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Isolated Anatomic Reconstruction of Anterior Cruciate Ligament in Sportsmen with High Pivot Shift Grade: Is it Enough for Rotational Stability?

Isolated Anatomic Reconstruction of Anterior Cruciate Ligament in Sportsmen with High Pivot Shift Grade: Is it Enough for Rotational Stability?

Mohamed Amine Gharbi , MD, TUNISIA Moatassem Belleh Jelassi, MD, TUNISIA Houssem Eddine Chahed, MD, TUNISIA Ahmed Zendeoui, MD, TUNISIA Anis Tebourbi, MD, TUNISIA Ramzi Bouzidi, PhD, TUNISIA Khelil Ezzaouia, PhD, TUNISIA Mouadh Nefiss, MD, TUNISIA

Mongi Slim Marsa University Hospital Center, Tunis, Tunis, TUNISIA


2023 Congress   ePoster Presentation   2023 Congress   rating (1)

 

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Anatomic Structure

Diagnosis Method


Summary: Isolated anatomic reconstruction after acute ACL injury may allow a reliable control of anteroposterior as well as rotational stability of the knee with satisfying functional results in amateur sportsmen with high pivot shift grade.


Background

Rotational instability of the knee remains an issue after anterior cruciate ligament (ACL) reconstruction. In fact, the association of antero-lateral ligament reconstruction seems to yield to better outcomes in patients with high grade pivot shift, however it remains a topic of discussion.

Objective

Our aim was to evaluate functional outcomes as well as clinical residual laxity after isolated anatomic ACL reconstruction in amateur sportsmen with high grade pivot shift.

Methods

Our retrospective study included 74 non-professional athletic patients participating in pivoting sports with at least grade II pivot shift who have had primary anatomic single-bundle reconstruction with hamstrings tendon graft for isolated acute ACL injury with minimum follow-up of two years.

Results

The mean time between injury and surgery was 4 months. At the last follow-up, 5% of our patients still have anterior residual laxity at the Lachman Test and 8% still have positive pivot shift (4 patients Grade I and 2 patients Grade II). Mean Lysholm-Tegner score was 70.6 ± 5.2 before the surgery and 92.3 ± 4.7 after the surgery. The mean IKDC score was 61.2 ± 4.3 before the surgery and 95.3 ± 2.4 after the surgery. 72% of patients have returned to their athletic activity with mean time interval of 8 months. Only shorter time interval between trauma and surgery was statistically associated to a better functional result.

Conclusion

Isolated anatomic ACL reconstruction was found to be effective in improving outcomes and allows a reliable control of anteroposterior as well as rotatory stability of the knee with satisfying functional results in amateur sportsmen with high pivot shift grade. Furthermore, additional reconstruction with anterolateral ligament maybe not mandatory, however reduction of the time interval between trauma and surgery is recommended for a better result.


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