scholarly journals Passive Knee Stability After Anterior Cruciate Ligament Reconstruction Using the Endobutton or ToggleLoc With ZipLoop as a Femoral Fixation Device: A Comparison of 1654 Patients From the Danish Knee Ligament Reconstruction Registry

2018 ◽  
Vol 6 (6) ◽  
pp. 232596711877850 ◽  
Author(s):  
Christian Asmus Peter Asmussen ◽  
Mikkel Lindegaard Attrup ◽  
Kristian Thorborg ◽  
Per Hölmich
Keyword(s):  
Anterior Cruciate Ligament ◽  
Ligament Reconstruction ◽  
Pivot Shift ◽  
Cruciate Ligament ◽  
Pivot Shift Test ◽  
Knee Stability ◽  
Knee Ligament ◽  
Knee Ligament Reconstruction ◽  
Anterior Cruciate ◽  
Tibial Translation

Background: Biomechanical studies show varying results regarding the elongation of adjustable fixation devices. This has led to growing concern over the stability of the ToggleLoc with ZipLoop used in anterior cruciate ligament (ACL) reconstruction (ACLR) in vivo. Purpose/Hypothesis: The purpose of this study was to compare passive knee stability 1 year after ACLR in patients in whom the Endobutton or ToggleLoc with ZipLoop was used for femoral graft fixation. The hypothesis was that the ToggleLoc with ZipLoop would be inferior in knee stability to the Endobutton 1 year after primary ACLR. Study Design: Cohort study; Level of evidence, 2. Methods: Data from 3175 patients (Endobutton: n = 2807; ToggleLoc with ZipLoop: n = 368) were included from the Danish Knee Ligament Reconstruction Registry (DKRR) between June 2010 and September 2013. Data were retrieved from standardized ACL forms filled out by the operating surgeon preoperatively, during surgery, and at a clinical examination 1 year after surgery. Passive knee stability was evaluated using 1 of 2 arthrometers (Rolimeter or KT-1000 arthrometer) and the pivot-shift test. Using the same database, the number of reoperations performed up to 4 years after primary surgery was examined. Results: Full data were available for 1654 patients (Endobutton: n = 1538; ToggleLoc with ZipLoop: n = 116). ACLR with both devices resulted in increased passive knee stability ( P < .001). Patients who received the ToggleLoc with ZipLoop were found to have a better preoperative ( P = .005 ) and postoperative ( P < .001) pivot-shift test result. No statistically significant difference regarding the number of reoperations ( P = .086) or the time to reoperation ( P = .295) was found. Conclusion: Patients who underwent fixation with the ToggleLoc with ZipLoop had improved passive knee stability 1 year after surgery, measured by anterior tibial translation and pivot-shift test results, similar to patients who underwent fixation with the Endobutton. No difference was seen in knee stability or reoperation rates between the 2 devices.

Anatomical anterior cruciate ligament reconstruction (ACLR) results in fewer rates of atraumatic graft rupture, and higher rates of rotatory knee stability: a meta-analysis

2020 ◽  
Vol 5 (6) ◽  
pp. 359-370
Author(s):  
Yousif Eliya ◽  
Khaled Nawar ◽  
Benjamin B Rothrauff ◽  
Bryson P Lesniak ◽  
Volker Musahl ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Failure Rate ◽  
Ligament Reconstruction ◽  
Pivot Shift ◽  
Cruciate Ligament ◽  
Meta Analysis ◽  
Knee Stability ◽  
Cruciate Ligament Reconstruction ◽  
Anterior Cruciate

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.

scholarly journals Non-anatomical Anterior Cruciate Ligament Remnants Do Not Contribute Dynamic Knee Stability ˜Quantitative Measurement Of The Pivot Shift Test˜

2014 ◽  
Vol 2 (7_suppl2) ◽  
pp. 2325967114S0010
Author(s):  
Kanto Nagai ◽  
Ryosuke Kuroda ◽  
Daisuke Araki ◽  
Yuichiro Nishizawa ◽  
Takehiko Matsushita ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Quantitative Measurement ◽  
Pivot Shift ◽  
Cruciate Ligament ◽  
Pivot Shift Test ◽  
Knee Stability ◽  
Anterior Cruciate

Quantitative Assessment of Rotatory Instability after Anterior Cruciate Ligament Reconstruction

2009 ◽  
Vol 37 (5) ◽  
pp. 909-916 ◽  
Author(s):  
Yasutaka Tashiro ◽  
Ken Okazaki ◽  
Hiromasa Miura ◽  
Shuichi Matsuda ◽  
Takefumi Yasunaga ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Anterior Cruciate Ligament ◽  
Pivot Shift ◽  
Cruciate Ligament ◽  
Pivot Shift Test ◽  
Resonance Imaging ◽  
Rotatory Instability ◽  
Open Magnetic Resonance Imaging ◽  
Anterior Cruciate ◽  
Tibial Translation

Background Anterior cruciate ligament reconstruction successfully reduces anterior knee instability, but its effect on rotatory stability is not fully understood. In addition, a definitive method for the quantitative evaluation of rotatory instability remains to be established. Hypothesis Measurement of anterolateral tibial translation by open magnetic resonance imaging could positively correlate with the clinical grading of the pivot-shift test and would clarify residual rotatory abnormalities not shown by conventional methods for measurement of anterior stability. Study Design Controlled laboratory study. Methods An anterior cruciate ligament—reconstructed group (n = 21) and an anterior cruciate ligament—deficient group (n = 20) were examined using a Slocum anterolateral rotatory instability test in open magnetic resonance imaging. Anterior tibial translation was measured at the medial and lateral compartments by evaluating sagittal images. Clinical knee stability was evaluated before the above measurement using the pivot-shift test, KT-2000 arthrometer, and stress radiography. A cutoff value for anterolateral tibial translation relating to pivot-shift was determined using a receiver operating characteristic curve. Results Side-to-side differences of anterolateral tibial translation correlated with clinical grade of the pivot-shift test and stress radiography but not with KT-2000 arthrometry in both groups. The cutoff value was established as 3.0 mm. Although the mean anterolateral translation showed no difference, 9 reconstructed knees revealed greater than 3 mm of anterolateral tibial translation, whereas only 3 uninjured knees did. Conclusion Measurement using an open magnetic resonance imaging successfully quantified the remaining rotatory instability in anterior cruciate ligament—reconstructed knees. Clinical Relevance This method is a useful means for quantifying anterior cruciate ligament function to stabilize tibial rotation.

EVALUATE THE RESULTS OF ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION WITH THE USE OF AUTOGENOUS PATELLAR LIGAMENT AT HUE UNIVERSITY HOSPITAL

2011 ◽  
pp. 105-115
Author(s):  
Nghi Thanh Nhan Le ◽  
Huu Toan Bui
Keyword(s):  
Anterior Cruciate Ligament ◽  
Ligament Reconstruction ◽  
Pivot Shift ◽  
Cruciate Ligament ◽  
University Hospital ◽  
Patellar Ligament ◽  
Pivot Shift Test ◽  
Cruciate Ligament Reconstruction ◽  
Lachman Test ◽  
Anterior Cruciate

Background: Anterior cruciate ligament (ACL) play the importance role in stability of knee. Our purpose was to report the stability and functional outcomes for a prospective series of patients with ACL injuries treated with reconstruction of use of autogenous patellar ligament. Methods: A prospective study of 30 patients with ACL ruptures treated with arthroscopically assisted reconstruction with autogenous patellar ligament was initiated from May 2008 to December 2010 at Hue University Hospital. Lachman test, anterior draw test, pivot shift test, functional Lysholm scores were obtained at each visit, including preoperatively and at the third and sixth month of follow-up visit. Results: Thirty patients (male : female = 2.3; with a mean age of thirty years) enrolled in the study. Twenty one knees had an isolated ACL tear, nine also had an associated PCL tear and/or meniscus injuries. Lachman test was positive in 100% of cases, draw test was positive in 86% and pivot-shift test was positive in 93%. Mean value of knee function according to Lysholm score was 56 points. Twenty-six patients were followed-up in six months. Lachman test was positive in 15% of all cases, draw test was positive in 7% and pivot-shift test was positive in 7%. Lysholm outcomes scores were improved to 89 points. Conclusions: Bone patellar tendon bone graft was a useful and safety technique for anterior cruciate ligament reconstruction.

scholarly journals Revision anterior cruciate ligament reconstruction due to knee instability

2007 ◽  
Vol 60 (11-12) ◽  
pp. 587-592 ◽  
Author(s):  
Miroslav Milankov ◽  
Aleksandar Milicic ◽  
Dragan Savic ◽  
Milan Stankovic ◽  
Srdjan Ninkovic ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Pivot Shift ◽  
Cruciate Ligament ◽  
Pivot Shift Test ◽  
Cruciate Ligament Reconstruction ◽  
The Mean ◽  
Anterior Cruciate ◽  
Sports Activities

Introduction. The primary goal of anterior cruciate ligament reconstruction is to provide stability to the knee and regain full range of motion. Although great improvement has been achieved in surgical techniques and rehabilitation, some patients are not completely satisfied with the results of surgery and a revision anterior cruciate ligament reconstruction is necessary. Material and Methods. Revision arthroscopic anterior cruciate ligament reconstruction was carried out in eleven patients with bone-tendon-bone autografts. The surgery was performed in a standard manner and the graft was taken from the opposite knee. Eight men and three women were evaluated. The mean age of patients was 26 (17-34) years. Repeated instability of the knee was caused by injury in five patients, while six patients were unsatisfied with the position of the graft. Results. The follow up was 4,2 years (2-8) respectively. The mean Lysholm and Gillquist score after operation was 88 (65-90). Preoperative and postoperative tibial shift was 9mm (6-15) and 2mm (0-4), respectively. The preoperative pivot shift test was grade 2 and 3 in all patients. Postoperative pivot shift test was negative in seven patients, in three it was grade 1 and grade 2 in one patient. According to the IKDC scale, preoperative results were abnormal in three patients and in eight they were severely abnormal. Postoperative IKDC score was normal in five patients, in four nearly normal, and in one patient the score was still abnormal. Five patients continued to be active in sports activities, four patients decreased the level of sports activity and two stopped all sports activities. Conclusion. Success of revision anterior cruciate ligament reconstruction requires detailed preoperative evaluation of the repeated instability of the knee. The treatment plan is then decided upon. The patients must be preoperatively informed about the real possibilities of revision surgery. Only a mutual collaboration between the patient, physiatrist and a surgeon is a key for successful treatment and return to previous level of sports activities.

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