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Concurrent Treatment Of A Displaced Bucket Handle And Anterior Cruciate Ligament Reconstruction: A Higher Risk Of Stiffness?

Etienne Deroche, MD, FRANCE Cécile Batailler, MD, PhD, FRANCE John Swan, MBBS, FRANCE Sebastien Lustig, MD, PhD, Prof., FRANCE Elvire Servien, MD, PhD, Prof., FRANCE

Orthopaedics surgery and Sports Medicine Department, FIFA medical center of excellence, Croix-Rousse Hospital, Lyon University Hospital, Lyon, Auvergne-Rhône-Alpes, FRANCE

2021 Congress Abstract Presentation 5 minutes rating (1)

Anatomic Location

Knee

Anatomic Structure

Ligaments Meniscus Medial Lateral

Diagnosis / Condition

Stiff Joints Trauma Tears

Treatment / Technique

Arthroscopy Repair / Reconstruction Single Bundle Sutures / Knots / Anchors

Ligaments

ACL

Diagnosis Method

Physical Examination MRI

Sports Medicine

Rehabilition / Physical Therapy Biomechanics Outcome Studies

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Summary: There is an increased risk of revision for arthrolysis after simultaneous treatment of DBH and ACL reconstruction.

Objectives: Postoperative stiffness is feared after anterior cruciate ligament (ACL) reconstruction. A bucket handle meniscal tear associated with an ACL tear requires urgent surgical treatment and may delay full range of motion (ROM) recovery. We hypothesize that the concurrent treatment of a displaced bucket handle (DBH) meniscal tear and ACL reconstruction is associated with an increased risk of revision for arthroscopic arthrolysis.

Methods

A retrospective case-control study of consecutive patients with ACL reconstruction performed between January 2009 and December 2018. Group A (cases) involved all patients who underwent simultaneous ACL reconstruction and DBH meniscal tear treatment, and patients in group B (2 controls for each case) underwent isolated ACL reconstruction. Groups were matched for age, sex, body mass index. The primary outcome was re-operation rate for arthrolysis <12 months after surgery. Other outcomes were stiffness in flexion and extension at 6 weeks and 6 months after surgery.
Study Design: Case-control study, Level of Evidence: Level 3

Results

69 patients were included in group A, 40 men (58%) and 29 women (42%) and 139 patients in group B, 68 men (49%) and 71 women (51%). Mean age was 29 +/_ 11.2 years in group A and 30 +/_ 10.4 years in group B. The revision rate for arthrolysis was higher in group A compared to group B, 7 (10.1%) and 4 (2.9%) patients respectively (p=0,044), with a survival rate of 89.7% (CI95% 82.7-97.2) and 97.1 (CI95% 94.3-99.9) respectively (p=0.023). There was more stiffness in flexion and in extension in group A after 6 weeks and after 6 months (p>0.05). The risk for arthrolysis was not statistically different regarding the delay from accident to surgery for the global series (p=0.421) and in group A specifically neither (p=0.887). The DBH was sutured for 39 patients (56.5%), with 3 failures (7.7%) after 12 months follow-up. Arthrolysis was performed for 6 patients treated by meniscal suture (15.4%) and for only one patient treated by meniscectomy (3.3%) (p=0.128).

Conclusion

Our study confirms an increased risk of revision for arthrolysis after simultaneous treatment of DBH and ACL reconstruction. The influence of the delay for surgery after ACL rupture and the type of DBH treatment (suture or meniscectomy) on postoperative stiffness has not been demonstrated.

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The Lateral Femoral Notch Sign Entails Increased Rotatory Laxity After Acl-Injury. Pivot Shift Quantification With Surgical Navigation System Abstract Presentation 5 minutes Gian Andrea Lucidi, MD, ITALY Piero Agostinone, MD, QATAR Stefano Di Paolo, Eng, PhD, ITALY Alberto Grassi, PhD, ITALY Luca Macchiarola, MD, ITALY Giacomo Dal Fabbro, MD, AUSTRALIA Nicola Pizza, MD, ITALY Stefano Zaffagnini, MD, Prof., ITALY
PROSPECTIVE RANDOMIZED STUDY: Double-bundle against single-bundle ACL reconstruction using allografts Abstract Presentation 5 minutes Edmundo Berumen Nafarrate, PhD, Prof., MEXICO Carlos Alejandro Vega Najera, MD, MEXICO Joel Alejandro Cabral, MD, MEXICO Jesus Javier Tonche, MD, MEXICO Ivan Ramos Moctezuma, Eng, MEXICO Luis Sigala Gonzalez, Eng, MEXICO Avril Pérez Fontes, MD, MEXICO Fatima Quintana Trejo, Eng, MEXICO Carlos Leal, MD, Prof., COLOMBIA
Effect Of Graft Choice On 6-Year Outcomes Of Revision Anterior Cruciate Ligament Reconstruction In The Multicenter ACL Revision Study (Mars) Cohort Abstract Presentation 6 minutes Rick W. Wright, MD, UNITED STATES
Early ROM exercise after ACLR with hamstring autograft does not cause joint laxity : A Prospective Randomized Controlled Trial, 2 years follow up ePoster Presentation Jeong-Ku Ha, MD, phD, Prof, KOREA, REPUBLIC OF Kyu Sung Chung, MD, PhD, Prof., KOREA, REPUBLIC OF
Dynamic Radiostereometry Evaluation Of Two Different Anterior Cruciate Ligament Reconstruction Techniques: Does Single Bundle Reconstruction Plus Lateral Plasty Cause Knee Over-Constraint? Abstract Presentation 4 minutes Alberto Grassi, PhD, ITALY Stefano Di Paolo, Eng, PhD, ITALY Piero Agostinone, MD, QATAR Gian Andrea Lucidi, MD, ITALY Erika Pinelly, MsC, ITALY Marco Bontempi, PhD, ITALY Laura Bragonzoni, Prof., ITALY Stefano Zaffagnini, MD, Prof., ITALY
Tunnel Position In Anterior Cruciate Ligament Reconstruction Varies Between High Volume And Low Volume Surgeons Abstract Presentation 6 minutes Jonathan D Hughes, MD, PhD, UNITED STATES Christopher M. Gibbs, MD, UNITED STATES Akere Atte, MD, PharmD, UNITED STATES Anmol Almast, BS, UNITED STATES Mikael Sansone, MD, PhD, SWEDEN Jon Karlsson, MD, PhD, Prof., SWEDEN Volker Musahl, MD, Prof., UNITED STATES
Relationship Between Posterior Tibial Slope And Sagittal Plane Mechanics During Jump Landing After Anterior Cruciate Ligament Reconstruction Abstract Presentation 6 minutes Robert A. Duerr, MD, UNITED STATES Jennifer Perry, MS, UNITED STATES Robert A Magnussen, MD, MPH, UNITED STATES David C. Flanigan, MD, UNITED STATES Benjamin Ormseth, BS, UNITED STATES Robert Siston, PhD, UNITED STATES Andrew Garrone, MD, UNITED STATES Christopher C. Kaeding, MD, UNITED STATES Laura C. Schmitt, PT, PhD, UNITED STATES
Inter- and Intra-Rater Reliability of Measurenebt of ACL TUnnels with Radiographs, CT, and MRI Abstract Presentation 4 minutes Robert A Magnussen, MD, MPH, UNITED STATES Alexander Sparks, BS, UNITED STATES Jacy Leon, BS, UNITED STATES Matthew Colatruglio, BS, UNITED STATES Joshua Bowler, MD James Oosten, BS, UNITED STATES Alex C. Dibartola, MD, MPH, UNITED STATES Joshua Scott Everhart, MD, MPH, UNITED STATES Robert A. Duerr, MD, UNITED STATES Christopher C. Kaeding, MD, UNITED STATES David C. Flanigan, MD, UNITED STATES
Analysis Of The Blood Supply To The Femoral Attachment Of The Anterior Cruciate Ligament After Acl Injury Abstract Presentation 4 minutes Jedrzej Jerzy Lesman, PhD MD, POLAND Marcin E. Domzalski, MD, Prof., POLAND Krzysztof Nowak, MD, PhD, POLAND Sebastian Zygmunt Żabierek, PhD, POLAND Radoslaw Grabowski, MD, POLAND Ilona Wagner-Olszewska, MD, POLAND
Quadriceps Tendon Vs. Hamstring Tendon Autograft In Primary Anterior Cruciate Ligament Reconstruction: A Matched-Pairs Study With A Mean Follow-Up Of 6.5 Years Award Winner 5 minutes Armin Runer, PD MD, GERMANY Aline Suter, MD, AUSTRIA Tommaso Roberti di Sarsina, MD, ITALY Caroline Hepperger, PhD, AUSTRIA Peter Gföller, MD, AUSTRIA Christian Hoser, MD, AUSTRIA Robert Csapo, PhD, AUSTRIA Christian Fink, MD, Prof., AUSTRIA
Comparison of three different Quadriceps Tendon ACL graft to BTB and Semi-T grafts: A biomechanical study ePoster Presentation Marc Jacob Strauss, MD, NORWAY Jonathan Miles, M.S, UNITED STATES Mitchell Iung Kennedy, BS, UNITED STATES Gilbert Moatshe, MD, PhD, NORWAY Grant J Dornan, MS, UNITED STATES Martin Lind, MD, PhD, Prof., DENMARK Lars Engebretsen, MD, PhD, NORWAY Robert F. LaPrade, MD, PhD, UNITED STATES

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Concurrent Treatment Of A Displaced Bucket Handle And Anterior Cruciate Ligament Reconstruction: A Higher Risk Of Stiffness?

Concurrent Treatment Of A Displaced Bucket Handle And Anterior Cruciate Ligament Reconstruction: A Higher Risk Of Stiffness?

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Concurrent Treatment Of A Displaced Bucket Handle And Anterior Cruciate Ligament Reconstruction: A Higher Risk Of Stiffness?

Concurrent Treatment Of A Displaced Bucket Handle And Anterior Cruciate Ligament Reconstruction: A Higher Risk Of Stiffness?

Methods

Results

Conclusion

More ISAKOS 2021: Global Content