Anterior Cruciate Ligament Injuries Clinical Trial
— GrafttypeOfficial title:
Graft Selection in Anatomic Anterior Cruciate Ligament Reconstruction: Patella, Hamstrings or Quadriceps Tendon Autograft
A rupture of the anterior cruciate ligament (ACL) is a severe injury of the knee. The current gold Standard treatment for young and active patients with instability, is a surgical ACL reconstruction. However, there still is no consensus on which graft is best suited for this.The aim of the current multi-center randomized controlled trial was to investigate the hypothesis that an anatomic single bundle anterior cruciate ligament reconstruction with a (flat) quadriceps tendon autograft is at least as effective as reconstruction of the ruptured anterior cruciate ligament with a patella tendon autograft or a hamstringtendon autograft, in terms of failure, measured 2 years postoperatively. Failure is defined gedefinieerd as pathologicai laxity, complaints of knee instability in the absence of any pathological laxity and/or discontinuïty ofthe graft on MRl or arthroscopy.
Status | Recruiting |
Enrollment | 439 |
Est. completion date | December 2029 |
Est. primary completion date | December 2029 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility |
Inclusion Criteria: - Patients active in sports, Tegner =/>5 - Primary ACL rupture, evident from anamnesis (acute trauma, snapping sensation, swelling within several hours, feeling of instability), physical examination (positive Lachman test, anterior drawertest and/or pivot shift test), radiograph and MRl - Willing to comply to the suggested (nationwide standard) rehabilitation protocol, supen/ised by a NFVS registerd sport-physical therapist - <6 months between initial trauma and surgery Exclusion Criteria: - History of knee surgery on the same side - History of tendon removal on the same side - Accompanying ligament injury ofthe knee, evident from anamnesis, physical examination, radiograph and MRl, defined as an ACL rupture in combination with a posterior cruciate ligament or collateral ligament injury, - Peroperative discovery of cartilage damage; larger than 2cm2 and more than 50% depth - Peroperative discovery of meniscus injury witch requires a meniscectomy of more than 20% or meniscus sutures - Osteoarthritis of Kellgren and Lawrence grade 2 or more, as evident from the radiograph - Severe malalignment of the leg - Tendency to form excessive scar tissue, such as arthrofibrosis - Muscular, neurological or vascular anomalies that influence healingtime or rehabilitation - Infection - Known hypersensitivity to any of the used materials - Long term relevant medication use such as prednisolone or cytostatics - Pregnancy at the time of inclusion or surgery - Known osteoporosis |
Country | Name | City | State |
---|---|---|---|
Netherlands | Martini Hospital Groningen | Groningen | |
Netherlands | OCON | Hengelo |
Lead Sponsor | Collaborator |
---|---|
Orthopedisch Centrum Oost Nederland | Gelderse Vallei Hospital, Martini Hospital Groningen |
Netherlands,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Other | Knee instability during jumping movements | Measured during jumping test. At OCON patients will be equiped with 3D accelerometer sensors in order to quantify the degree of (in)stability of the affected knee during the execution of jump tests under the supervision of a specialized sports physiotherapist | 1 and 2 years after ACL reconstruction surgery | |
Other | Complications and other adverse events | number and type complications and adverse events | 6 wks, 6 months, 9 months, 1, 2, 5 10 years after ACL reconstruction surgery | |
Primary | Physical examination ACL Failure | Presence / absence of anterior cruciate ligament failure. Failure is defined as pathologicai laxity, complaints of knee instability in the absence of any pathological laxity and/or discontinuïty ofthe graft on MRl or arthroscopy. | 2 years after ACL reconstruction surgery | |
Secondary | quality of life (ACL-QoL) | level of self-reported quality of life | preoperative, 6 wks, 6 months, 9 months, 1, 2, 5 10 years after ACL reconstruction surgery | |
Secondary | functional knee and health status (IKDC) | level of functional knee and current health status | preoperative, 6 wks, 6 months, 9 months, 1, 2, 5 10 years after ACL reconstruction surgery | |
Secondary | physical examination of knee (in)stability | instability in the absence of any pathological laxity and/or discontinuïty of the graft on MRl or arthroscopy. | preoperative, 6 wks, 6 months, 9 months, 1, 2, 5 10 years after ACL reconstruction surgery | |
Secondary | Knee and Injury Osetoarthritis Outcome Score questionnaire (KOOS) | self-reported level of physical activity in daily life | preoperative, 6 wks, 6 months, 9 months, 1, 2, 5 10 years after ACL reconstruction surgery | |
Secondary | sports intensity questionnaire (Tegner Activity Level) | self-reported level of pivoting sports execution | preoperative, 6 wks, 6 months, 9 months, 1, 2, 5 10 years after ACL reconstruction surgery | |
Secondary | questionnaire | level of physical activity (Lysholm score) | preoperative, 6 wks, 6 months, 9 months, 1, 2, 5 10 years after ACL reconstruction surgery | |
Secondary | knee pain | self-reported level of pain during activity and rest on visual analogue scale | preoperative, 6 wks, 6 months, 9 months, 1, 2, 5 10 years after ACL reconstruction surgery | |
Secondary | Instability knee | VAS score (patient perception) | preoperative, 6 wks, 6 months, 9 months, 1, 2, 5 10 years after ACL reconstruction surgery | |
Secondary | satisfaction with result of ACL surgery | self-reported level of satisfaction with ACL surgery on visual analogue scale | 6 wks, 6 months, 9 months, 1, 2, 5 10 years after ACL reconstruction surgery | |
Secondary | physical examination | degree of knee (in)stability during jumping tests (Leg Symmetry Index) | 6 months, 9 months, 1, 2, 5 10 years after ACL reconstruction surgery | |
Secondary | physical examination | degree of knee (in)stability in strenght (Leg Symmetry Index) | preoperative, 6 months, 9 months, 1, 2, 5 10 years after ACL reconstruction surgery | |
Secondary | Lachman test | physical examination: degree of knee (in)stability measured by rollimeter (operated-nonoperated side ratio) | 6 wks, 6 months, 9 months, 1, 2, 5 10 years after ACL reconstruction surgery | |
Secondary | Degree of Osteoarthritis on x-ray | Kellgren-Lawrence classification will be applied to assess the degree of osteoarthritis | Baseline, 1,2,5 10 years after ACL reconstruction surgery |
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