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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/cdn\/css\/http\/css_Xg7z6oCTVgud_Q0huYz9x9iiD5H_2YPSJ5z2ZViSWdY.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EThis article presents data from a study that was conducted to analyze \u003Cem\u003Ein vivo\u003C\/em\u003E human anterior cruciate ligament (ACL) graft motion during activities of daily living in patients who had received bone\u2014patellar tendon\u2014bone (BTB) or hamstring (HS) autografts. The results showed that BTB autografts have more femoral tunnel motion than HS autografts 6?weeks after ACL reconstruction.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EOrthopaedic Procedures\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EHip \u0026amp; Knee Conditions\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ESports Medicine Clinical Trials\u003C\/li\u003E\u003C\/ul\u003E\u003Cul class=\u0022kwd-group clinical-trial\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EOrthopaedic Procedures\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EHip \u0026amp; Knee Conditions\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ESports Medicine\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EOrthopaedics Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EOrthopaedics\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EJames N. Irvine, Jr, MD, University of Pittsburgh, Pittsburgh, Pennsylvania, USA, presented data from a study that was conducted to analyze \u003Cem\u003Ein vivo\u003C\/em\u003E human anterior cruciate ligament (ACL) graft motion during activities of daily living in patients who had received bone\u2014patellar tendon\u2014bone (BTB) or hamstring (HS) autografts. The results showed that BTB autografts have more femoral tunnel motion than HS autografts 6 weeks after ACL reconstruction.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EGraft type is one of numerous surgical variables that influences graft-tunnel healing following ACL reconstruction. However, the optimal choice of graft remains controversial because of a lack of evidence-based consensus available to guide surgeons\u0027 decision making. According to Dr. Irvine, although clinical and kinematic outcomes of BTB and HS autografts are similar, data from animal studies have suggested that their healing processes may differ.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EWith this in mind, Dr. Irvine and colleagues conducted a prospective study to compare postoperative BTB and HS graft motion within the femoral and tibial tunnels and the intra-articular graft. They hypothesized that BTB autografts would have less intraosseous tunnel motion, greater midsubstance strain, and less anterior tibial translation than HS autografts at 6 weeks following ACL reconstruction as a result of faster osteointegration.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EThe study included 12 patients (ages 16 to 37 years; mean age, 24 years) who received BTB (n = 6) or HS (n = 6) autografts. A single surgeon performed anatomic single-bundle ACL reconstruction through a medial portal with the same technique for ACL tunnel placement and used suspensory fixation in all cases. Outcome measurements included graft motion within bone tunnels, midsubstance ACL strain, and knee kinematics at 6 weeks postoperatively.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EPrior to implantation, six .8-mm tantalum beads were embedded into each graft, pairs of which were located within each bone tunnel and in the graft midsubstance. Computed tomographic scans were obtained 6 weeks postoperatively and used to create 3-dimensional femur and tibia bone models. Cylindrical coordinate systems were then fit to the bone tunnels to examine tunnel motion, and dynamic stereo x-ray images were collected while patients walked on a treadmill and descended stairs. Longitudinal (along tunnel axis) and transverse (within tunnel cross section) graft motion was quantified by 2 methods. One was described as graft excursion, defined as the total path distance traveled by the graft over a set period of time (walking: 200 ms following foot strike; stair descent: 300 ms following single-leg support).\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003EPostoperative rehabilitation was similar in both groups, with all patients having returned to their activities of daily living at 6 weeks postoperatively. The grafts were still moving in all patients within the femoral and tibial bone tunnels at the 6-week follow-up testing. The BTB group displayed significantly more longitudinal graft excursion within the femoral tunnel compared with the HS patients (\u003Ca id=\u0022xref-fig-1-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F1\u0022\u003EFigure 1\u003C\/a\u003E). It is important to note that all patients were doing well at follow-up. The findings of this study showed no evidence of faster graft osteointegration of BTB over HS, no detectable midsubstance strain because the grafts were still moving within the bone tunnels, and no difference in knee kinematics between the grafts, Dr. Irvine said.\u003C\/p\u003E\u003Cdiv id=\u0022F1\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/23\/14.2\/F1.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022Longitudinal Graft Motion in Bone Tunnels 6 Weeks After ACL Reconstruction\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-695589225\u0022 data-figure-caption=\u0022Longitudinal Graft Motion in Bone Tunnels 6 Weeks After ACL Reconstruction\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure 1.\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/23\/14.2\/F1.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/23\/14.2\/F1.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure 1.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/23\/14.2\/F1.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/14770\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption attrib\u0022\u003E\u003Cspan class=\u0022fig-label\u0022\u003EFigure 1.\u003C\/span\u003E \n            \u003Cp id=\u0022p-8\u0022 class=\u0022first-child\u0022\u003ELongitudinal Graft Motion in Bone Tunnels 6 Weeks After ACL Reconstruction\u003C\/p\u003E\n         \u003Cq class=\u0022attrib\u0022 id=\u0022attrib-1\u0022\u003EACL, anterior cruciate ligament; BTB, bone\u2014patellar tendon\u2014bone autograft.\u003C\/q\u003E\u003Cq class=\u0022attrib\u0022 id=\u0022attrib-2\u0022\u003EReproduced with permission from J. N. Irvine, Jr, MD.\u003C\/q\u003E\u003Cq class=\u0022attrib\u0022 id=\u0022attrib-3\u0022\u003EOn November 12, 2014, the bracket was added to this figure.\u003C\/q\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-9\u0022\u003EDr. Irvine acknowledged that some limitations of this study included its small sample size and the absence of contralateral knee data. Although 1-year follow-up testing remains under way for this trial to assess whether the pattern of findings in this study changes as healing progresses, future studies using quantitative magnetic resonance imaging will be essential to further assess graft healing.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2014 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/14\/23\/14.2.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_figures.js?nzowwp\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzowwp\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}