25-Year Experience

25 Years of Rizzoli OTT Review 🎉 (JEO 2023, Zaffagnini et al.)

https://pubmed.ncbi.nlm.nih.gov/37005946/

• 👥 Clinical experience: Technique developed at Rizzoli >25 years ago, performed in >6,000 patients worldwide, with multiple prospective cohorts and randomized studies
• 📊 10-year survivorship (267 patients):
• Revision rate: 1.1% at 2 years, 1.9% at 5 years, 3.7% at 10 years
• KOOS outcomes comparable to MOON registry benchmarks
• 🕒 20–24 year follow-up (original 1990s cohort):
• 86% normal/nearly normal knees
• 86% still active in sports (mostly recreational)
• No excess lateral compartment osteoarthritis
• 🔬 Biomechanical strength:

Superior control of rotatory instability and pivot shift compared to isolated single-bundle or non-anatomic double-bundle techniques

• 🩸 Biological advantage:

Preserves tibial hamstring insertion → sustained vascularity, improved tendon–bone healing, stronger graft integration (supported by cadaveric, animal, and MRI studies)

• 🛠 Versatility & safety:

Ideal for revision cases, skeletally immature patients, high-risk adolescents, and combined procedures; low 90-day readmission rate (~2.3%)

Marcacci-Zaffagnini OTT+LET in History