Safety and feasibility of using calcium phosphate hybridization method for quadriceps tendon-bone graft in anterior cruciate ligament reconstruction

Hirotaka Mutsuzaki; Tomonori Kinugasa; Masataka Sakane

doi:10.1016/j.jor.2019.04.004

Safety and feasibility of using calcium phosphate hybridization method for quadriceps tendon-bone graft in anterior cruciate ligament reconstruction

J Orthop. 2019 May 1;16(5):422-425. doi: 10.1016/j.jor.2019.04.004. eCollection 2019 Sep-Oct.

Authors

Hirotaka Mutsuzaki¹, Tomonori Kinugasa², Masataka Sakane³

Affiliations

¹ Department of Orthopaedic Surgery, Ibaraki Prefectural University of Health Sciences, 4669-2 Ami Ami-machi, Inashiki-gun, Ibaraki, 300-0394, Japan.
² Department of Orthopaedic Surgery, Ichihara Hospital, 3681 Oozone, Tsukuba, Ibaraki, 300-3295, Japan.
³ Department of Orthopaedic Surgery, Tsukuba Gakuen Hospital, 2573-1 Kamiyokoba, Tsukuba, Ibaraki, 305-0854, Japan.

Abstract

Background: To improve tendon-to-bone healing in anterior cruciate ligament (ACL) reconstruction, a novel technique via the calcium phosphate (CaP) hybridization method for tendon graft using an alternate soaking process was developed. The use of the CaP hybridization method for quadriceps tendon-bone (QTB) graft in ACL reconstruction has not been reported in previous studies. Thus, this clinical trial aimed to clarify the safety and feasibility of using CaP hybridization method for quadriceps tendon-bone (QTB) graft in ACL reconstruction.

Methods: Eight patients (average age, 41.6 ± 10.6 years; 2 men and 6 women) with unilateral ACL injury were included in this study. They underwent ACL reconstruction using QTB graft that hybridized CaP. The follow-up period was from 2 months to 4 years (average, 2.4 ± 1.5 years). Cases of adverse events, including tumor formation, infection, fracture, contracture, severe pain, and re-rupture, were recorded. Moreover, clinical results (KT-1000 arthrometry, pivot-shift test, International Knee Documentation Committee grade, Lysholm scale, and sports activity level), and images of graft and bone tunnel (magnetic resonance imaging, arthroscopic appearance, and computed tomography) were also evaluated.

Results: No adverse events were observed in the follow-up periods. Postoperative clinical results showed improvement compared with the preoperative findings. The sports activity level after the surgery became equivalent to that before injury. There was no progression of bone tunnel enlargement.

Conclusions: Using the CaP hybridization method for QTB graft in ACL reconstruction was safe and feasible in the clinical trial. Moreover, this method may improve clinical outcomes. In the future, it is necessary to verify the effect of the CaP hybridization method for QTB graft in ACL reconstruction.

Keywords: ACL, Anterior cruciate ligament; Anterior cruciate ligament reconstruction; CSAs, Cross-sectional areas; CT, Computed tomography; CaP, Calcium phosphate; Calcium phosphate hybridization; Clinical trial; IKDC, International knee documentation committee; MRI, Magnetic resonance imaging; QTB, Quadriceps tendon-bone; Quadriceps tendon-bone graft; Safety and feasibility.