scholarly journals The effect of short-graft preparation with tape suspension and screw fixation on loss of knee extension following anterior cruciate ligament reconstruction: A retrospective cross-sectional analysis of public hospital cases from 2015 - 2017

2020 ◽  
Author(s):  
Maha Jegatheesan ◽  
Corey Scholes ◽  
Kirby Tuckerman ◽  
Christopher Bell
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Screw Fixation ◽  
Cruciate Ligament ◽  
Knee Extension ◽  
Initial Assessment ◽  
Cruciate Ligament Reconstruction ◽  
Maximum Extension ◽  
Anterior Cruciate

AbstractBackgroundThe Tape Locking Screw (TLS®) system for anterior cruciate ligament reconstruction (ACLR) is an emerging short graft with tape suspension (SGTS) technique which uses a single hamstring tendon with tape suspension and dedicated interference screw fixation. Few studies have examined the SGTS technique versus other techniques. The objective of this study was to compare LOE in patients undergoing ACLR with the SGTS technique with other ACLR techniques. We hypothesised that the SGTS technique would be superior to others in terms of minimising LOE.Materials and methodsWe retrospectively reviewed 138 patients who received primary ACLR between January 2015 and December 2017 and had elected to participate in a rehabilitation program with the hospital physiotherapy department had postoperative knee extension assessed. Patients were followed up by a department physiotherapist until baseline function was achieved. Patients were grouped as having either SGTS ACLR or non-SGTS ACLR during chart review and compared for LOE at initial assessment and when the maximum extension had been achieved.ResultsThere were 44 patients in the SGTS group and 94 patients in the non-SGTS group. The SGTS group had a significantly larger median graft diameter (8.5mm vs. 8.0mm, P <0.001) and less incidence of notchplasty (17.8% vs. 44.7%, P <0.001). LOE incidence was significantly associated with the use of notchplasty and graft type at initial assessment. At the time of maximum extension, LOE incidence was significantly associated with LOE at initial assessment, graft size, graft type and lateral meniscus injury. Time to maximum extension was significantly associated with the presence of LOE at initial assessment.ConclusionIn this retrospective analysis, the SGTS technique was not inferior to other ACLR techniques with respect to postoperative loss of extension. Longer time to achieve full extension in the SGTS group was not considered clinically significant. Further studies are needed to assess longer term success and functional outcomes.

scholarly journals Knee-Extension Torque Variability and Subjective Knee Function in Patients With a History of Anterior Cruciate Ligament Reconstruction

2016 ◽  
Vol 51 (1) ◽  
pp. 22-27 ◽  
Author(s):  
John Goetschius ◽  
Joseph M. Hart
Keyword(s):  
Anterior Cruciate Ligament ◽  
Motor Control ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Knee Extension ◽  
Knee Function ◽  
Cruciate Ligament Reconstruction ◽  
History Of ◽  
Anterior Cruciate

Context  When returning to physical activity, patients with a history of anterior cruciate ligament reconstruction (ACL-R) often experience limitations in knee-joint function that may be due to chronic impairments in quadriceps motor control. Assessment of knee-extension torque variability may demonstrate underlying impairments in quadriceps motor control in patients with a history of ACL-R. Objective  To identify differences in maximal isometric knee-extension torque variability between knees that have undergone ACL-R and healthy knees and to determine the relationship between knee-extension torque variability and self-reported knee function in patients with a history of ACL-R. Design  Descriptive laboratory study. Setting  Laboratory. Patients or Other Participants  A total of 53 individuals with primary, unilateral ACL-R (age = 23.4 ± 4.9 years, height = 1.7 ± 0.1 m, mass = 74.6 ± 14.8 kg) and 50 individuals with no history of substantial lower extremity injury or surgery who served as controls (age = 23.3 ± 4.4 years, height = 1.7 ± 0.1 m, mass = 67.4 ± 13.2 kg). Main Outcome Measure(s)  Torque variability, strength, and central activation ratio (CAR) were calculated from 3-second maximal knee-extension contraction trials (90° of flexion) with a superimposed electrical stimulus. All participants completed the International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, and we determined the number of months after surgery. Group differences were assessed using independent-samples t tests. Correlation coefficients were calculated among torque variability, strength, CAR, months after surgery, and IKDC scores. Torque variability, strength, CAR, and months after surgery were regressed on IKDC scores using stepwise, multiple linear regression. Results  Torque variability was greater and strength, CAR, and IKDC scores were lower in the ACL-R group than in the control group (P &lt; .05). Torque variability and strength were correlated with IKDC scores (P &lt; .05). Torque variability, strength, and CAR were correlated with each other (P &lt; .05). Torque variability alone accounted for 14.3% of the variance in IKDC scores. The combination of torque variability and number of months after surgery accounted for 21% of the variance in IKDC scores. Strength and CAR were excluded from the regression model. Conclusions  Knee-extension torque variability was moderately associated with IKDC scores in patients with a history of ACL-R. Torque variability combined with months after surgery predicted 21% of the variance in IKDC scores in these patients.

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