Summary: Symptomatic patients with minor residual instability and an intact graft after ACL reconstruction showed improvements in KT-1000 and pivot-shift test and subjective functional scales after an isolated lateral extra-articular procedure.

Background

Some patients submitted to isolated ACL reconstruction may have symptomatic postoperative rotational instability. The objective of this study is to evaluate a population with mild rotatory instability after ACL reconstruction, which was submitted to an isolated extra-articular procedure.

Methods

Patients submitted to an isolated extra-articular procedure after ACL reconstruction were retrospectively evaluated. Only patients presenting anterior knee instability of less than 5 mm, pivot-shift of a maximum of 1+, and ACL graft intact were included. Demographic data, physical examination and subjective functional scales were evaluated.

Results

Twenty patients were included. The mean age was 27.0 ± 7.3 years. The follow-up time after the extra-articular procedure was 27.5 ± 6.2 months. The KT-1000 decreased from 3.0 mm ± 0.7 mm to 2 mm ± 0.4 mm (p = 0.00016). The pivot-shift improved from 100% of grade 1 positivity to 30% (6/20 patients) of grade 1 positivity (p < 0.0001). The IKDC showed no difference (74.4 ± 11.8 vs. 87.6 ± 5.8; p = 0.087), but the percentage of patients who passed the PASS IKDC cutoff value increased from 45% (9/20) to 95% (19/20) (p= 0.0012). The Lysholm increased from 81.1 ± 7.3 to 91.2 ± 5.7 (p = 0.0001).

Conclusion

Patients submitted to isolated extra-articular procedure due to residual instability after ACL reconstruction showed improvement in physical examination (KT-1000 and pivot-shift) and subjective functional scales. This procedure can be considered for a specific population with minor instabilities and intact ACL graft, avoiding a complete ACL revision.

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An Isolated Lateral Extra-Articular Procedure can be Indicated for Symptomatic Patients with Minor Instabilities and Intact Graft After Anterior Cruciate Ligament Reconstruction

An Isolated Lateral Extra-Articular Procedure can be Indicated for Symptomatic Patients with Minor Instabilities and Intact Graft After Anterior Cruciate Ligament Reconstruction

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An Isolated Lateral Extra-Articular Procedure can be Indicated for Symptomatic Patients with Minor Instabilities and Intact Graft After Anterior Cruciate Ligament Reconstruction

An Isolated Lateral Extra-Articular Procedure can be Indicated for Symptomatic Patients with Minor Instabilities and Intact Graft After Anterior Cruciate Ligament Reconstruction

Background

Methods

Results

Conclusion