Biologic and Mechanical Augmentation in Anterior Cruciate Ligament Reconstruction: Fibrin Clot Augmentation of 5-Strand Hamstring Autograft
Hamstring autografts in anterior cruciate ligament reconstruction have an excellent clinical track record, but some patients have hamstring tendons that yield grafts of smaller diameter, which has been shown to be a significant risk factor for worse outcomes and graft failure. Some authors have advo...
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2017-10-01
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Online Access: | http://www.sciencedirect.com/science/article/pii/S2212628717302323 |
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doaj-d8130697f7d646eebe63b3f3ff323dab2021-06-10T04:54:36ZengElsevierArthroscopy Techniques2212-62872017-10-0165e1851e1855Biologic and Mechanical Augmentation in Anterior Cruciate Ligament Reconstruction: Fibrin Clot Augmentation of 5-Strand Hamstring AutograftMichael H. Amini, M.D.0Juan F. Prieto, P.A.-C., A.T.C.1Address correspondence to Michael H. Amini, M.D., Southwest Orthopaedic Surgery Specialists, 7520 N Oracle Rd, Ste 200, Tucson, AZ 85704, U.S.A.; Southwest Orthopaedic Surgery Specialists, Tucson, Arizona, U.S.A.Southwest Orthopaedic Surgery Specialists, Tucson, Arizona, U.S.A.Hamstring autografts in anterior cruciate ligament reconstruction have an excellent clinical track record, but some patients have hamstring tendons that yield grafts of smaller diameter, which has been shown to be a significant risk factor for worse outcomes and graft failure. Some authors have advocated augmentation with allograft in these patients. Tripling the semitendinosus yields a completely autogenous 5-strand graft with a larger diameter but still of sufficient length. In addition, imaging studies still show signal heterogeneity within grafts, even autografts, after the healing process, which correlates with worse biomechanical properties. Recent animal studies have shown improved incorporation and better remodeling of soft tissue grafts with the use of an endogenous fibrin clot. We present our technique of biologic and mechanical augmentation of hamstring autografts with fibrin clot and a 5-strand graft.http://www.sciencedirect.com/science/article/pii/S2212628717302323 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Michael H. Amini, M.D. Juan F. Prieto, P.A.-C., A.T.C. |
spellingShingle |
Michael H. Amini, M.D. Juan F. Prieto, P.A.-C., A.T.C. Biologic and Mechanical Augmentation in Anterior Cruciate Ligament Reconstruction: Fibrin Clot Augmentation of 5-Strand Hamstring Autograft Arthroscopy Techniques |
author_facet |
Michael H. Amini, M.D. Juan F. Prieto, P.A.-C., A.T.C. |
author_sort |
Michael H. Amini, M.D. |
title |
Biologic and Mechanical Augmentation in Anterior Cruciate Ligament Reconstruction: Fibrin Clot Augmentation of 5-Strand Hamstring Autograft |
title_short |
Biologic and Mechanical Augmentation in Anterior Cruciate Ligament Reconstruction: Fibrin Clot Augmentation of 5-Strand Hamstring Autograft |
title_full |
Biologic and Mechanical Augmentation in Anterior Cruciate Ligament Reconstruction: Fibrin Clot Augmentation of 5-Strand Hamstring Autograft |
title_fullStr |
Biologic and Mechanical Augmentation in Anterior Cruciate Ligament Reconstruction: Fibrin Clot Augmentation of 5-Strand Hamstring Autograft |
title_full_unstemmed |
Biologic and Mechanical Augmentation in Anterior Cruciate Ligament Reconstruction: Fibrin Clot Augmentation of 5-Strand Hamstring Autograft |
title_sort |
biologic and mechanical augmentation in anterior cruciate ligament reconstruction: fibrin clot augmentation of 5-strand hamstring autograft |
publisher |
Elsevier |
series |
Arthroscopy Techniques |
issn |
2212-6287 |
publishDate |
2017-10-01 |
description |
Hamstring autografts in anterior cruciate ligament reconstruction have an excellent clinical track record, but some patients have hamstring tendons that yield grafts of smaller diameter, which has been shown to be a significant risk factor for worse outcomes and graft failure. Some authors have advocated augmentation with allograft in these patients. Tripling the semitendinosus yields a completely autogenous 5-strand graft with a larger diameter but still of sufficient length. In addition, imaging studies still show signal heterogeneity within grafts, even autografts, after the healing process, which correlates with worse biomechanical properties. Recent animal studies have shown improved incorporation and better remodeling of soft tissue grafts with the use of an endogenous fibrin clot. We present our technique of biologic and mechanical augmentation of hamstring autografts with fibrin clot and a 5-strand graft. |
url |
http://www.sciencedirect.com/science/article/pii/S2212628717302323 |
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1721385849144213504 |