2025 ISAKOS Biennial Congress ePoster
An Isolated Lateral Extra-Articular Procedure can be Indicated for Symptomatic Patients with Minor Instabilities and Intact Graft After Anterior Cruciate Ligament Reconstruction
Camilo P. Helito, MD, PhD, Prof, São Paulo, SP BRAZIL
Andre Giardino Moreira Da Silva, MD, São Paulo, São Paulo BRAZIL
Matt Daggett, DO, MBA, Lee's Summit, MO UNITED STATES
Sergio Marinho De Gusmão Canuto, Maceió , Alagoas BRAZIL
Carlo L. Paione, Sao Joao da Boa Vista, SP BRAZIL
Hernan Galan, Rosario, Santa Fe ARGENTINA
Riccardo Cristiani, MD, PhD, Stockholm SWEDEN
University of São Paulo, São Paulo, SP, BRAZIL
FDA Status Not Applicable
Summary
Symptomatic patients with minor residual instability and an intact graft after ACL reconstruction showed improvements in KT-1000 and pivot-shift test and subjective functional scales after an isolated lateral extra-articular procedure.
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Abstract
Background
Some patients submitted to isolated ACL reconstruction may have symptomatic postoperative rotational instability. The objective of this study is to evaluate a population with mild rotatory instability after ACL reconstruction, which was submitted to an isolated extra-articular procedure.
Methods
Patients submitted to an isolated extra-articular procedure after ACL reconstruction were retrospectively evaluated. Only patients presenting anterior knee instability of less than 5 mm, pivot-shift of a maximum of 1+, and ACL graft intact were included. Demographic data, physical examination and subjective functional scales were evaluated.
Results
Twenty patients were included. The mean age was 27.0 ± 7.3 years. The follow-up time after the extra-articular procedure was 27.5 ± 6.2 months. The KT-1000 decreased from 3.0 mm ± 0.7 mm to 2 mm ± 0.4 mm (p = 0.00016). The pivot-shift improved from 100% of grade 1 positivity to 30% (6/20 patients) of grade 1 positivity (p < 0.0001). The IKDC showed no difference (74.4 ± 11.8 vs. 87.6 ± 5.8; p = 0.087), but the percentage of patients who passed the PASS IKDC cutoff value increased from 45% (9/20) to 95% (19/20) (p= 0.0012). The Lysholm increased from 81.1 ± 7.3 to 91.2 ± 5.7 (p = 0.0001).
Conclusion
Patients submitted to isolated extra-articular procedure due to residual instability after ACL reconstruction showed improvement in physical examination (KT-1000 and pivot-shift) and subjective functional scales. This procedure can be considered for a specific population with minor instabilities and intact ACL graft, avoiding a complete ACL revision.