Editorial Commentary: Knee Lateral Extra-articular Tenodesis Procedures: Appropriate Study Design Is Essential for Reducing Conflicting Findings and Unnecessary Controversy in the Orthopaedic Literature.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: Disclosures The authors report the following potential conflicts of interest or sources of funding: B.S-C. receives royalties or licenses from Arthrex, consulting fees from Arthrex, support for attending meetings and/or travel from Arthrex, and payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Arthrex; has a leadership or fiduciary role with the French Arthroscopic Society and SANTI Study Group; has stock or stock options with AREAS; and is an editorial board member for OJSM. A.S. receives royalties or licenses from Convergence Medical, consulting fees from Arthrex, and support for attending meetings and/or travel from MacMedical and Arthroscopy Journal; has a leadership or fiduciary role with the ISAKOS Committees, AANA Committees, AAOS Committee, SANTI Study Group, and Maricopa County Medical Society; is an Editorial Board member for AJSM and OJSM; and is an Associate Editor for AANA (Arthroscopy Journal). All other authors (C.F. and T.D.V.) declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Full ICMJE author disclosure forms are available for this article online, as supplementary material. 20. Knee Surg Sports Traumatol Arthrosc. 2005 May;13(4):248-55. doi: 10.1007/s00167-004-0606-5. Epub 2005 Feb 3. ACL reconstruction using bone-patellar tendon-bone press-fit fixation: 10-year clinical results. Hertel P(1), Behrend H, Cierpinski T, Musahl V, Widjaja G. Author information: (1)Department of Trauma Surgery, Martin-Luther-Hospital, Berlin, Germany. Comment in Knee Surg Sports Traumatol Arthrosc. 2005 May;13(4):247. doi: 10.1007/s00167-005-0650-9. Multiple techniques for anterior cruciate ligament (ACL) reconstruction are currently available, most of which use hardware or resorbable material for fixation of the graft inside or outside the bony tunnels. In this study, the long-term results of 95 patients at a mean follow-up of 10.7 years were assessed. The ACL was reconstructed using a patellar tendon autograft with a press-fit fixation. Between 1987 and 1991, 159 patients were operated by the senior author (PH), 95 could be seen for follow-up. Evaluation included detailed history, physical examination, functional knee ligament testing, KT-1000 arthrometer testing, the IKDC standard evaluation form, Lysholm, Flandry, and Tegner scoring systems. Radiographs were obtained preoperatively and at follow-up to assess the grade of osteoarthritis. Subjectively, none of the patients that were seen for follow-up complained of instability. Numbness of the skin was reported by 54% of the patients and pain during knee walking was described as mild in 25% and severe in 2%. The mean Flandry score was 243 (max: 280). The mean Lysholm score was 93.2 at follow-up and the Tegner activity level was 6.8 preinjury and 6.0 postoperatively. The average KT-1000 side-to-side difference was 1.8 mm on a manual maximum pull. The IKDC knee scoring revealed 84% of the patients with normal (A) or nearly normal (B) knee joints, 15% were (C), 1% was (D). Radiographically, joint space narrowing was found in 19%, 15%, and 25% for the patello-femoral, medial, and lateral compartments, respectively. Meniscus surgery was a determining factor. This study presents long-term clinical data on a press-fit fixation for ACL reconstruction. Results were excellent and good in more then 80% of the followed patients. The advantages of the press-fit fixation are direct bone-to-bone healing of the graft, decreased donor site morbidity, cost-effectiveness and ease for revision surgery. DOI: 10.1007/s00167-004-0606-5