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investigated. It is reasonable to assume that patients with chronic injuries may have a worse outcome, and therefore it is essential to diagnose and treat this problem early. Appropriate clinical decision-making and a multidisciplinary team approach are key for
Osteoarticular Surgery Research, Hospital La Paz Institute for Health Research – IdiPAZ (La Paz University Hospital – Autonomous University of Madrid), Madrid, Spain
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knee. Allografts include Achilles tendon, extensor mechanism apparatus, BPTB, or tibialis anterior tendon. The problem with allografts is that they are expensive and sometimes not readily available. Synthetic grafts, such as the Ligament Augmentation
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and possible wound healing problems) and a faster recovery. Also, it helps avoid revision surgery, reducing bone loss and mechanical problems. Arthroscopic debridement can be considered in a small number of patients who meet the following criteria
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Graft size in hamstring autograft anterior cruciate ligament (ACL) surgery is an important factor directly related to failure. Most of the evidence in the field suggests that the size of the graft in hamstring autograft ACL reconstruction matters when the surgeon is trying to avoid failures.
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The exact graft diameter needed to avoid failures is not absolutely clear and could depend on other factors, but newer studies suggest than even increases of 0.5 mm up to a graft size of 10 mm are beneficial for the patient. There is still no evidence to recommend the use of grafts > 10 mm.
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Several methods – e.g. folding the graft in more strands – that are simple and reproducible have been published lately to address the problem of having an insufficient graft size when performing an ACL reconstruction. Due to the evidence presented, we think it is necessary for the surgeon to have them in his or her arsenal before performing an ACL reconstruction.
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There are obviously other factors that should be considered, especially age. Therefore, a larger graft size should not be taken as the only goal in ACL reconstruction.
Cite this article: EFORT Open Rev 2018;3:93-97. DOI: 10.1302/2058-5241.3.170038
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anterior cruciate ligament reconstruction (ACLR) surgeries performed annually has increased to over 100 000 and continues to increase ( 2 ). However, despite great progress made in ACLR research, many controversies and problems still remain ( 3 ). No clear
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impingement, it is critical to make sure that the tibial tunnel entrance is just posterior to the intercondylar roof with the knee at maximum passive hyperextension position. Roof impingement is a clinical problem presenting in extension with two consequences
Clínica Alemana-Universidad del Desarrollo, Santiago, Chile
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Hospital Padre Hurtado, Santiago, Chile
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Dom Henrique Research Centre, Portugal
3Bs Research Group – Biomaterials, Biodegradables and Biomimetics, University of Minho, Braga, Portugal
ICVS/3Bs–PT Government Associate Laboratory, Braga, Portugal
Orthopaedics Department of Minho University, Braga, Portugal
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algorithm specially made to deal with this clinical setting. Approach to the problem As there are no publications regarding the election of the graft in this specific setting (combined ACL and MCL reconstruction), the review of the literature was
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they found that only the restoration of both injuries restored the normal knee kinematics. 5 The main problem with ramp lesions is that clinical and radiological diagnosis is difficult. Although several MRI signs have been proposed, all authors
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. 30 Fresh osteochondral allografts stored at physiological temperatures are used due to high levels of viable donor chondrocytes, which is important for the success of OCA transplantation. 13 The principle problem with this technique is that
Ripoll y De Prado Sports Clinic, Murcia-Madrid, FIFA Medical Centre of Excellence, Madrid, Spain
International Centre of Sports Traumatology of the Ave, Vila do Conde, Portugal
3Bs Research Group, I3Bs, Research Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Parque de Ciência e Tecnologia, Barco, Guimarães, Portugal
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ICVS/3Bs, PT Government Associate Laboratory, Braga/Guimarães, Portugal
Clínica do Dragão, Espregueira-Mendes Sports Centre, FIFA Medical Centre of Excellence, Porto, Portugal
Orthopedic Department, University of Minho, Braga, Portugal
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The Discoveries Centre for Regenerative and Precision Medicine, Headquarters at University of Minho, Avepark, Barco, Guimarães, Portugal
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ICVS/3Bs, PT Government Associate Laboratory, Braga/Guimarães, Portugal
Orthopaedic Department, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain
The Discoveries Centre for Regenerative and Precision Medicine, Headquarters at University of Minho, Avepark, Barco, Guimarães, Portugal
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are enhancing scaffolds for this propose, most clinical studies report only to acellular scaffold replacement. Current TERM strategies have not yet met the clinical needs. The problems are related to the lack of simultaneous success in biology
