scholarly journals Female Soccer Players With Anterior Cruciate Ligament Reconstruction Have a Higher Risk of New Knee Injuries and Quit Soccer to a Higher Degree Than Knee-Healthy Controls

2018 ◽  
Vol 47 (1) ◽  
pp. 31-40 ◽  
Author(s):  
Anne Fältström ◽  
Joanna Kvist ◽  
Håkan Gauffin ◽  
Martin Hägglund
Keyword(s):  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Knee Injuries ◽  
Activity Level ◽  
Soccer Players ◽  
Healthy Controls ◽  
Acl Injuries ◽  
Activity Scale ◽  
Anterior Cruciate ◽  
Tegner Activity Scale

Background: Many patients with anterior cruciate ligament (ACL) reconstruction who return to sport suffer new ACL injuries or quit sports soon after returning. Purpose: To prospectively follow a cohort of female soccer players with primary unilateral ACL reconstruction and matched knee-healthy controls from the same soccer teams to compare (1) the rate of new traumatic and nontraumatic knee injuries and other injuries, (2) the proportion of players who quit soccer, and (3) player-reported activity level and satisfaction with activity level and knee function. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 117 active female soccer players (mean ± SD age, 19.9 ± 2.5 years) 18.9 ± 8.7 months after ACL reconstruction and 119 knee-healthy female soccer players (19.5 ± 2.5 years) matched from the same teams were prospectively followed for 2 years for new knee injuries, other injuries, soccer playing level, activity level according to the Tegner Activity Scale, and satisfaction with activity level and knee function. Results: Players with ACL reconstruction had a higher rate of new ACL injuries (n = 29 vs 8; 19 vs 4 per 100 player years; rate ratio [RR], 4.82; 95% CI, 2.20-10.54; P < .001), other traumatic knee injuries (29 vs 16 per 100 player years; RR, 1.84; 95% CI, 1.16-2.93; P < .01), and nontraumatic knee injuries (33 vs 9 per 100 player years; RR, 3.62; 95% CI, 2.11-6.21; P < .001) as compared with controls. There was no difference in the rate of other (not knee) injuries (43 vs 48 per 100 player years; RR, 0.90; 95% CI, 0.65-1.23; P = .494). During the 2-year follow-up, 72 (62%) players with ACL reconstruction quit soccer, as opposed to 43 (36%) controls ( P = .001). The median Tegner Activity Scale score decreased in both groups ( P < .001) but more for the ACL-reconstructed group ( P < .015). Conclusion: Female soccer players with ACL reconstruction had nearly a 5-fold-higher rate of new ACL injuries and a 2- to 4-fold-higher rate of other new knee injuries, quit soccer to a higher degree, and reduced their activity level to a greater extent as compared with knee-healthy controls.

scholarly journals High Risk of New Knee Injuries in Female Soccer Players After Primary Anterior Cruciate Ligament Reconstruction at 5- to 10-Year Follow-up

2021 ◽  
pp. 036354652110444
Author(s):  
Anne Fältström ◽  
Joanna Kvist ◽  
Martin Hägglund
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Risk Ratio ◽  
Knee Injury ◽  
Cruciate Ligament ◽  
Knee Injuries ◽  
Acl Injury ◽  
Soccer Players ◽  
Healthy Controls ◽  
Anterior Cruciate

Background: A new anterior cruciate ligament (ACL) injury after ACL reconstruction is a feared outcome. Purpose: To study the risk of new knee injuries in female soccer players 5 to 10 years after primary unilateral ACL reconstruction and to compare players who returned to soccer with (1) players who did not return and (2) knee-healthy soccer players (controls). Study Design: Cohort study; Level of evidence, 2. Methods: Demographic, soccer-specific, and surgical data were recorded at baseline for 317 female soccer players (mean ± SD age, 20.1 ± 2.7 years) 1.6 ± 0.7 years after ACL reconstruction and for 119 matched controls (mean age, 19.5 ± 2.5 years). Data on new knee injuries and soccer-playing status were collected 5 to 10 years after ACL reconstruction via a questionnaire. Results: Among players with ACL reconstruction, 222 (70%) responded at a mean 6.5 ± 1.0 years after primary ACL reconstruction. We compared 3 cohorts: (1) among 163 players with ACL reconstruction who returned to soccer, 68 (42%) sustained 44 reruptures and 29 contralateral ruptures; (2) among 59 players with ACL reconstruction who did not return to soccer, 11 (19%) sustained 9 reruptures and 2 contralateral ruptures; and (3) among 113 knee-healthy controls, 12 (11%) sustained 13 ACL injuries. Players who returned had a >2-fold higher risk of a new ACL injury than players who did not return (risk ratio, 2.24; 95% CI, 1.27-3.93; P = .005) and a 4-fold higher risk than controls (risk ratio, 3.93; 95% CI, 2.23-6.91; P <.001). A new ACL, meniscal, or cartilage injury was the most frequent new knee injury. Among players who returned to soccer, 68% reported a new knee injury, and they had a 2- to 5-times higher risk of any new knee injury and knee surgery than players who did not return and controls. Conclusion: Two-thirds of female soccer players with ACL reconstruction who returned to soccer sustained a new knee injury within 5 to 10 years; 42% had a new ACL injury. Their risk of a new knee injury and knee surgery was 2 to 5 times greater than that for players who did not return and for knee-healthy controls. New injury may have negative consequences for long-term knee health and should be a critical consideration in the decision to return to play.

The Role of Patient Characteristics in the Success of Nonoperative Treatment of Anterior Cruciate Ligament Injuries

2020 ◽  
Vol 48 (7) ◽  
pp. 1657-1664 ◽  
Author(s):  
Jelle P. van der List ◽  
Frans J.A. Hagemans ◽  
Dirk Jan Hofstee ◽  
Freerk J. Jonkers
Keyword(s):  
Anterior Cruciate Ligament ◽  
Multivariate Analysis ◽  
Physical Therapy ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Patient Characteristics ◽  
Nonoperative Treatment ◽  
Activity Level ◽  
Acl Injuries ◽  
Anterior Cruciate

Background: Anterior cruciate ligament (ACL) tears can either be treated nonoperatively with physical therapy and then treated operatively if persistent instability is present, or be directly treated operatively. Advantages of early ACL reconstruction surgery include shorter time from injury to surgery and potentially fewer meniscal injuries, but performing early ACL reconstruction in all patients results in surgery in patients who might not need ACL reconstruction. It is important to assess in which patients nonoperative treatment is successful and which patients will require ACL reconstruction and thus might be better treated surgically in an earlier phase. Purpose: To identify patient characteristics that predict the success of nonoperative treatment. Study Design: Cohort study (Prognosis); Level of evidence, 2. Methods: All patients with complete ACL injuries who were evaluated between 2014 and 2017 at our clinic were included. The minimum follow-up was 2 years. The initial treatment and ultimate ACL reconstruction were reviewed. Univariate analysis was performed using Mann-Whitney U tests and chi-square tests and multivariate analysis using binary logistic regression. Results: A total of 448 patients were included with a median age of 26 years and median Tegner level of 7 and mean Tegner level of 6.4. At initial consultation, 210 patients (47%) were treated nonoperatively with physical therapy and 126 of these patients (60%) ultimately required ACL reconstruction. Nonoperative treatment failed in 88.9% of patients <25 years of age, 56.0% of patients 25 to 40 years, and 32.9% of patients >40 years ( P < .001); and 41.9% of patients with Tegner level 3 to 6, and 82.8% of patients with Tegner level 7 to 10. Age <25 years (odds ratio [OR], 7.4; P < .001) and higher Tegner levels (OR, 4.2; P < .001) were predictive of failing nonoperative treatment in multivariate analysis. Patients in the failed nonoperative group had longer time from diagnosis to surgery than the direct reconstruction group (6.2 vs 2.2 months; P < .001), and more frequently had new meniscal injuries (17.4% vs 3.1%; P < .001) at surgery. Conclusion: Nonoperative treatment of ACL injuries failed in 60% of patients and was highly correlated with age and activity level. In patients aged 25 years or younger or participating in higher-impact sports, early ACL reconstruction should be considered to prevent longer delay between injury and surgery, as well as new meniscal injuries.

scholarly journals Incidence of Second Anterior Cruciate Ligament Tears (1990-2000) and Associated Factors in a Specific Geographic Locale

2017 ◽  
Vol 45 (7) ◽  
pp. 1567-1573 ◽  
Author(s):  
Nathan D. Schilaty ◽  
Nathaniel A. Bates ◽  
Thomas L. Sanders ◽  
Aaron J. Krych ◽  
Michael J. Stuart ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Patellar Tendon ◽  
Cruciate Ligament ◽  
Population Based ◽  
Contralateral Side ◽  
Activity Level ◽  
Acl Injuries ◽  
Acl Tear ◽  
Anterior Cruciate

Background: Second anterior cruciate ligament (ACL) tears after reconstruction occur at a reported rate of 20% to 30%. This high frequency indicates that there may be factors that predispose an athlete to graft failure and ACL tears of the contralateral knee. Purpose: To determine the incidence of second ACL injuries in a geographic population-based cohort over a 10-year observation period. Study Design: Descriptive epidemiological study. Methods: International Classification of Diseases, 9th Revision (ICD-9) codes relevant to the diagnosis of an ACL tear and the procedure code for ACL reconstruction were searched across the Rochester Epidemiology Project, a multidisciplinary county database, between the years of 1990 and 2000. This cohort of patients was tracked for subsequent ACL injuries through December 31, 2015. The authors identified 1041 patients with acute, isolated ACL tears. These patients were stratified by primary and secondary tears, sex, age, activity level, side of injury, sex by side of injury, and graft type. Results: Of the 1041 unique patients with a diagnosed ACL tear in Olmsted County, Minnesota, from 1990 to 2000, there were 66 (6.0%) second ACL tears; 66.7% of these tears occurred on the contralateral side. A second ACL injury was influenced by graft type ( P < .0001), election of ACL reconstruction ( P = .0060), and sex by side of injury ( P = .0072). Nonparametric analysis of graft disruption by graft type demonstrated a higher prevalence of second ACL tears with allografts compared with hamstring ( P = .0499) or patellar tendon autografts ( P = .0012). Conclusion: The incidence of second ACL tears in this population-based cohort was 6.0%, with 66.7% of these tears occurring on the contralateral side from the original injury. There was a high population incidence of second ACL injuries in female patients younger than age 20 years. The utilization of patellar tendon autografts significantly reduced the risk of second ACL injuries compared with allografts or hamstring autografts in this cohort.

scholarly journals Epidemiology of surgically managed anterior cruciate ligament ruptures in a sports surgery practice

2017 ◽  
Vol 25 (1) ◽  
pp. 230949901668428 ◽  
Author(s):  
Andrew Arjun Sayampanathan ◽  
Bryan Koh Thean Howe ◽  
Hamid Rahmatullah Bin Abd Razak ◽  
Chong Hwei Chi ◽  
Andrew Hwee Chye Tan
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Road Traffic ◽  
Cruciate Ligament ◽  
Lateral Meniscus ◽  
Knee Injuries ◽  
Treatment Strategies ◽  
Senior Author ◽  
Acl Injuries ◽  
Anterior Cruciate

Introduction: Anterior cruciate ligament (ACL) tears are common knee injuries, especially among sportsmen and sportswomen. The aim of this study is to better understand the epidemiology of surgically managed ACL tears sustained in our institution. Methods: All patients who underwent arthroscopic ACL reconstruction by the senior author of this article in Singapore from 2008 to 2013 were studied. Patients who were diagnosed clinically and/or radiologically to have a complete tear of the ACL and subsequently underwent arthroscopic ACL reconstruction were included. Patients who suffered from traumatic knee dislocation were excluded. Two hundred and ninety-two patients were available for analysis. All patients were operated on by the senior author. Results: 83.9% of patients were male. 60.5, 23.0, 8.46, and 8.11% were of Chinese, Malay, Indian and other origins, respectively. 69.6 and 28.7% were in white-collared and blue-collared jobs, respectively, while 1.69% were unemployed. Mean age at operation was 29.4 years. Mean body mass index was 25.3 kg/m2. 82.4 and 17.6% of ACL tears were sports (contact—27.5%; non-contact—72.5%) and non-sports injuries (activities of daily living—94.2%, road traffic accidents—5.77%), respectively. The top four sporting activities causing ACL tears were soccer, basketball, racquet games and volleyball. 56.2% of ACL tears presented with concomitant knee injuries (medial meniscus—63.4%; lateral meniscus—31.1%; posterior cruciate ligament—5.49%). 84.5% were primary tears. Conclusions: In this epidemiological review of ACL injuries, we found that ACL injuries tend to cluster within certain population subgroups. Patterns of mechanisms of injuries have been observed. These findings may lead to better preventive and treatment strategies in the management of ACL tears.

scholarly journals Poor Validity of Functional Performance Tests to Predict Knee Injury in Female Soccer Players With or Without Anterior Cruciate Ligament Reconstruction

2021 ◽  
pp. 036354652110025
Author(s):  
Anne Fältström ◽  
Martin Hägglund ◽  
Henrik Hedevik ◽  
Joanna Kvist
Keyword(s):  
Acl Reconstruction ◽  
Predictive Validity ◽  
Knee Injury ◽  
Functional Performance ◽  
Cruciate Ligament ◽  
Knee Injuries ◽  
Acl Injury ◽  
Soccer Players ◽  
Performance Tests ◽  
Anterior Cruciate

Background: Various tests have been developed to evaluate athletes’ functional performance and for use as screening tools for injury prediction. Further validation of their accuracy to predict injury is needed. Purpose: To investigate the validity of predetermined cutoffs used to differentiate between high- and low-risk players in different functional performance tests to predict (1) anterior cruciate ligament (ACL) injury or (2) severe traumatic knee injury in a cohort of female soccer players with a primary unilateral ACL reconstruction and a cohort of knee-healthy players. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 117 active female soccer players (mean age ± SD, 20 ± 2 years) an average of 19 ± 9 months after ACL reconstruction and 119 knee-healthy players (age, 19 ± 3 years) were prospectively followed up for 2 years for new knee injuries. At baseline, all players underwent tests to assess postural control (Star Excursion Balance Test), hop performance (single-leg hop for distance, side hop), and movement asymmetries in the lower limbs and trunk (drop vertical jump [DVJ], tuck jump). The predictive validity of the test cutoffs to identify players who would sustain an ACL injury or a severe traumatic knee injury (absence from soccer play, >28 days) was assessed. The risk ratio (RR), area under the receiver operating characteristic curve (AUC), sensitivity, and specificity were calculated. Results: A total of 46 players (39%) with ACL reconstruction sustained 48 severe knee injuries, including 28 ACL ruptures. Of the knee-healthy players, 13 (11%) sustained 14 severe knee injuries, including 8 ACL ruptures. No association was found between the predetermined functional performance test cutoffs and the risk of a new ACL injury or severe knee injury in players with ACL reconstruction. In knee-healthy players, the only variable associated with future ACL injury was ≥6.5 cm knee valgus in the frontal plane (any knee) in the DVJ (RR, 4.93; 95% CI, 1.04-23.40; P = .045), but with only fair predictive validity (AUC, 0.7; sensitivity, 0.75; specificity, 0.65). Conclusion: In our cohorts of female soccer players, the validity of commonly used functional performance tests to predict new knee injuries was poor. Only knee valgus during the DVJ was associated with new ACL injuries in knee-healthy players, but with only fair predictive validity.

Can Talented Youth Soccer Players Who Have Undergone Anterior Cruciate Ligament Reconstruction Reach the Elite Level?

2020 ◽  
pp. 036354652097665
Author(s):  
Alexander Sandon ◽  
Tor Söderström ◽  
Andreas Stenling ◽  
Magnus Forssblad
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Reconstructive Surgery ◽  
Cruciate Ligament ◽  
Activity Level ◽  
Return To Play ◽  
Soccer Players ◽  
Youth Soccer ◽  
Elite Level ◽  
Anterior Cruciate

Background: Anterior cruciate ligament (ACL) ruptures are common in soccer players, and reconstructive surgery is often performed to restore knee stability and enable a return to play. Purpose: To investigate whether an ACL reconstruction for talented youth soccer players affects their potential to become elite players at the senior level. Study Design: Cohort study; Level of evidence, 3. Methods: All soccer players who participated in the Swedish National Elite Camp for 15-year-old players between 2005 and 2011 (N = 5285 players; 2631 boys and 2654 girls) were matched with the Swedish National Knee Ligament Registry to identify the players who had undergone ACL reconstruction. Information on player participation in Swedish league games and level of play was collected from the Swedish Football Association’s administrative data system. The players with an ACL reconstruction who were injured at the ages of 15 to 19 years were compared with the rest of the players who participated in the National Elite Camp to see whether an early ACL reconstruction affected whether they remained active as soccer players and their chance to play at the elite level as seniors. Results: A total of 524 (9.9%) players had undergone an ACL reconstruction, and 292 (5.5%; 75 male and 217 female) had sustained their injury at age 15 to 19 years. During the follow-up period, 122 (23.3%) players underwent ACL reconstruction: revision (11.5%; n = 60) or contralateral (11.8%; n = 62). Male and female soccer players undergoing an ACL reconstruction at age 15 to 19 years experienced no significant effect on being active or playing at the elite level in the season that they turned 21 years old. Of the youth players who underwent ACL reconstruction, 12% of the male players and 11.5% of the female players progressed to the elite level at the age of 21 years compared with 10.3% of the men and 11.1% of the women among the uninjured players. Conclusion: ACL reconstructive surgery in talented youth soccer players offers them the opportunity to become elite players as seniors and permits an activity level on a par with that of their uninjured peers. However, almost 1 in 4 requires further ACL surgery, so the players’ future knee health should be considered when deciding on a return to play.

More Than a 2-Fold Risk of Contralateral Anterior Cruciate Ligament Injuries Compared With Ipsilateral Graft Failure 10 Years After Primary Reconstruction

2020 ◽  
Vol 48 (2) ◽  
pp. 310-317 ◽  
Author(s):  
Alberto Grassi ◽  
Luca Macchiarola ◽  
Gian Andrea Lucidi ◽  
Federico Stefanelli ◽  
Mariapia Neri ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Graft Failure ◽  
Cruciate Ligament ◽  
Activity Level ◽  
Acl Injuries ◽  
Contralateral Knee ◽  
Acl Revision ◽  
Anterior Cruciate

Background: Failure of anterior cruciate ligament (ACL) reconstruction or an injury to the ACL in the contralateral knee represents a devastating event for patients, especially those young and physically active. However, controversies are still present regarding long-term failure rates and risk factors. Purpose: To assess the long-term rate of ipsilateral graft failure and contralateral ACL injuries after ACL reconstruction performed at a single center using the same surgical technique with a hamstring autograft and to investigate the effect of sex, age, and preinjury activity level as predictors of second ACL injuries. Study Design: Case series; Level of evidence, 4. Methods: The study cohort consisted of 244 consecutive patients (mean age, 30.7 years) who underwent ACL reconstruction with a single bundle plus lateral plasty technique using the hamstring tendon between November 2007 and May 2009. The number of subsequent ACL injuries (ipsilateral ACL revision or contralateral ACL reconstruction) was determined at a minimum follow-up of 10 years. Survivorship of either knee and subgroup analysis included sex, age, preoperative Tegner activity level, timing of ACL reconstruction, body mass index, and smoking status. Results: Ipsilateral ACL revision was performed in 8 (3.4%) patients and contralateral ACL reconstruction in 19 (7.8%) patients. Only 1 patient had both ipsilateral and contralateral injuries. No predictors were found for ipsilateral ACL revision, while age <18 years and preoperative Tegner level ≥7 had a higher risk of contralateral ACL reconstruction. The highest rate of a second ACL reconstruction procedure was in young (<18 years) and active (Tegner ≥7) patients, in whom the 10-year survival of either knee was 61.1%. Six years after primary ACL reconstruction, the rate of contralateral ACL reconstruction was significantly higher than that of ipsilateral ACL revision (hazard ratio, 2.4-3.6). Conclusion: In the long term, a second injury to either the ipsilateral or the contralateral knee in young and active populations could reach 40%, with a more than double-fold risk of contralateral ACL reconstruction compared with ipsilateral ACL revision.

scholarly journals Anatomic All-Inside Anterior Cruciate Ligament Reconstruction Using the TransLateral Technique

2017 ◽  
Vol 2 (s3) ◽  
pp. 17-21 ◽  
Author(s):  
Octav Russu ◽  
Tiberiu Bățagă ◽  
Marcela Todoran ◽  
Emilian Ciorcila ◽  
Teodora Maria Denisa Popa ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Clinical Effectiveness ◽  
Lysholm Score ◽  
Post Surgery ◽  
Activity Scale ◽  
Anterior Cruciate ◽  
Acl Deficient ◽  
Tegner Activity Scale

Abstract Background: Anterior cruciate ligament (ACL) reconstruction is a commonly performed procedure and considered to be the gold standard in restoring knee function and stability in ACL-deficient knees. The TransLateral all-inside technique implies the use of only two portals – anterolateral and anteromedial, without the use of an accessory portal. The work is done using the lateral portal, while the medial portal serves as a viewing site. Only a few studies have been published regarding the assessment of the functional and clinical outcomes of this novel technique. Aim of the study: To determine the clinical effectiveness of the TransLateral procedure used for ACL reconstruction and its ability to re-establish joint functionality and stability in ACL-deficient knees. Material and methods: A prospective study was conducted at the Orthopedics and Traumatology Clinic no. 2 in Tîrgu Mureș. Thirty-two patients matched our inclusion criteria and were operated using the TransLateral technique for ACL reconstruction. Outcome assessment was performed using the Knee injury and Osteoarthritis Outcome Score (KOOS), the Lysholm score and the Tegner Activity Scale. The questionnaires include items referring to pain, physical functioning, sports activities, and quality of life. Operative time and ACL graft size were also documented. Results: All patients underwent single-bundle ACL restoration using a quadrupled semitendinosus tendon. Out of 32 patients, 21 had associated meniscus lesions and 8 collateral ligament injuries. Mean graft diameter was 8.7 mm and mean length 63.2 mm. Significantly improved KOOS values were found at 12 months post-surgery regarding the mean baseline score: 59.3 ± 5.3 vs. 95.3 ± 4.9, p <0.0001. The Lysholm score improved from a mean of 56.3 ± 4.9 to 93.9 ± 5.6, p <0.0001 at the end-point. The Tegner activity scale ranged from 3.8 ± 1.9 to 5.9 ± 2.4, p <0.0001 at the final follow-up. Conclusions: The TransLateral technique proved its clinical effectiveness and its ability to restore knee stability after ACL reconstruction surgery.

ACL Reconstruction in the Multiple Ligament Injured Knee

2019 ◽  
Vol 33 (05) ◽  
pp. 418-420
Author(s):  
Robert G. Marx ◽  
Isabel A. Wolfe
Keyword(s):  
Acl Reconstruction ◽  
Sports Injuries ◽  
Current Knowledge ◽  
Cruciate Ligament ◽  
Knee Injuries ◽  
High Energy ◽  
Acl Injuries ◽  
Proper Diagnosis ◽  
Anterior Cruciate ◽  
Injured Knee

AbstractMultiple ligament knee injuries are complex and can result from sports injuries or high energy trauma. The proper diagnosis and treatment of multiple ligament knee injuries are essential, and careful evaluation and planning are required to achieve successful outcomes. Anterior cruciate ligament (ACL) reconstruction in the multiple ligament injured knee is complicated by several factors, necessitating additional technical considerations. Patient selection, surgical timing, graft selection, and surgical technique require consideration specific to the ACL component of these injuries. We present a summary of the current knowledge with respect to the treatment of ACL injuries in the context of the multiple ligament injured knee.

scholarly journals ADVANTAGES AND FEATURES OF ARTHROSCOPIC REINSERTION OF THE ANTERIOR CRUCIATE LIGAMENT OF THE KNEE JOINT WITH INTERNAL SPLINTING (internal brace technology)

2021 ◽  
pp. 18-33
Author(s):  
V. G. Lutsyshyn ◽  
V. M. Maiko ◽  
Y. A. Filonenko ◽  
O. V. Maiko
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Knee Injuries ◽  
Activity Level ◽  
Ligament Injury ◽  
Results Of Treatment ◽  
Number Of Patients ◽  
Internal Brace ◽  
Anterior Cruciate

Background. Despite the annual increase in the number of patients with knee injuries, there is no gen-erally accepted algorithm for treating patients with anterior cruciate ligament injury (ACL). Conservative treatment is ineffective, as in 75-87% gives chronic anterior medial instability, increases the risk of post-traumatic arthritis by 51,2%. There is a considerable interest in arthroscopic primary recovery of ACL. The aim of the study is to evaluate the results of treatment of patients with ACL rapture and to develop a differentiated approach in its treatment. Materials and methods. The results of treatment of patients with ACl rupture who underwent ligament reinsertion (n = 40) and ACL reconstruction (n = 50) were analyzed. The assessment was performed on the scale of VAS for 2 days, VAS and IKDC 2-6-12 weeks after surgery Results. On the second day after the ligament reinsertion, patients had less pain compared to their post-reconstruction sensations: VAS 4,1 versus 5,3. In the group of patients after reinsertion of ACL in the period of 2-6 weeks there were lower rates of pain, namely 2,25 compared with 3,4 in the group of ACL reconstruction. At 2 weeks after reinsertion, patients reported moderate pain and an activity level of 66,4 ± 3,5 compared with the 61,3 ± 2,6 ligament reconstruction group on the IKDC scale. At 6 weeks, the positive dynamics persists, 80,2 ± 2,8 and 76,9 ± 3,1 IKDC, respectively. In 12 weeks, patients in both groups recover almost completely and return to daily activity, 93,9 ± 3,6 and 91,7 ± 2,4 on the IKDC scale, respectively. Conclusions. Primary recovery for proximal ACL ruptures shows good results and may be an alternative to ACL reconstruction. Success is based on the location of the ligament rupture and the tissues quality. The possibility of the initial ACL recovery is solved during surgery. If there is any doubt about the suitability of tissues for recovery, it is recommended to perform a standard reconstruction of ACL.

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