Anterior Cruciate Ligament Reconstruction Clinical Trial
Official title:
The Best Method for ACL Reconstruction. A Study Comparing Reconstructions of Anterior Cruciate Ligament Using Grafts Taken From Three Different Anatomical Locations at the Knee and Thigh. A Randomized Clinical Trial
The investigators wish to compare 3 methods for reconstruction of the anterior cruciate
ligament using 3 different grafts: bone-patella tendon-bone, hamstrings and iliotibial tract
graft, as these methods influence the muscles around the knee differently. Methods using
bone-patella tendon-bone and hamstrings are performed as standard operations, and the use of
the iliotibial tract graft using a new method of reconstruction.
The purpose is:
1. To assess whether one of three different grafts used for reconstruction of the ACL shows
superior results compared to the others in relation to mechanical stability and
re-rupture rates.
2. To assess whether one of three different methods for reconstruction of the ACL shows
superior results compared to the others in subjective patient outcome measures.
3. To assess whether one of three different methods for reconstruction of the ACL shows
superior results compared to the others when considering specific symptoms and
complications that can be related to donor-site morbidity.
4. To assess whether one of three different methods for reconstruction of the ACL shows
superior results compared to the others when considering muscular power, muscle
coordination, and function.
The purpose of the study is described in the "Brief Summary" section.
Patients scheduled for ACL reconstruction at the Section of Arthroscopic Surgery and Sports
Traumatology M51, Department of Orthopedics, Bispebjerg-Frederiksberg Hospital are eligible
for this study Eligibility criteria are described in the "Eligibility" section.
The patients are scheduled for ACL surgery at consultation with a doctor from the Section of
Arthroscopic Surgery and Sports Traumatology after usual, clinical criteria. The doctor
informs the patient about the project, gives the patient the written patient information, and
if the patient shows interest in the study, an appointment is scheduled with one of the
surgeons involved in the project.
At this appointment the patient is informed about the project by the surgeon. The patients
will be granted the reflection time they need before consenting or rejecting.
Before the day of surgery muscle power, muscle coordination and functional tests are
performed, and objective tests and PROMs are completed.
Surgery is performed by one of two surgeons experienced in all three methods of surgery as
described in the "Arms and Interventions" section.
After the patient is put under general anaesthesia the method of ACL reconstruction is chosen
by opening a sealed envelope.
Outcome measures are recorded at 1-year and 2-year follow-up.
All three methods of reconstruction are believed to have the same risk for basic
complications: infection (approx. 1%), stiffening of the knee (approx. 2%) and deep venous
thrombosis (approx. 1 %)
It is assumed that a 20% difference in a patient reported outcome score (KNEES-ACL)
represents a clinically relevant difference. Based on standard deviations for the outcome
score, and with a 90% power, significant differences of 20 % can be shown in a sample of 20
patients. Significance level is set at 5%. The investigators aim for 30 patients in each
group, considering potential drop-outs.
;
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