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Second-Look Arthroscopic Evaluation And Clinical Outcomes After Anatomical Double-Bundle Anterior Cruciate Ligament Reconstruction With Generalized Joint Laxity Or Hyperextended Knee

Yasunari Oniki, MD, PhD
JAPAN

Second-Look Arthroscopic Evaluation And Clinical Outcomes After Anatomical Double-Bundle Anterior Cruciate Ligament Reconstruction With Generalized Joint Laxity Or Hyperextended Knee

Yasunari Oniki, MD, PhD, JAPAN Taiki Murakami, JAPAN Eiichi Nakamura, MD, PhD, JAPAN

Rehabilitation & Sports Medical Center Kumamoto Kaiseikai Hospital, Kamimashiki-Gun, Kumamoto, JAPAN

2021 Congress Abstract Presentation 6 minutes Not yet rated

Anatomic Location

Knee

Anatomic Structure

Ligaments

Diagnosis / Condition

Instability

Treatment / Technique

Double Bundle Arthroscopy Autograft

Ligaments

ACL

Diagnosis Method

Physical Examination

Sports Medicine

Outcome Studies

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Summary: Generalized joint laxity and/or hyperextended knee (GJL and/or HK) affect ligamentization of the grafts and clinical outcomes after anatomic double-bundle ACL reconstruction. GJL and/or HK was placed in L group, while the other group was placed in N group, There was no significant difference between the two groups in AMB, however it was significantly poorer ligamentization in PLB in L group

Purpose

There are many factors—such as the surgical techniques used, rehabilitation protocol, and structural and physiologic characteristics of the patients—that contribute to success after anterior cruciate ligament (ACL) reconstruction. Recent studies have suggested generalized joint laxity (GJL) and/or hyperextended knees (HK) as risk factors for graft failure after ACL reconstruction. The aim of this study was to investigate whether GJL and/or HK affect ligamentization of the grafts and clinical outcomes after anatomic double-bundle (AD) ACL reconstruction.

Materials And Methods

One hundred twenty-six patients (mean age 20.6 ± 9.3 years) underwent ADACL reconstruction using semitendinosus tendon autografts. All operations were performed by one experienced surgeon. These patients consented to remove the post screw that fixed the grafts onto the tibia and to a second-look arthroscopic examination. The mean follow-up period after ACL reconstruction was 14.8 ± 3.6 months. Patients were divided into two groups. One patient group that had GJL and/or HK was placed in the laxity group (L group, n = 35), while the other group was placed in the normal group (N group, n = 91). The focus of the second-look arthroscopy was on graft thickness, apparent tension, and synovium coverage of the anteromedial bundle (AMB) and the posterolateral bundle (PLB) graft. Each bundle was evaluated as excellent, fair, or poor according to Hokkaido university classification. Functional evaluations involved instrument-measured side-to-side difference of anterior laxity (KS), peak isokinetic (60°/s) and isometric (80° of flexion) torque of the quadriceps and hamstrings, and one-leg hop test and heel-height difference (HHD). Subjective evaluations included the International Knee Documentation Committee (IKDC) subjective score and Lysholm score.

Results

The second-look arthroscopic evaluation of the AMB graft revealed no significant difference between each group (P = 0.26). However, the PLB graft showed an excellent rating in 62.9%, a fair in 25.7%, and a poor in 11.4% of the L group; it also showed an excellent rating in 82.4%, a fair in 17.6%, and a poor in 0% of the N group. The L group (P < 0.01) showed statistically significant results. There was no significant difference between the two groups in KS (P = 0.74), mean peak isokinetic torque (quadriceps: P = 0.56, hamstrings: P = 0.44), isometric torque (quadriceps: P = 0.80, hamstrings: P = 0.52) torque, HHD (P = 0.49), one-leg hop test (P = 0.29), the IKDC subjective score (P = 0.31) or Lysholm score (P = 0.48).

Conclusion

Our study showed poor ligamentization of the PLB after ADACL reconstruction due to GJL and/or HK. In the case with GJL and/or HK, rehabilitation management and the selection of surgical procedure may lead to more success graft ligamantization.

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Posterior Tibial Plateau Impaction Fractures Are Not Associated With Increased Knee Instability: A Quantitative Pivot Shift Analysis Abstract Presentation 8 minutes Brian M Godshaw, MD, UNITED STATES Joshua C Setliff, BA, UNITED STATES Jonathan D Hughes, MD, PhD, UNITED STATES Volker Musahl, MD, Prof., 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
Tranexamic Acid Has No Effect On Post-Operative Hemarthrosis Or Pain Control Following Acl Reconstruction Using Bone Patella Tendon Bone Autograft: A Double-Blinded Randomized Control Trial Abstract Presentation 5 minutes Jordan W Fried, BM, UNITED STATES David Bloom, BA, UNITED STATES Eoghan T. Hurley, MB, BCh, MCh, IRELAND Samuel Baron, MD, UNITED STATES Kirk Anthony Campbell, MD, UNITED STATES Eric Jason Strauss, MD Laith M. Jazrawi, MD, UNITED STATES Michael J Alaia, MD, UNITED STATES
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
Predicting Subjective Failure of ACL Reconstruction: A Machine Learning Analysis of the Norwegian Knee Ligament Register and Patient Reported Outcomes Award Winner 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
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
Creating A Crosswalk For Knee Outcomes After ACLR From The KOOS(5) To The IKDC-SKF Abstract Presentation 6 minutes Jessica L. Johnson, DPT, PhD, UNITED STATES Aaron Boulton, PhD, UNITED STATES Kurt Paul Spindler, MD, UNITED STATES Laura J. Huston, MS, UNITED STATES Tim Spalding, FRCS(Orth), UNITED KINGDOM Laura Asplin, UNITED KINGDOM May Arna Risberg, PT, PhD, NORWAY Lynn Snyder-Mackler, PT, ScD, FAPTA, UNITED STATES
Nerve injury during anterior cruciate ligament reconstruction: A comparison between patellar and hamstring tendon grafts harvest Abstract Presentation 5 minutes Jonathan Singer, MD, ISRAEL Ehud Rath, Prof., ISRAEL Mustafa Yassin, MD, ISRAEL Shlomo Bronak, MD, ISRAEL Barak Haviv, MD, ISRAEL
Ligamentous Laxity, Male Sex, Chronicity, Meniscus Injury And Posterior Tibial Slope Are Associated With A High-Grade Pre-Operative Pivot Shift: A Post Hoc Analysis Of The Stability Study Abstract Presentation 6 minutes Lachlan Batty, FRACS, AUSTRALIA Andrew Firth, PhD, CANADA Gilbert Moatshe, MD, PhD, NORWAY Dianne M. Bryant, PhD, CANADA S. Mark A. Heard, MD, FRCS, CANADA Robert G. McCormack, MD, CANADA Alex Rezansoff, MD, FRCSC, CANADA Devin Clarke Peterson, MD, FRCSC, Dip Sport Med, CANADA Davide Bardana, MD, CANADA Peter B. MacDonald, MD, FRCS, Dip Sport Med, CANADA Tim Spalding, FRCS(Orth), UNITED KINGDOM Alan Getgood, MD, FRCS(Tr&Orth), DipSEM, QATAR
The Effect Of Lateral Extraarticular Tenodesis On In Vivo Cartilage Contact In Combined Anterior Cruciate Ligament Reconstruction ePoster Presentation Kyohei Nishida , MD, PhD, JAPAN Tom Gale, MS, UNITED STATES Daisuke Chiba, MD, PhD, JAPAN Felipe Martin Suntaxi, MS, UNITED STATES Bryson P. Lesniak, MD, UNITED STATES Freddie H. Fu, MD, UNITED STATES William Anderst, PhD, UNITED STATES Volker Musahl, MD, Prof., UNITED STATES
Concurrent Treatment Of A Displaced Bucket Handle And Anterior Cruciate Ligament Reconstruction: A Higher Risk Of Stiffness? Abstract Presentation 5 minutes 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
Clinical Outcomes Of Primary Acl Reconstruction With Tibial Attachment Preserving Quadrupled Hamstring Graft: Does Graft Size Matter? - A Prospective Study With Review Of Literature Abstract Presentation 5 minutes Shaival Dalal, M.S.MRCS(Edinburgh), UNITED KINGDOM Ghislain N. Aminake, MBBS, MMed(Ortho),MRCPS(Glasg), CAMEROON Randy Guro, BSc, UNITED KINGDOM Amit Pramod Chandratreya, FRCS(Tr&Orth), MS(Orth), MCh(Orth), UNITED KINGDOM Rahul Kotwal, FRCS(Ortho), UNITED KINGDOM

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Second-Look Arthroscopic Evaluation And Clinical Outcomes After Anatomical Double-Bundle Anterior Cruciate Ligament Reconstruction With Generalized Joint Laxity Or Hyperextended Knee

Second-Look Arthroscopic Evaluation And Clinical Outcomes After Anatomical Double-Bundle Anterior Cruciate Ligament Reconstruction With Generalized Joint Laxity Or Hyperextended Knee

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Second-Look Arthroscopic Evaluation And Clinical Outcomes After Anatomical Double-Bundle Anterior Cruciate Ligament Reconstruction With Generalized Joint Laxity Or Hyperextended Knee

Second-Look Arthroscopic Evaluation And Clinical Outcomes After Anatomical Double-Bundle Anterior Cruciate Ligament Reconstruction With Generalized Joint Laxity Or Hyperextended Knee

Purpose

Materials And Methods

Results

Conclusion

More ISAKOS 2021: Global Content