All ACLR procedures were performed within 20 days from the injury. As a result of a previous study concerning graft rerupture rates,24 (link)
hamstring tendon grafts are no longer used as our primary option for professional athletes, and soft tissue quadriceps tendon (QT) or bone–patellar tendon–bone (BTPB) grafts are the current choices for elite soccer players in our clinical practice. QT graft is the first choice in case of patellar tendinitis (ipsi- or contralateral), patella baja, patellofemoral pain, chondromalacia of the patellofemoral joint, and history of Osgood-Schlatter disease or Sinding-Larsen-Johansson syndrome. A BTPB graft is preferred in case of quadriceps tendinitis (ipsi- or contralateral) and history of rectus femur injuries.
For all players in the present study, regardless of graft type, a rectangular femoral tunnel was used as described by Fink et al.9 (link)
A rectangular tunnel is able to cover the footprint area more efficiently with the same cross-sectional area (graft size) as compared with the round reamer.9 (link),25 ,26 (link)
For femoral graft fixation, an extracortical flip button was utilized in all grafts. The tibial tunnel was created with a conventional tibial guide and standard round reamers. For soft tissue QT grafts, a fully threaded, cannulated bioabsorbable interference screw matching the tunnel diameter was used with the suture ends tied over a cortical bone bridge.9 (link)
Patellar tendon grafts were fixed with titanium interference screws. Concomitant meniscal tears and chondral injuries were treated considering several factors. The time from injury to surgery and the location, size, and stability of meniscal tear were considered in the choice between meniscal repair and meniscectomy. Microfractures were indicated in case of chondral lesions of ICRS grade 3 or 4 (International Cartilage Repair Society) no larger than 2 to 4 cm2. Chondroplasty was performed in case of chondral lesion of ICRS grade 1 or 2 with an unstable part.15 (link)
LET, specifically a modified Ellison technique,13 (link)
was added in patients considered at high risk of reinjury. Age, generalized ligamentous laxity, high-grade pivot shift, presence of Segond fracture, posterior tibial slope >12°, or history of ipsi- or contralateral ACL injuries are all factors that are taken into account during the decision process.29 (link)
After satisfactory review at 6 months postoperatively, the progression of rehabilitation and fitness to RTP was supervised by the teams’ medical staff.
hamstring tendon grafts are no longer used as our primary option for professional athletes, and soft tissue quadriceps tendon (QT) or bone–patellar tendon–bone (BTPB) grafts are the current choices for elite soccer players in our clinical practice. QT graft is the first choice in case of patellar tendinitis (ipsi- or contralateral), patella baja, patellofemoral pain, chondromalacia of the patellofemoral joint, and history of Osgood-Schlatter disease or Sinding-Larsen-Johansson syndrome. A BTPB graft is preferred in case of quadriceps tendinitis (ipsi- or contralateral) and history of rectus femur injuries.
For all players in the present study, regardless of graft type, a rectangular femoral tunnel was used as described by Fink et al.9 (link)
A rectangular tunnel is able to cover the footprint area more efficiently with the same cross-sectional area (graft size) as compared with the round reamer.9 (link),25 ,26 (link)
For femoral graft fixation, an extracortical flip button was utilized in all grafts. The tibial tunnel was created with a conventional tibial guide and standard round reamers. For soft tissue QT grafts, a fully threaded, cannulated bioabsorbable interference screw matching the tunnel diameter was used with the suture ends tied over a cortical bone bridge.9 (link)
Patellar tendon grafts were fixed with titanium interference screws. Concomitant meniscal tears and chondral injuries were treated considering several factors. The time from injury to surgery and the location, size, and stability of meniscal tear were considered in the choice between meniscal repair and meniscectomy. Microfractures were indicated in case of chondral lesions of ICRS grade 3 or 4 (International Cartilage Repair Society) no larger than 2 to 4 cm2. Chondroplasty was performed in case of chondral lesion of ICRS grade 1 or 2 with an unstable part.15 (link)
LET, specifically a modified Ellison technique,13 (link)
was added in patients considered at high risk of reinjury. Age, generalized ligamentous laxity, high-grade pivot shift, presence of Segond fracture, posterior tibial slope >12°, or history of ipsi- or contralateral ACL injuries are all factors that are taken into account during the decision process.29 (link)
After satisfactory review at 6 months postoperatively, the progression of rehabilitation and fitness to RTP was supervised by the teams’ medical staff.
