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Analysis Of The Blood Supply To The Femoral Attachment Of The Anterior Cruciate Ligament After Acl Injury

Jedrzej Jerzy Lesman, PhD MD, POLAND Marcin E. Domzalski, MD, Prof., POLAND Krzysztof Nowak, MD, PhD, POLAND Sebastian Zygmunt Żabierek, PhD, POLAND Radoslaw Grabowski, MD, POLAND Ilona Wagner-Olszewska, MD, POLAND

Medical University of Lódz, Lódz, POLAND

2021 Congress Abstract Presentation 4 minutes Not yet rated

Anatomic Location

Knee

Anatomic Structure

Ligaments

Diagnosis / Condition

Tears

Treatment / Technique

Repair / Reconstruction

Ligaments

ACL

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Summary: Age above 38 years and 9 months from complete rupture of the ACL cause lower blood supply and lower bone quality of subchondral bone.

Anterior cruciate ligament injury is one of the most common knee injuries occurring in both professional athletes and amateurs. The actual knowledge does not take under the consideration the effects on the femoral bone after the rupture. Therefore, a group of researchers from Medical University of Lódz decided to perform the research. The aim of the study was to assess bone quality and the degree of blood supply to the femoral attachment of the anterior cruciate ligament on the femur.
The study involved mature patients diagnosed with ACL rupture. Before the procedure, the researchers obtained data from the patients regarding: gender, age, time from injury to surgery, smoking cigarettes and the level of the patient's activity after injury. During the cruciate ligament reconstruction surgery in patients, before drilling the femoral canal, a 4.5 mm bone block with a diameter of 3.5 mm and a length of 2 cm on average was collected using Synthes® Hollow Reamer. A block meeting the test criteria was collected in 50 patients. The block was subjected to decalcification, then it was divided into 3 equal blocks. A cross-section was made of each block, which was fixed in hematoxylin and eosin, as well as an immunohistochemical test for cells with the presence of CD34. The number of blood vessels and clusters of positive cells for CD34 per mm2 was counted using ImageJ ™. Bone tissue quality was also analyzed by counting the average and total number of tissue windows left by osteocytes. Finally the statistical analysis was performed.
The median waiting time for surgery was 9.5 months. Patients who had undergone surgery before 9 months showed an average number of 5 blood vessels per mm2 cross-section, while in patients who waited longer for the procedure the number was 2 vessels, a statistically significant difference (p <0.01). Similar statistical significance was observed when examining the number of clusters of cells stained with CD34 marker, on average 5 clusters in the group up to 9 months after injury, less than 3 in the group waiting longer for surgery. Bone quality deterioration is also reflected in the time of waiting for surgery - the first group average osteocyte density per mm2 is 74, the second group 54 (p <0.01). A statistically significant interaction was also observed between age and time from injury - where, firstly, there was a negative correlation of time from injury to vessel density, and secondly, the relationship would be stronger among people up to 38 years of age. than in people over 38 years (r = -0.659; p <0.001; over 38 years r = -0.523; p = 0.018) (Figure 2). The analyzes did not reveal the interactive relationship between sex and time from injury.
In summary, the waiting time for surgery has a significant impact on the blood supply and bone quality of the ACL attachment site. Age above 38 years and 9 months from complete rupture of the ligament may cause a longer healing period of the graft.

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Predicting Patient Lost to Follow-up in the STABILITY 1 Study: A Multi-centre, International, Randomized Controlled Trial of Young, Active Patients Undergoing Anterior Cruciate Ligament Reconstruction Abstract Presentation 6 minutes Andrew Firth, PhD, CANADA Dianne M. Bryant, PhD, CANADA Andrew Johnson, PhD, CANADA Stability Study Group, CANADA Alan Getgood, MD, FRCS(Tr&Orth), DipSEM, CANADA
Quadriceps Tendon Vs. Hamstring Tendon Autograft In Primary Anterior Cruciate Ligament Reconstruction: A Matched-Pairs Study With A Mean Follow-Up Of 6.5 Years Award Winner 5 minutes Armin Runer, PD MD, GERMANY Aline Suter, MD, AUSTRIA Tommaso Roberti di Sarsina, MD, ITALY Caroline Hepperger, PhD, AUSTRIA Peter Gföller, MD, AUSTRIA Christian Hoser, MD, AUSTRIA Robert Csapo, PhD, AUSTRIA Christian Fink, MD, Prof., AUSTRIA
Coach Education Improves Implementation Of ACL Injury Prevention Programs: A Cluster-Randomized Controlled Trial Abstract Presentation 5 minutes Daphne Ling, PhD, MPH, TAIWAN Caroline Boyle, UNITED STATES Brandon Schneider, MS, UNITED STATES Joseph Janosky, DrPHc, MS, PT, ATC, UNITED STATES James Kinderknecht, UNITED STATES Robert G. Marx, MD, UNITED STATES
Effect Of Graft Choice On 6-Year Outcomes Of Revision Anterior Cruciate Ligament Reconstruction In The Multicenter ACL Revision Study (Mars) Cohort Abstract Presentation 6 minutes Rick W. Wright, MD, UNITED STATES
The Lateral Femoral Notch Sign Entails Increased Rotatory Laxity After Acl-Injury. Pivot Shift Quantification With Surgical Navigation System Abstract Presentation 5 minutes Gian Andrea Lucidi, MD, ITALY Piero Agostinone, MD, ITALY Stefano Di Paolo, Eng, ITALY Alberto Grassi, PhD, ITALY Luca Macchiarola, MD, ITALY Giacomo Dal Fabbro, MD, ITALY Nicola Pizza, MD, ITALY Stefano Zaffagnini, MD, Prof., ITALY
Full-Thickness Peroneus Longus Tendon Autograft For Anterior Cruciate Ligament Reconstruction: Outcomes And Donor Site Morbidity ePoster Presentation Tarun Goyal, MBBS, MS, DNB, MCh, FRCS (Edin), INDIA Souvik Paul, MBBS, MS Orthopedics (AIIMS), DNB, MCh, Dip SICOT, INDIA Lakshmana Das Sekar, MS, DNB Orthopaedics, INDIA Arghya Kundu Choudhury, MS, MCh Joint replacement and reconstruction, INDIA
Same Knee, Different Goals: Patients and Surgeons have Different Priorities Related to ACL Reconstructions and Surgeons are Resistant to Changing Clinical Practice Abstract Presentation 4 minutes Hana Marmura, BSc, CANADA Dianne M. Bryant, PhD, CANADA Trevor B. Birmingham, PT, PhD, CANADA Kurt Paul Spindler, MD, UNITED STATES Christopher C. Kaeding, MD, UNITED STATES Tim Spalding, FRCS(Orth), UNITED KINGDOM Alan Getgood, MD, FRCS(Tr&Orth), DipSEM, CANADA
Quadriceps Tendon Autograft Has Lower MRI Signal Than Hamstring Tendon Autograft In Anterior Cruciate Ligament Reconstructions Of Adolescent Athletes Abstract Presentation 5 minutes David Alcoloumbre, MD, UNITED STATES Alexandra Hunter Aitchison, UNITED STATES Douglas Mintz, MD, UNITED STATES Frank A. Cordasco, MD, MS, UNITED STATES Daniel W. Green, MD, MS, UNITED STATES
Tunnel Position In Anterior Cruciate Ligament Reconstruction Varies Between High Volume And Low Volume Surgeons Abstract Presentation 6 minutes Jonathan D Hughes, MD, UNITED STATES Christopher M. Gibbs, MD, UNITED STATES Akere Atte, MD, PharmD, UNITED STATES Anmol Almast, BS, UNITED STATES Mikael Sansone, MD, PhD, SWEDEN Jon Karlsson, MD, PhD, Prof., SWEDEN Volker Musahl, MD, Prof., UNITED STATES
Risk Factors for Grade 3 Pivot Shift in Acute ACL-Injured Knees Abstract Presentation 5 minutes Adnan Saithna, MD, FRCS, UNITED STATES Edoardo Monaco, MD, ITALY Edoardo Gaj, MD, ITALY Valerio Andreozzi, ITALY Alessandro Annibaldi, MD, ITALY Alessandro Carrozzo, MD, ITALY Thais Dutra Vieira, MD, FRANCE Bertrand Sonnery-Cottet, MD, PhD, FRANCE Andrea Ferretti, Prof., ITALY
Posterior Tibial Plateau Impaction Fractures Are Not Associated With Increased Knee Instability: A Quantitative Pivot Shift Analysis Abstract Presentation 8 minutes Brian M Godshaw, MD, UNITED STATES Joshua C Setliff, BA, UNITED STATES Jonathan D Hughes, MD, UNITED STATES Volker Musahl, MD, Prof., UNITED STATES

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Analysis Of The Blood Supply To The Femoral Attachment Of The Anterior Cruciate Ligament After Acl Injury

Analysis Of The Blood Supply To The Femoral Attachment Of The Anterior Cruciate Ligament After Acl Injury

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Analysis Of The Blood Supply To The Femoral Attachment Of The Anterior Cruciate Ligament After Acl Injury

Analysis Of The Blood Supply To The Femoral Attachment Of The Anterior Cruciate Ligament After Acl Injury

More ISAKOS 2021: Global Content