Long Term Clinical and Radiographical Outcomes of Different Anterior Cruciate Ligament Reconstruction Techniques
Condition: Anterior Cruciate Ligament Tear; Osteoarthritis, Knee
MeSH terms: Osteoarthritis; Osteoarthritis, Knee; Anterior Cruciate Ligament Injuries
Study type: Interventional

Summary: 
      The purpose of this study is to evaluate the long-term results of various anterior cruciate
      ligament reconstruction techniques. This assessment is necessary for the current context of
      anterior cruciate ligament research as several techniques and grafts are used in clinical
      practice, however, the various studies existing in the literature focus mainly only on the
      direct comparison of two techniques and usually with short-to-medium term follow-up. Since
      gonarthrosis is one of the most debated consequences of cruciate ligament reconstruction, a
      comparison of different long-term procedures would be desirable to have a clearer picture of
      the risks and benefits associated with different types of intervention.
    

Detailed description: 
      In the beginning, the Database of our Institute is consulted, all the patients that underwent
      ACL reconstruction at least 15 years ago are selected. The original group will be divided
      into subgroups based on the surgical technique adopted, of the different techniques we took
      into consideration only these three: anatomical ACL reconstruction with patellar tendon,
      anatomical ACL reconstruction with hamstrings, non-anatomical ACL reconstruction
      "Over-the-top plus lateral plasty". The patients will be contacted to ask if they are
      interested to take part in the study; at least 25 patients for each group will be recruited.
      All the patients recruited will sign an informed consent about the study and the personal
      data treatment. After consent acquisition, patients will undergo a clinical examination and a
      questionnaire about pain and knee status will be administered; moreover, a radiographical
      examination of the operated knee will be performed to assess the osteoarthritis progression.
      Patients that reported graft rupture will be registered as failures.
    

Intervention name(s): Anatomical single bundle ACL reconstruction with hamstrings; Anatomical single bundle ACL reconstruction with patellar tendon; ACL reconstruction with over the top plus lateral plasty technique
Intervention type(s): Procedure; Procedure; Procedure
Intervention description(s): Anatomical ACL reconstruction with quadruple-bundle hamstrings graft; Anatomical single bundle ACL reconstruction with patellar tendon; Non-anatomical ACL reconstruction, the hamstrings' tibial insertion is preserved; a double-bundle hamstring graft is passed intra-articularly, fixed in over the top position on the lateral femoral condyle, and then passed extra-articularly deeply to ileo-tibial band up to the tibia, where it is fixed at the level of Gerdy's tubercle.
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: anterior cruciate ligament; knee osteoarthritis; hamstrings; patellar tendon; lateral extra articular tenodesis