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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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Acl Deficiency Influences Medio-Lateral Tibial Alignment And Knee Varus–Valgus During In Vivo Activities Abstract Presentation 3 minutes Piero Agostinone, MD, ITALY Stefano Di Paolo, Eng, PhD, ITALY Alberto Grassi, PhD, ITALY Marco Bontempi, PhD, ITALY Erika Pinelli, MsC, ITALY Laura Bragonzoni, Prof., ITALY Stefano Zaffagnini, MD, Prof., ITALY
Factors associated with anterior cruciate ligament (ACL) reconstruction among ACL injuries in Alberta, Canada ePoster Presentation Yuba Raj Paudel, MPH, CANADA Mark F. Sommerfeldt, MD, CANADA Donald C. Voaklander, PhD, CANADA
Impingement Due to Graft Buckling Is More Prevalent after ACL Reconstructions with an Adjustable-Loop Compared to a Fixed-Loop Abstract Presentation 5 minutes Julian De Rover, NETHERLANDS Inge Van Den Akker-Scheek, PhD, NETHERLANDS Hugo Christiaan van der Veen, MD, PhD, NETHERLANDS
Combined Reconstruction Of The Medial Collateral Ligament And Anterior Cruciate Ligament Using Ipsilateral Semitendinosus Tendon And Opposite Semitendinosus With Ipsilateral Gracilis Tendon: A Minimum One-Year Follow-Up Study In NITOR.Dhaka,Bnagladesh Abstract Presentation 4 minutes Dibakar Sarkar, MS(Orthopaedic surgery),FACS(USA),AO fellow(Bangko, BANGLADESH
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
Risk Factors for Grade 3 Pivot Shift in Acute ACL-Injured Knees Abstract Presentation 5 minutes Adnan Saithna, MD, FRCS, UNITED STATES Edoardo Monaco, MD, ITALY Edoardo Gaj, MD, ITALY Valerio Andreozzi, ITALY Alessandro Annibaldi, MD, ITALY Alessandro Carrozzo, MD, ITALY Thais Dutra Vieira, MD, FRANCE Bertrand Sonnery-Cottet, MD, PhD, FRANCE Andrea Ferretti, Prof., ITALY
Predicting Subsequent Revision ACL Reconstruction: A Machine Learning Analysis of the Norwegian Knee Ligament Register Abstract Presentation 5 minutes R. Kyle Martin, MD, FRCSC, UNITED STATES Solvejg Wastvedt, BA, UNITED STATES Ayoosh Pareek, MD, UNITED STATES Andreas Persson, MD, PhD, NORWAY Havard Visnes, MD, PT, PhD, NORWAY Anne Marie Fenstad, MSc, NORWAY Gilbert Moatshe, MD, PhD, NORWAY Julian Wolfson, PhD, UNITED STATES Lars Engebretsen, MD, PhD, NORWAY
Return To Elite Sport After ACL Reconstruction In 376 'Professional' Athletes Abstract Presentation 5 minutes Kyle Borque, MD, UNITED STATES Mary Jones, MSc, Grad. Dip. Phys., UNITED KINGDOM Ganesh Balendra, MBBS, AUSTRALIA Lukas Willinger, MD, GERMANY Vitor Hugo Pinheiro, MD, UNITED KINGDOM Andy Williams, MBBS, FRCS(Orth), FFSEM(UK), UNITED KINGDOM
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
Sex Related Outcomes Following Anterior Cruciate Ligament Reconstruction (Aclr): A Systematic Review and Meta-Analysis Abstract Presentation 5 minutes Anthony Charles Mok, BS, UNITED STATES Andrew J Fancher, BS, UNITED STATES Matthew L Vopat, MD, UNITED STATES Jordan Charles Baker, BS, UNITED STATES Armin Tarakemeh, BS, UNITED STATES Mary K. Mulcahey, MD, UNITED STATES Scott Mullen, MD, UNITED STATES Paul Schroeppel, MD, UNITED STATES Kimberly J. Templeton, MD, UNITED STATES Bryan Vopat, UNITED STATES
Quadriceps Tendon Autograft Has Lower MRI Signal Than Hamstring Tendon Autograft In Anterior Cruciate Ligament Reconstructions Of Adolescent Athletes Abstract Presentation 5 minutes David Alcoloumbre, MD, UNITED STATES Alexandra Hunter Aitchison, UNITED STATES Douglas Mintz, MD, UNITED STATES Frank A. Cordasco, MD, MS, UNITED STATES Daniel W. Green, MD, MS, 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