scholarly journals Factors Associated With Function After Anterior Cruciate Ligament Reconstruction

2009 ◽  
Vol 1 (1) ◽  
pp. 47-53 ◽  
Author(s):  
Trevor A. Lentz ◽  
Susan M. Tillman ◽  
Peter A. Indelicato ◽  
Michael W. Moser ◽  
Steven Z. George ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
International Knee Documentation Committee ◽  
Psychological Variables ◽  
Cruciate Ligament Reconstruction ◽  
Subjective Form ◽  
Anterior Cruciate ◽  
Tampa Scale For Kinesiophobia

Background: Many individuals do not resume unrestricted, preinjury sports participation after anterior cruciate ligament reconstruction, thus a better understanding of factors associated with function is needed. The purpose of this study was to investigate the association of knee impairment and psychological variables with function in subjects with anterior cruciate ligament reconstruction. Hypothesis: After controlling for demographic variables, knee impairment and psychological variables contribute to function in subjects with anterior cruciate ligament reconstruction. Study Design: Cross-sectional study; Level of evidence, 4a. Methods: Fifty-eight subjects with a unilateral anterior cruciate ligament reconstruction completed a standardized testing battery for knee impairments (range of motion, effusion, quadriceps strength, anterior knee joint laxity, and pain intensity), kinesiophobia (shortened Tampa Scale for Kinesiophobia), and function (International Knee Documentation Committee subjective form and single-legged hop test). Separate 2-step regression analyses were conducted with International Knee Documentation Committee subjective form score and single-legged hop index as dependent variables. Demographic variables were entered into the model first, followed by knee impairment measures and Tampa Scale for Kinesiophobia score. Results: A combination of pain intensity, quadriceps index, Tampa Scale for Kinesiophobia score, and flexion motion deficit contributed to the International Knee Documentation Committee subjective form score (adjusted r2 = 0.67; P < .001). Only effusion contributed to the single-legged hop index (adjusted r2 = 0.346; P = .002). Conclusion: Knee impairment and psychological variables in this study were associated with self-report of function, not a performance test. Clinical Relevance: The results support focusing anterior cruciate ligament reconstruction rehabilitation on pain, knee motion deficits, and quadriceps strength, as well as indicate that kinesiophobia should be addressed. Further research is needed to reveal which clinical tests are associated with performance testing.

Bioresorbable Pins and Interference Screws for Fixation of Hamstring Tendon Grafts in Anterior Cruciate Ligament Reconstruction Surgery

2009 ◽  
Vol 37 (9) ◽  
pp. 1692-1698 ◽  
Author(s):  
Dirk Stengel ◽  
Dirk Casper ◽  
Kai Bauwens ◽  
Axel Ekkernkamp ◽  
Michael Wich
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
International Knee Documentation Committee ◽  
Clinical Results ◽  
Interference Screws ◽  
Cruciate Ligament Reconstruction ◽  
Anterior Cruciate

Background Biodegradable cross-pins have been shown to provide higher failure loads than do screws for fixation of hamstring tendons under laboratory conditions. Purpose To compare the clinical results of biodegradable pins (RigidFix) and interference screws (BioCryl) for fixation of hamstring grafts in arthroscopically assisted anterior cruciate ligament reconstruction. Study Design Randomized controlled trial; Level of evidence, 1. Methods To test the hypothesis of a difference of 1.0 ± 1.2 mm in anterior knee laxity between the two fixation options, 54 patients were randomly assigned to groups via a block randomization scheme and sealed envelopes. All patients underwent standardized hamstring graft reconstruction and had similar postoperative aftercare by an accelerated rehabilitation protocol. Measures assessed at baseline and after 1 and 2 years of follow-up included (1) the side-to-side difference in anterior laxity (KT-1000 arthrometer), (2) Short Form 36 physical and mental component scores, and (3) the International Knee Documentation Committee form scores. Results After 1 and 2 years, 26 and 21 patients in the BioCryl group and 28 and 24 patients in the RigidFix group were available for follow-up examination. No significant difference was noted in instrumented anterior translation between BioCryl and RigidFix fixation: 1 year, 0.11 (95% CI, —0.60 to 0.82; P = .7537); 2 years, 0.33 (95% CI, —0.43 to 1.08 mm; P = .3849). Also, there were no significant differences in the mean physical and mental component scores and International Knee Documentation Committee form scores and in overall complication and surgical revision rates. A pin dislocation was classified as the sole procedure-specific serious adverse event. Conclusion Bioresorbable pins do not provide better clinical results than do resorbable interference screws for hamstring graft fixation in anterior cruciate ligament reconstruction surgery.

scholarly journals Correlation of Graft Maturity with Knee Function Scores Post Anterior Cruciate Ligament Reconstruction: A Retrospective Study

2021 ◽  
Author(s):  
Rongjin Chen ◽  
Zhu Haozhong ◽  
Gu Xinyi ◽  
xiang xianxiang
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
International Knee Documentation Committee ◽  
Knee Function ◽  
Resonance Imaging ◽  
Cruciate Ligament Reconstruction ◽  
Signal Noise ◽  
Anterior Cruciate

Abstract BACKGROUND: The relationship between the signal/noise quotient value and knee function scores has not been extensively studied. Thus, we aimed to investigate the correlation between graft maturity and knee function after anterior cruciate ligament reconstruction.METHODS: In this retrospective study, we included patients (n=50; 28 male patients; age, 31.0 years) who underwent anterior cruciate ligament reconstruction with autogenous tendons between August 2016 and August 2018. At 6 months and 2 years postoperatively, the signal/noise quotient values of the tibia and femur, indicating graft maturity, were measured using magnetic resonance imaging. The Tegner, Lysholm, and International Knee Documentation Committee scores were used to evaluate knee function. Mean signal/noise quotient values of the grafts’ femoral and tibial ends were considered the final signal/noise quotient values. The correlation between the signal/noise quotient value at 6 months postoperatively and knee function score at 2 years postoperatively was analyzed. RESULTS: All patients were followed up for 24–28 months. The International Knee Documentation Committee, Lysholm, and Tegner scores of the knee joint at 6 months and 2 years postoperatively were significantly higher than the preoperative scores, and those at 2 years postoperatively were significantly higher than those at 6 months postoperatively. The signal/noise quotient value for all patients at 6 months postoperatively was negatively correlated with the Lysholm, International Knee Documentation Committee, and Tegner scores at 2 years postoperatively.CONCLUSION: The signal/noise quotient value based on magnetic resonance imaging in the early stage after anterior cruciate ligament reconstruction can predict knee function in the later stage.

Five-Year Results of Single-Incision Arthroscopic Anterior Cruciate Ligament Reconstruction with Patellar Tendon Autograft

1998 ◽  
Vol 26 (2) ◽  
pp. 181-188 ◽  
Author(s):  
David Otto ◽  
Leo A. Pinczewski ◽  
Amanda Clingeleffer ◽  
Ross Odell
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Single Incision ◽  
Cruciate Ligament ◽  
International Knee Documentation Committee ◽  
Cruciate Ligament Reconstruction ◽  
Anterior Cruciate ◽  
Tendon Autograft ◽  
Anterior Cruciate Ligament Deficient

We performed a retrospective study on 80 patients who underwent single-incision arthroscopic anterior cruciate ligament reconstruction with patellar tendon autograft and interference fit screw fixation in 1989. Twelve patients were lost to followup, allowing a clinical assessment of 68 patients to be conducted by independent examiners at 1 and 5 years after surgery, with radiographic assessment at 5 years. Thirty-three patients had chronic anterior cruciate ligament-deficient knees. Three patients reruptured their grafts during sports at 29, 48, and 56 months. At 5 years, 64 patients (98%) had grade 0 or 1 Lachman and pivot shift tests with manual stability testing. Fifty patients (77%) were participating in level I or II activities according to the International Knee Documentation Committee scale. Twenty-nine patients (45%) experienced low levels of pain when performing at their highest activity level. Five (8%) had thigh atrophy greater than 1 cm, and three (5%) had an extension loss of more than 3°. Eleven patients (17%) had tenderness over the graft site when kneeling. Fifteen of 62 patients (24%) had degenerative changes on radiographs, and this was more common in patients with chronic anterior cruciate ligament-deficient knees. Fifty-two patients (80%) had normal or nearly normal knees according to the overall International Knee Documentation Committee score.

scholarly journals Quality of life and thigh girth following anterior cruciate ligament reconstruction using hamstring autograft

2019 ◽  
Vol 6 (1) ◽  
pp. 49
Author(s):  
Mirza A. Baig
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
International Knee Documentation Committee ◽  
Quadriceps Strength ◽  
Sensory Loss ◽  
Research Centre ◽  
Cruciate Ligament Reconstruction ◽  
Anterior Cruciate

<p class="abstract"><strong>Background:</strong> Arthroscopic anterior cruciate ligament reconstruction is commonly performed with intent to return earlier to normal activities, so graft selection becomes more important. The use of hamstring tendon autograft is supposed to have less postoperative morbidities. In this prospective study we assess the early post-operative complications.</p><p class="abstract"><strong>Methods:</strong> 25 patients were operated in Shadan Institute of Medical Sciences and Research Centre, Hyderabad, India, by the same surgeon and were assessed preoperatively, and 3 and 6 months after surgery. The hamstring and quadriceps strength were measured with PRIMUS RS machine. The patients were also assessed for their subjective complaints using International Knee Documentation Committee (IKDC) knee scoring system.<strong></strong></p><p class="abstract"><strong>Results:</strong> The peak power of flexion and extension of the knee joint significantly improved following the surgery which is essential for any athletic activities. Quadriceps and hamstring strengths were restored to 90%, which suggests that the grafting has been successful in restoring isometric strength. This is necessary to return to sporting activities. Power of hamstrings and quadriceps significantly improved following surgery. Quadriceps and hamstring endurance recovered and improved at the end of 6 months following surgery. Using IKDC scoring, nearly normal were 14, normal were 10 and abnormal 1. 3 patients (12%) presented with anterior knee pain. Sensory loss was noted in 6 patients (24%) at the end of 6 months following surgery. Swelling was noted in 5 patients (25%).</p><p class="abstract"><strong>Conclusions:</strong> Most morbidities are temporary in nature and do not significantly affect the patient’s activities.</p>

Posteromedial versus Anteromedial Hamstring Tendon Harvest for Anterior Cruciate Ligament Reconstruction: A Retrospective Comparison of Accidental Gracilis Harvests, Outcomes, and Operative Times

2018 ◽  
Vol 32 (11) ◽  
pp. 1121-1127 ◽  
Author(s):  
Henry T. Shu ◽  
Blake M. Bodendorfer ◽  
Evan M. Michaelson ◽  
Evan H. Argintar
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
International Knee Documentation Committee ◽  
Hamstring Tendon ◽  
Patient Reported Outcome Measures ◽  
Cruciate Ligament Reconstruction ◽  
Patient Reported ◽  
Anterior Cruciate

AbstractHamstring autografts are frequently harvested for anterior cruciate ligament reconstruction (ACLR), traditionally through the anteromedial (AM) approach. Recently, a posteromedial (PM) approach has been described. The primary purpose of this study was to compare rates of unintentional gracilis (Gr) harvest or premature tendon amputation with these approaches. We also sought to compare operative times and patient-reported outcome measures (PROMs) between both groups and between those with only semitendinosus (ST) grafts or with combined ST and Gr grafts. Patients who underwent ACLR with hamstring autograft by a single surgeon from 2014 to 2016 were retrospectively reviewed. An accidental harvest was identified as an unintentional Gr harvest or premature graft amputation. PROMs included the Knee Osteoarthritis and Outcomes Score, Western Ontario and McMaster Universities Osteoarthritis Index, and International Knee Documentation Committee score. Two out of 22 (9.1%) patients in the AM group had unintentional Gr tendon harvests, while none (out of 29) were identified in the PM group (p = 0.101). Group mean PROMs were not significantly different between patients in either group or patients with either ST-only grafts and those with combined ST + Gr. Average operative times and tourniquet times were significantly shorter with the PM approach versus the AM approach (101 ± 18.2 vs 129 ± 25.6 minutes, p = 0.002; 68 ± 14.8 vs 90 ± 28.9 minutes, p = 0.005). The PM approach was associated with a trend toward decreased risk of unintentional harvest of the Gr tendon and significantly decreased operative and tourniquet times without affecting knee outcomes compared with the traditional AM approach. Accidental Gr harvest was not associated with worse outcomes.

Revision Anterior Cruciate Ligament Reconstruction Using a 2-Stage Technique with Bone Grafting of the Tibial Tunnel

2005 ◽  
Vol 33 (11) ◽  
pp. 1701-1709 ◽  
Author(s):  
Neil P. Thomas ◽  
Raghu Kankate ◽  
Felicity Wandless ◽  
Hemant Pandit
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Bone Grafting ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Tibial Tunnel ◽  
International Knee Documentation Committee ◽  
Salvage Procedure ◽  
Cruciate Ligament Reconstruction ◽  
Anterior Cruciate

Background Revision anterior cruciate ligament surgery is often considered a salvage procedure with limited goals. However, this limitation need not be the case. Similar to primary reconstruction, the goal should be to choose an appropriate graft and place it in an anatomical position in a good quality bone. The issue of good quality bone seems to have been ignored. Hypothesis A 2-stage anterior cruciate ligament revision reconstruction with bone grafting of the tibial tunnel and the use of a different femoral tunnel will produce measured knee laxity and International Knee Documentation Committee scores similar to a primary anterior cruciate ligament reconstruction. Study Design Case control study; Level of evidence, 3. Methods This prospective study involved 49 consecutive 2-stage anterior cruciate ligament revisions (group R) performed by a single surgeon from 1993 to 2000. Two-stage revision surgery was performed if the tibial tunnel from a previous reconstruction surgery would overlap (either partially or fully) the correctly placed revision tunnel. The first stage consisted of removal of the old graft and interfering metalwork, together with bone grafting of the tibial tunnel. After ensuring adequate bone graft incorporation using computed tomography scan, the second stage revision was undertaken. This stage comprised harvesting the autograft, its anatomical placement, and its adequate fixation. The results were compared with the results of a matched group of patients with primary anterior cruciate ligament reconstruction (group P). Results In group R, as meniscal and chondral lesions were more common, the International Knee Documentation Committee scores were lower than those of group P (61.2 for group R and 72.8 for group P; P =. 006). Objective laxity measurement was similar in both groups (1.36 mm for group R and 1.2 mm for group P; P =. 25). Conclusion This study establishes that the laxity measurements achieved with a 2-stage revision anterior cruciate ligament reconstruction can be similar to those achieved after primary anterior cruciate ligament reconstruction, although the International Knee Documentation Committee rating is lower.

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