CT Evaluation of ACL Anatomical Reconstruction

Anatomical Transportal ACL Reconstruction : Effect of Using 2 or 3 Portal Technique on Femoral Tunnel Position

Our research is to evaluate the position and length of femoral tunnel, and to examine whether knee stability and clinical functional outcomes are better while using two-portal or three-portal technique .

Study Overview

• Status: Not yet recruiting
• Conditions: ACL Tear
• Intervention / Treatment: Radiation: CT

Detailed Description

Arthroscopic anterior cruciate ligament (ACL) reconstruction is one of the most often performed orthopedic surgeries . Restoration of normal anatomy after ACL reconstruction is related to achieve better function and a satisfactory long-term outcomes. The principles for anatomical ACL reconstruction are to functionally reestablish the ACL to its native dimensions, collagen orientation and insertion sites . The basis for the completion of these principles lies in the correct identification of the insertion sites. The conventional 2-portal technique uses the anterolateral portal as the viewing portal and the anteromedial portal as the working portal. the 3-portal technique allows interchangeable use of the portals as a viewing and working portals depending on the specific task that is being performed. The internal joint anatomy, as soft tissue remnants and bony landmarks, should guide the placement of the portals in ACL anatomical reconstruction and that each of the portals has a specific role during ACL anatomical reconstruction . So does the improved visualization through 3-portal technique compared to 2-portal technique have an impact on femoral tunnel position ?

• Study Type: Observational
• Enrollment (Estimated): 72

Contacts and Locations

• Study Contact: Name: Mostafa Almeldien Mohamed, master degree; Phone Number: +201020567115 0884695376; Email: zalatawe@gmail.com
• Study Contact Backup: Name: Mohamed Ali Masoud, lecturer; Phone Number: +201092698830; Email: Masoud.ortho@aun.edu.eg

Study Locations

• Egypt
  • Assiut, Egypt
    • Assiut university

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

Postoperative evaluation of patients who had previous ACL reconstruction (within terms of inclusion criteria & study sample ) by ct , clinical examination and functional scores .

Description

Inclusion Criteria:

1. Age ( 16 - 50 ) .
2. Isolated ACL tear with or without meniscal inj
3. Patient who have undergone ACL reconstruction in the last 5 years in Arthroscopy and sports injuries unit .

Exclusion Criteria:

• 1- Age ( < 16 ) 2- Patient with multi ligamentous inj . 3- Revision ACL tear .

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
2 portal group; The conventional 2-portal technique uses the anterolateral portal as the viewing portal and the anteromedial portal as the working portal	Radiation: CT; 3D CT scan have been used to evaluate the tunnels location after ACL reconstruction, as they can provide excellent perspective of the tunnel aperture, good visualization of bony structure and shape of the intercondylar notch, that preclude the use of a conventional 2-dimensional CT scan for measurement of the ACL tunnels location
3 portal group; the 3-portal technique allows interchangeable use of the portals as a viewing and working portals depending on the specific task that is being performed	Radiation: CT; 3D CT scan have been used to evaluate the tunnels location after ACL reconstruction, as they can provide excellent perspective of the tunnel aperture, good visualization of bony structure and shape of the intercondylar notch, that preclude the use of a conventional 2-dimensional CT scan for measurement of the ACL tunnels location

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Ct evaluation	3D CT scan have been used to evaluate the tunnels location after ACL reconstruction, as they can provide excellent perspective of the tunnel aperture, good visualization of bony structure and shape of the intercondylar notch, that preclude the use of a conventional 2-dimensional CT scan for measurement of the ACL tunnels location	1 day after surgery

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Clinical Examination & Functional scores	- KOOS ( Knee Injury & Osteoarthritis Outcome ) The KOOS's five patient-relevant dimensions are scored separately: Pain (nine items); Symptoms (seven items); ADL Function (17 items); Sport and Recreation Function (five items); Quality of Life (four items). A Likert scale is used and all items have five possible answer options scored from 0 (No problems) to 4 (Extreme problems) and each of the five scores is calculated as the sum of the items included. Scores are transformed to a 0-100 scale, with zero representing extreme knee problems and 100 representing no knee problems as common in orthopaedic scales and generic measures. Scores between 0 and 100 represent the percentage of total possible score achieved.	at least 2 years after surgery

Collaborators and Investigators

• Sponsor: Assiut University

Publications and helpful links

General Publications

• Lohmander LS, Ostenberg A, Englund M, Roos H. High prevalence of knee osteoarthritis, pain, and functional limitations in female soccer players twelve years after anterior cruciate ligament injury. Arthritis Rheum. 2004 Oct;50(10):3145-52. doi: 10.1002/art.20589.
• Bedi A, Altchek DW. The "footprint" anterior cruciate ligament technique: an anatomic approach to anterior cruciate ligament reconstruction. Arthroscopy. 2009 Oct;25(10):1128-38. doi: 10.1016/j.arthro.2009.03.008. Epub 2009 Aug 22.
• van Eck CF, Schreiber VM, Liu TT, Fu FH. The anatomic approach to primary, revision and augmentation anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. 2010 Sep;18(9):1154-63. doi: 10.1007/s00167-010-1191-4. Epub 2010 Jun 9.
• Nikolaou VS, Efstathopoulos N, Sourlas I, Pilichou A, Papachristou G. Anatomic double-bundle versus single-bundle ACL reconstruction: a comparative biomechanical study in rabbits. Knee Surg Sports Traumatol Arthrosc. 2009 Aug;17(8):895-906. doi: 10.1007/s00167-009-0754-8. Epub 2009 Mar 17.
• Snow M, Stanish WD. Double-bundle ACL reconstruction: how big is the learning curve? Knee Surg Sports Traumatol Arthrosc. 2010 Sep;18(9):1195-200. doi: 10.1007/s00167-010-1062-z. Epub 2010 Feb 6.

Study record dates

Study Major Dates

• Study Start (Estimated): September 1, 2024
• Primary Completion (Estimated): September 1, 2025
• Study Completion (Estimated): October 1, 2025

Study Registration Dates

• First Submitted: August 24, 2024
• First Submitted That Met QC Criteria: August 26, 2024
• First Posted (Actual): August 28, 2024

Study Record Updates

• Last Update Posted (Actual): September 3, 2024
• Last Update Submitted That Met QC Criteria: August 29, 2024
• Last Verified: August 1, 2024

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Wounds and Injuries; Leg Injuries; Knee Injuries; Anterior Cruciate Ligament Injuries
• Other Study ID Numbers: CT evaluation of ACL repair

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No