Autologous bone graft versus silicate-substituted calcium phosphate in the treatment of tunnel defects in 2-stage revision anterior cruciate ligament reconstruction: a prospective, randomized controlled study with a minimum follow-up of 2 years
Purpose: To compare and evaluate knee laxity and functional outcomes between autologous bone graft and silicate-substituted calcium phosphate (Si-CaP) in the treatment of tunnel defects in 2-stage revision anterior cruciate ligament reconstruction (ACLR). Methods: This prospective, randomized contro...
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| Main Authors: | , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
2020
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| In: |
Arthroscopy
Year: 2020, Volume: 36, Issue: 1, Pages: 178-185 |
| ISSN: | 1526-3231 |
| DOI: | 10.1016/j.arthro.2019.07.035 |
| Online Access: | Verlag, Volltext: https://doi.org/10.1016/j.arthro.2019.07.035 Verlag: https://www.arthroscopyjournal.org/article/S0749-8063(19)30709-1/pdf 
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| Author Notes: | Jan von Recum, Julia Gehm, Thorsten Guehring, Sven Y. Vetter, Philipp von der Linden, Paul-Alfred Gruetzner, and Marc Schnetzke |
| Summary: | Purpose: To compare and evaluate knee laxity and functional outcomes between autologous bone graft and silicate-substituted calcium phosphate (Si-CaP) in the treatment of tunnel defects in 2-stage revision anterior cruciate ligament reconstruction (ACLR). Methods: This prospective, randomized controlled trial was conducted between 2012 and 2015 with a total of 40 patients who underwent 2-stage revision ACLR. The tunnels were filled with autologous iliac crest cancellous bone graft in 20 patients (control group) and with Si-CaP in the other 20 patients (intervention group). After a minimum follow-up period of 2 years, functional outcomes were assessed by KT-1000 arthrometry (side-to-side [STS] difference), the Tegner score, the Lysholm score, and the International Knee Documentation Committee score. Results: A total of 37 patients (follow-up rate, 92.5%) with an average age of 31 years were followed up for 3.4 years (range, 2.2-5.5 years). The KT-1000 measurement did not show any STS difference between the bone graft group (0.9 +/- 1.5 mm) and the Si-CaP group (0.7 +/- 2.0 mm) (P = .731). One patient in the intervention group (5%) had an STS difference greater than 5 mm. Both groups showed significant improvements in the Tegner score, Lysholm score, and International Knee Documentation Committee score from preoperative assessment to final follow-up (P <= .002), without any difference between the 2 groups (P >= .396). Complications requiring revision occurred in 4 control patients (22%) and in 2 patients in the intervention group (11%) (P = .660). No complications in relation to Si-CaP were observed. Conclusions: Equivalent knee laxity and clinical function outcomes were noted 3 years after surgery in both groups of patients. Si-CaP bone substitute is therefore a safe alternative to autologous bone graft for 2-stage ACLR. |
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| Item Description: | Online 18 December 2019 Gesehen am 27.01.2020 |
| Physical Description: | Online Resource |
| ISSN: | 1526-3231 |
| DOI: | 10.1016/j.arthro.2019.07.035 |