. RESULTS A total of 249 sites were observed, of which 49 were discarded as duplicates (8) or not relevant to the topic (41). Of the 200 sites surveyed, 47 were affiliated to a singular surgeon (23.5%), 31 to private stakeholders (15.5%), 73 to information sites (36.5%), 8 to public hospitals (4%), 13 to universities (6.5%), and 28 referred to international scientific journals (14%). Only 76 sites (38%) were rated as fair or better, while the remaining 124 (62%) were classified as poor or very poor. CONCLUSIONS The quality of the information promoted for stem cells in orthopedics is generally low, although a significant minority of the sites offers good quality information. A greater commitment on the part of surgeons and other stakeholders is desirable to promote information on regenerative medicine through scientific criteria supported by adequate literature.
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Affiliation(s)
- Michele Venosa
- Department of Life, Health and
Environmental Sciences, University of L’Aquila, L’Aquila, Abruzzo, Italy,RomaPro, Polo Sanitario San Feliciano,
Rome, Italy,Michele Venosa, Department of Life, Health
and Environmental Sciences, University of L’Aquila, Via Vetoio, Coppito 2,
L’Aquila, Abruzzo 67100, Italy.
| | - Alessio Tarantino
- Department of Life, Health and
Environmental Sciences, University of L’Aquila, L’Aquila, Abruzzo, Italy
| | - Irene Schettini
- Department of Management and Law,
University of Rome Tor Vergata, Rome, Lazio, Italy
| | - Roberto Padua
- RomaPro, Polo Sanitario San Feliciano,
Rome, Italy,GLOBE, Italian Working Group on
Evidence Based Orthopedics, Rome, Italy
| | - Maria Grazia Cifone
- Department of Life, Health and
Environmental Sciences, University of L’Aquila, L’Aquila, Abruzzo, Italy
| | - Vittorio Calvisi
- Department of Life, Health and
Environmental Sciences, University of L’Aquila, L’Aquila, Abruzzo, Italy,UOSD, Department of Mini-invasive and
Computer-assisting Orthopedic Surgery, San Salvatore Hospital, L’Aquila, Italy
| | - Emilio Romanini
- RomaPro, Polo Sanitario San Feliciano,
Rome, Italy,GLOBE, Italian Working Group on
Evidence Based Orthopedics, Rome, Italy
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Abstract
Background and purpose - The main purpose of arthroplasty registries is to collect information on patients, techniques, and devices to monitor and improve the outcome of the specific procedure. This study analyses the role played by registries in the orthopedic research community and describes publication trends, characteristics, and patterns of this field of research.Patients and methods - A descriptive-bibliometric review was conducted. Scopus was the database used for the research. All articles published from 1991 to December 2020 containing keywords related to registries and arthroplasty were considered. In particular, the following dimensions were analyzed in detail: (i) papers/year; (ii) journals; (iii) countries; (iv) research growth rate; (v) collaboration among countries. VOSviewer software was used to perform the bibliometric analysis. Finally, the 50 most cited papers of the last 10 years were briefly analyzed.Results - 3,933 articles were identified. There has been growing interest in the topic since 2010. Acta Orthopaedica ranked first for the number of articles published. The country with the largest number of articles citing registries was the United States, followed by the United Kingdom and Sweden. The relative number of articles per 100,000 inhabitants is 0.60 for Europe and 0.38 for the United States. The literature in this research area has an average yearly growth rate of 28%.Interpretation - The publication rate in the field of arthroplasty registries is constantly growing with a noteworthy impact in the evolution of this research and clinical area. The growth rate is significantly higher than that of arthroplasty literature (28% vs. 10%) and the collaboration among countries is strong and increasing with time.
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Affiliation(s)
- Emilio Romanini
- RomaPro Center for Hip and Knee Arthroplasty, Polo Sanitario San Feliciano, Rome, Italy;,GLOBE, Italian Working Group on Evidence Based Orthopaedics, Rome;,Correspondence:
| | - Irene Schettini
- Department of Management and Law, University of Rome Tor Vergata, Rome
| | - Marina Torre
- Scientific Secretariat of the Presidency, Istituto Superiore di Sanità, Rome
| | - Michele Venosa
- RomaPro Center for Hip and Knee Arthroplasty, Polo Sanitario San Feliciano, Rome, Italy
| | | | | | - Gustavo Zanoli
- GLOBE, Italian Working Group on Evidence Based Orthopaedics, Rome;,Casa di Cura Santa Maria Maddalena, Occhiobello, RO, Italy
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Tarantino A, Romanini E, Venosa M, Torre M, Schettini I, Goderecci R, Logroscino G, Calvisi V. [Italian Arthroplasty Registry: learning curve and optimization of data entry procedures.]. Recenti Prog Med 2020; 111:327-330. [PMID: 32448883 DOI: 10.1701/3366.33414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Arthroplasty registries represent a fundamental tool for the production of evidence in total joint replacement. Italy started in 2005 a national registry (Italian Arthroplasty Registry - RIAP) organised as federation of regional registries under the coordination of the Istituto Superiore di Sanità. However, data collection still appears to be hardened by the additional workload required from clinicians. The aim of the study was to evaluate the data entry times for an inexperienced operator and the relative learning curve. The analysis carried out shows that after 15 cases, a plateau of about two minutes is reached for the compilation of a single case of primary hip and knee arthroplasty, up to 4 minutes for the shoulder and for revision surgery. The work burden for the orthopedist does not seem to justify the reluctance in data collection observed in these years of RIAP experience.
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Affiliation(s)
| | - Emilio Romanini
- Dipartimento MeSVA, Università dell'Aquila - Artrogruppo, Casa di Cura San Feliciano, Roma
| | | | - Marina Torre
- Registro Italiano ArtroProtesi (RIAP), Segreteria Scientifica della Presidenza, Istituto Superiore di Sanità, Roma
| | - Irene Schettini
- Dipartimento di Management e Diritto, Università di Roma Tor Vergata
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Romanini E, Decarolis F, Luzi I, Zanoli G, Venosa M, Laricchiuta P, Carrani E, Torre M. Total knee arthroplasty in Italy: reflections from the last fifteen years and projections for the next thirty. Int Orthop 2018; 43:133-138. [PMID: 30293141 DOI: 10.1007/s00264-018-4165-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 09/14/2018] [Indexed: 12/30/2022]
Abstract
PURPOSE Annual rates of knee arthroplasty are increasing in all developed countries, imposing a significant economic and organizational burden; it is crucial to forecast the future need for knee arthroplasty, to assist stakeholders in planning strategies and investments, especially in a country like Italy, with the largest proportion of elderly citizens in Europe. Few epidemiological studies have been performed worldwide to estimate the demand for future knee replacement, and a variety of methods have been proposed. METHODS We investigated the epidemiology of knee arthroplasty performed in Italy in the last 15 years and projected incidence rates up to the year 2050, utilizing, comparing, and adapting the available methodologies. RESULTS From 2001 to 2016, 812,639 primary TKA were performed in Italy on patients over 40. The total number of surgeries increased by 262% with an average annual growth rate of 6.6%. CONCLUSIONS Adopting the best fitting projection method, an increase of 45% in incidence rate is expected for 2050.
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Affiliation(s)
- Emilio Romanini
- GLOBE, Italian Working Group on Evidence Based Orthopaedics, Rome, Italy. .,Artrogruppo, Casa di Cura San Feliciano, Rome, Italy.
| | | | - Ilaria Luzi
- National Centre for Clinical Excellence, Safety and Quality of Care, Istituto Superiore di Sanità, Rome, Italy
| | - Gustavo Zanoli
- GLOBE, Italian Working Group on Evidence Based Orthopaedics, Rome, Italy.,Casa di Cura Santa Maria Maddalena, Occhiobello, RO, Italy
| | | | - Paola Laricchiuta
- National Centre for Clinical Excellence, Safety and Quality of Care, Istituto Superiore di Sanità, Rome, Italy
| | - Eugenio Carrani
- National Centre for Clinical Excellence, Safety and Quality of Care, Istituto Superiore di Sanità, Rome, Italy
| | - Marina Torre
- GLOBE, Italian Working Group on Evidence Based Orthopaedics, Rome, Italy.,National Centre for Clinical Excellence, Safety and Quality of Care, Istituto Superiore di Sanità, Rome, Italy
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Venosa M, Delcogliano M, Padua R, Alviti F, Delcogliano A. Femoral Tunnel Positioning in Anterior Cruciate Ligament Reconstruction: Anteromedial Portal versus Transtibial Technique-A Randomized Clinical Trial. Joints 2017; 5:34-38. [PMID: 29114628 PMCID: PMC5672862 DOI: 10.1055/s-0037-1601413] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Purpose
The purpose of this study was to investigate, through three-dimensional computed tomography (3D-CT), the accuracy of femoral tunnel positioning in patients undergoing anterior cruciate ligament (ACL) reconstruction, comparing transtibial (TT) and anteromedial (AM) techniques.
Methods
We evaluated postoperative 3D-CT scans of 26 patients treated with ACL reconstruction with hamstrings autograft using a low accessory AM portal technique and 26 treated with the TT technique. The position of the femoral tunnel center was measured with the quadrant method.
Results
Using quadrant method on CT scans, femoral tunnels were measured at a mean of 32.2 and 28.1% from the proximal condylar surface (parallel to Blumensaat line) and at a mean of 31.2 and 15.1% from the notch roof (perpendicular to Blumensaat line) for the AM and TT techniques, respectively.
Conclusion
The AM portal technique provides more anatomical graft placement than TT techniques.
Level of Evidence
Level I, randomized clinical study.
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Affiliation(s)
- Michele Venosa
- Department of Orthopaedic Surgery, San Carlo di Nancy Hospital - GVM, Rome, Italy
| | - Marco Delcogliano
- Department of Orthopaedic Surgery, EOC - Ente Ospedaliero Cantonale - Lugano, Switzerland
| | - Roberto Padua
- GLOBE, Evidence-based Orthopaedics Working Group of the Italian Society of Orthopaedics and Traumatology; Nicola's Foundation, Arezzo, Italy
| | - Federica Alviti
- Department of Physical Medicine and Rehabilitation, "La Sapienza" University, Rome, Italy
| | - Antonio Delcogliano
- Department of Orthopaedic Surgery, San Carlo di Nancy Hospital - GVM, Rome, Italy
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Padua R, Alviti F, Venosa M, Mazzola C, Padua L. The influence of graft placement on clinical outcome in anterior cruciate ligament reconstruction. Joints 2016; 4:12-6. [PMID: 27386442 DOI: 10.11138/jts/2016.4.1.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE the aim of the present study was to investigate the influence of graft tunnel position on both clinical outcome and instrumental knee stability in patients submitted to arthroscopic ACL reconstruction using a bone-patellar tendon-bone (BPTB) graft. METHODS thirty patients (24 men and 6 women) who underwent ACL reconstruction performed using an autologous bone-patellar tendon-bone graft were studied at a mean follow-up of 18 months. Clinical outcome was assessed on the basis of the Lysholm score, Tegner activity level, International Knee Documentation Committee (IKDC) subjective form and the Short Form-36. Clinical outcomes were correlated with both femoral and tibial tunnel placement measured on standard anteroposterior and lateral knee radiographs, in accordance with established guidelines. RESULTS tibial tunnel position on the lateral view correlated significantly with both the IKDC subjective form (r = -0.72; p<0.05) and the Lysholm score (r=-0.73; p<0.05). Tibial tunnel position on the lateral view also correlated with stability measured using a KT-1000 arthrometer at 30N of force (r=0.57; p<0.05). No correlation was found between α angle and anteroposterior (AP) laxity measured by KT-1000 arthrometer. No significant correlation was found between femoral tunnel position (on either view) and Lysholm score, IKDC score and Tegner activity level. Similarly, no correlation was found between AP laxity measured by KT-1000 arthrometer and femoral tunnel position. CONCLUSIONS these results suggest that the more anterior the placement of the tibial tunnel, the better the clinical outcome will be. On the basis of literature data and our findings, we discuss the hypothesis that there exists a "correct area" for tunnel placement, making it possible to obtain the best results. LEVEL OF EVIDENCE Level IV, case series.
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Affiliation(s)
- Roberto Padua
- GLOBE, Evidence-based orthopaedics working group of the Italian Society of Orthopaedics and Traumatology; Nicola's Foundation, Arezzo, Italy
| | - Federica Alviti
- Department of Physical Medicine and Rehabilitation, "Sapienza" University of Rome, Italy
| | - Michele Venosa
- GLOBE, Evidence-based orthopaedics working group of the Italian Society of Orthopaedics and Traumatology; Nicola's Foundation, Arezzo, Italy
| | | | - Luca Padua
- Department of Physical Medicine and Rehabilitation, "Sapienza" University of Rome, Italy
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