Quantitative Correlation Between IKDC Score, Static Laxity, and Pivot-Shift Test: A Kinematic Analysis of Knee Stability in Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction

2008 ◽  
Vol 18 (3) ◽  
pp. 185-189 ◽  
Author(s):  
Nicola Lopomo ◽  
Simone Bignozzi ◽  
Stefano Zaffagnini ◽  
Giovanni Giordano ◽  
James J. Irrgang ◽  
...  
Author(s):  
Yousif Eliya ◽  
Khaled Nawar ◽  
Benjamin B Rothrauff ◽  
Bryson P Lesniak ◽  
Volker Musahl ◽  
...  

ImportanceThis review highlights the differences in outcomes between anatomical and non-anatomical anterior cruciate ligament reconstruction (ACLR) techniques.ObjectiveTo compare clinical and functional outcomes between anatomical and non-anatomical ACLR techniques.Evidence reviewA search of MEDLINE, Embase and PubMed from 1 January 2000 to 24 October 2019 was conducted. Randomised and prospective primary ACLR studies using autograft and a minimum of 2 years of follow-up were included. The Anatomic Anterior Cruciate Ligament Reconstruction Checklist (AARSC) was used to categorise studies as anatomical. Outcomes analysed included failure rate, knee stability and functional outcomes. A meta-analysis using risk ratio and mean differences was conducted using a random effects model.FindingsThirty-six studies were included, representing 3710 patients with a follow-up range of 24–300 months. The overall failure rate was 96/1470 (6.5%) and 131/1952 (6.7%) in the anatomical group and non-anatomical group, respectively. The pooled results of the overall failure rate showed that there was no statistically significant difference between the anatomical and the non-anatomical groups (p=0.96). There were 37/60 (61.7%) and 29/67 (43.3%) traumatic failures in the anatomical and non-anatomical groups, respectively. The number of patients with the negative postoperative pivot-shift test was 995/1252 (79.5%) and 1140/1589 (71.1%) in the anatomical and non-anatomical groups, respectively. The pooled results indicated a statistically significant higher number of patients with a positive pivot shift in the non-anatomical group compared with the anatomical group (p=0.03).Conclusions and relevanceThis study demonstrated that the overall failure rate was similar between the anatomical and non-anatomical approaches. However, the anatomical ACLR demonstrated a significantly superior restoration of rotatory stability, as evidenced by a higher percentage with a negative postoperative pivot-shift test. Non-anatomical ACLR resulted in higher rates of atraumatic graft ruptures and persistent rotatory knee instability. Surgeons should consider anatomical ACLR when treating rotatory knee stability in patients.Level of evidenceII, systematic review and meta-analysis of level I and II studies.


2021 ◽  
Author(s):  
Jingyue Gan ◽  
Jie Li ◽  
Vidmi Taolam Martin ◽  
Ke Liu ◽  
Bo Yu

Abstract Purpose We modified the hamstring tendon graft into the hamstring-bone composite graft in double-bundle anterior cruciate ligament reconstruction for anterior cruciate ligament (ACL) injuries. Here, we evaluated the technique's effectiveness by investigating the clinical results in restoring the stability and function of the knee joint. Methods We reviewed 42 patients who underwent anterior cruciate ligament reconstruction (ACLR) with the hamstring-bone graft for ACL injuries from January 2013 to April 2015, with an average follow-up of 66.6 months. The objective evaluations (KT-1000, Lachman test and pivot-shift test) and the subjective evaluations (International Knee Documentation Committee (IKDC) scores, Lysholm scores, and Tegner scores) were performed preoperatively and postoperatively. Results Forty-one of 42 patients were negative in the Lachman test and forty of 42 patients were negative in the pivot-shift test after the operation at the final follow-up time. The IKDC, Lysholm, and Tegner scores improved significantly from 56.24±9.28 to 85.33±3.37, from 62.00±11.09 to 90.43±3.71,and from 2.3±0.87 to 6.5±0.67 at the final follow-up. Conclusion Double-bundle anatomic ACLR with a hamstring-bone composite graft can restore the anteroposterior and rotational stability for ACL injuries. The modified technique can provide excellent clinical outcomes with a long-term follow-up.


2012 ◽  
Vol 20 (4) ◽  
pp. 743-751 ◽  
Author(s):  
Stefano Zaffagnini ◽  
Giulio Maria Marcheggiani Muccioli ◽  
Nicola Lopomo ◽  
Cecilia Signorelli ◽  
Tommaso Bonanzinga ◽  
...  

Author(s):  
Binod Sherchan ◽  
Saroj Rai ◽  
Nira Tamang ◽  
Siddhartha Dhungana ◽  
Laxmi Kanta Sharma ◽  
...  

ObjectivesDespite various challenges, orthopaedic sports surgeons are still providing the arthroscopic service in low-income and middle-income countries like Nepal; however, it is hardly being reported. The main purpose of this study was to compare the clinical outcomes and complications of patients undergoing arthroscopic anterior cruciate ligament reconstruction (ACLR) in the urban group and that of the rural group.MethodsWe evaluated a total of 194 patients, including 98 patients in the urban group and 96 patients in the rural group, undergoing arthroscopic ACLR between August 2015 and February 2018, and had completed a minimum of 2-year follow-up. Subjective evaluations were performed using the Tegner-Lysolm score and International Knee Documentation Committee (IKDC) subjective knee evaluation form. Laxity assessments were performed using the Lachman test and the Pivot-shift test. Functional evaluation included the range of motion, single-leg hop test and overall IKDC score. Radiological assessment was performed according to the IKDC guidelines. SPSS was used for data analysis.ResultsThere was statistically significant differences in the subjective assessments between 2 groups. No statistically significant differences existed between 2 groups in terms of laxity and functional assessments. However, the proportion of laxity, in terms of Lachman test and Pivot-shift test, was higher in the young and active individuals and the proportion of abnormal and severely abnormal in all parameters of functional outcomes was higher in the older female in the rural group. Graft failure occurred in 19 (17.6%) knees in the urban group and 17 (16.8%) knees in the rural group. Graft failure in the urban group was higher in young and active male patients, whereas failure in the rural group was more in female patients. Similarly, overall infection occurred in 13 (6.2%) knees, including 5 (2.3%) deep infections and 8 (3.8%) superficial infections.ConclusionWe advised similar rehabilitation protocol for all the patients; however, the outcomes were significantly lower in patients living in rural areas as they are found to have poor compliance with the rehabilitation protocol. The overall graft failure rate was 17.2%; however, the reoperation rate was higher in the urban group than the rural group. The rate of deep infection was higher in the rural group as compared with the urban group.Level of evidenceLevel III, retrospective comparative study.


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