Summary
Patients with Generalised Joint Hypermobility do well after Anterior Cruciate Ligamnet reconstruction
Abstract
Purpose
To investigate the prevalence of Generalised Joint hypermobility (GJH) among patients undergoing anterior cruciate ligament reconstruction (ACLR). Secondary, to evaluate associations between GJH and pre- and postoperative knee laxity, patient-reported knee outcome and revision rate between different autografts received.
Methods
Patients between 13 and 50 years old, who underwent primary single band ACLR with all types of autografts, at our institution, between April 2020 and December 2021, and have responded to a self-reported Beighton score questionnaire were included. The cut off value for GJH was Beighton score > 4. Knee laxity was assessed, pre-operatively and at 6-months follow up using the KT-1000 arthrometer (134 N anterior tibial load). Knee injury and Osteoarthritis Outcome Score (KOOS) data from the Swedish National Knee Ligament Registry (SNKLR) was collected pre-operatively and at 1 year and 2 years after the surgery. Regarding revision, data from SNKLR was collected up to two years or until revision surgery was registered within two years after primary ACLR.
Results
During the study period a total of 522 patients were included. Of them, 151 patients (28.9%) had Beighton score > 4 and 95 (62.5%) were females. Both groups had similar side-to -side (STS) laxity > 5 mm preoperatively. Patients with GJH had a significant smaller reduction in anterior knee laxity compared with patients without GJH (1.87 mm vs 1.98 mm; P< 0.001), but less postoperative “surgical failures”, defined as STS difference > 5 mm (1.3% vs 3%, P< 0.001). The revision rate was significant less for the patients with GJH compared to patients without GJH (1.3 % vs 3.5%; P< 0.001).
Conclusions
GJH is common among patients with ACL injury. Moreover, GJH was associated with greater postoperative knee laxity but not with more “surgical failures” and inferior patient-reported outcome. The revision rate was less for patients with GJH compared to patients without GJH.
Level of evidence: level 3, retrospective cohort study