scholarly journals Effect of anterior cruciate ligament reconstruction with hamstring tendons on Insall-Salvati index and anterior knee pain

2018 ◽  
Vol 146 (3-4) ◽  
pp. 174-178
Author(s):  
Ozgur Korkmaz ◽  
Melih Malkoc
Keyword(s):  
Acl Reconstruction ◽  
Knee Pain ◽  
Anterior Knee Pain ◽  
Cruciate Ligament ◽  
Hamstring Tendon ◽  
Lysholm Score ◽  
Activity Score ◽  
First Year ◽  
Anterior Cruciate ◽  
Anterior Knee

Introduction/Objective. The aim of this study was to evaluate the relationship between anterior knee pain and Insall-Salvati ratio after anterior cruciate ligament (ACL) reconstruction with hamstring tendon. Methods. We have evaluate 39 patient that had an ACL reconstruction surgery with hamstring tendon retrospectively. 14 patient had anterior knee pain at the and of the first year of the surgery. All the patient were evaluated for Insall-Salvati ratio preoperatively and postoperatively. Patients were evaluated at the end of the first year after the surgery with Lysholm score and Tegner activity scale. Patients preoperative and postoperative measurements were analyzed by using the Wilcoxon test and differences between patients with anterior knee pain and without pain was analyzed by the Mann-Whitney U test. Results. Mean Insall-Salvati ratio was found preoperatively 0,91?0,1 and postoperatively 0,85?0,09 (p?0,05). Mean Tegner activity score was 8,56?1,04 and mean Lysholm score was 87,36?9,42 in the group without anterior knee pain. Mean Tegner activity score was 7,21?0,97 and mean Lysholm score was 74,43?9,94 in the group with anterior pain. There is an decrease in ?nsall-Salvati ratio as a result of the surgery. But patients with anterior knee pain had lower values of ?nsall-Salvati ratio preoperatively. Conclusion. Preoperatively low ?nsall-Salvati ratio can be premised indicator of anterior knee pain in the early period after ACL reconstruction with hamstring tendons. Mean Tegner activity score and mean Lysholm score have higher values in the group without anterior pain post operatively.

scholarly journals Anterior Knee Pain After Anterior Cruciate Ligament Reconstruction

2020 ◽  
Vol 8 (10) ◽  
pp. 232596712096108
Author(s):  
Fabiano da Silva Marques ◽  
Pedro Henrique Borges Barbosa ◽  
Pedro Rodrigues Alves ◽  
Sandro Zelada ◽  
Rodrigo Pereira da Silva Nunes ◽  
...  
Keyword(s):  
Patellar Tendon ◽  
Knee Pain ◽  
Anterior Knee Pain ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Hamstring Tendon ◽  
Tendon Graft ◽  
Extension Deficit ◽  
Anterior Cruciate ◽  
Anterior Knee

Background: Anterior knee pain is a frequent condition after anterior cruciate ligament reconstruction (ACLR), but its origin remains uncertain. Studies have suggested that donor site morbidity in autologous bone–patellar tendon–bone reconstructions may contribute to patellofemoral pain, but this does not explain why hamstring tendon reconstructions may also present with anterior pain. Purpose: To evaluate the prevalence of anterior knee pain after ACLR and its predisposing factors. Study Design: Case-control study; Level of evidence, 3. Methods: We evaluated the records of all patients who underwent ACLR between 2000 and 2016 at a private facility. The prevalence of anterior knee pain after surgery was assessed, and possible risk factors (graft type, patient sex, surgical technique, range of motion) were evaluated. Results: The records of 438 patients (mean age, 30 years) who underwent ACLR were analyzed. Anterior knee pain was found in 6.2% of the patients. We found an increased prevalence of anterior knee pain with patellar tendon graft, with an odds ratio of 3.4 ( P = .011). Patients who experienced extension deficit in the postoperative period had an odds ratio of 5.3 of having anterior pain ( P < .001). Anterior knee pain was not correlated with patient sex or surgical technique. Conclusion: The chance of having anterior knee pain after ACLR was higher when patellar tendon autograft was used compared with hamstring tendon graft, as well as in patients who experienced extension deficit in the postoperative period.

Complications After Anterior Cruciate Ligament Reconstruction and Their Relation to the Type of Graft: A Prospective Study of 958 Cases

2019 ◽  
Vol 47 (11) ◽  
pp. 2543-2549 ◽  
Author(s):  
Romain Rousseau ◽  
Charlotte Labruyere ◽  
Charles Kajetanek ◽  
Olivia Deschamps ◽  
Konstantinos G. Makridis ◽  
...  
Keyword(s):  
Acl Reconstruction ◽  
Patellar Tendon ◽  
Knee Pain ◽  
Anterior Knee Pain ◽  
Cruciate Ligament ◽  
Meniscal Lesions ◽  
Significant Difference ◽  
Anterior Cruciate ◽  
Anterior Knee

Background: Complications and adverse events after anterior cruciate ligament (ACL) reconstruction are well known, but they have been underestimated in previous studies. Purpose: To describe the complications and adverse events after ACL reconstruction within a 2-year follow-up and analyze them in relation to the type of graft. Study Design: Cohort study; Level of evidence, 3. Methods: From 2000 to 2012, 958 patients with an isolated ACL injury underwent surgery by a single knee surgeon. ACL reconstruction was performed with the medial portal technique for the femoral tunnel and the use of bone–patellar tendon–bone (BPTB) or hamstring tendon graft. Patients were reviewed at 6 weeks and 3, 6, 12, and 24 months after surgery with the International Knee Documentation Committee score, plain radiographs, and the KT-1000 arthrometer. Results: Of 958 patients enrolled, 147 (15%) were lost at last follow-up. The 2 groups (bone–patellar tendon–bone [n = 257] and hamstring [n = 554]) were similar regarding the mean age at the time of surgery and preoperative anterior laxity. The main complications were as follows: anterior knee pain (n = 130 of 811, 16%), stiffness (n = 72, 8.8%), secondary meniscal lesions (n = 59, 7.2%), pain attributed to fixation (n = 79, 9.7%), ACL rerupture (n = 47, 5.7%), contralateral ACL ruptures (n = 24, 3%), patellar fractures (n = 3, 0.3%), infections (n = 9, 1%), and thromboembolic complications (n = 5, 0.6%). There was no significant difference between the grafts with respect to the frequency of joint stiffness, secondary meniscal lesions, or anterior knee pain. During the first 2 postoperative years, the percentage of patients with anterior knee pain was higher in the patellar tendon group (23.3% vs 12.6%, P < .001); however, this difference was not significant after the 2-year interval (3.1% vs 2.5%, P = .63). The percentage of patients with a rerupture of the graft was significantly lower in the patellar tendon group than in the hamstring group (25 of 811 [3.1%] vs 57 of 811 [7%], P = .023). Similar results were recorded regarding the pain related to the hardware material (7 of 811 [0.8%] in the BPTB group vs 113 of 811 [13.9%] in the hamstring group, P = .001). The percentage of ACL ruptures contralateral to the repair was higher in the patellar tendon group (41 of 811 [5%] vs 17 of 811 [2%], P = .016). Conclusion: The total rate of complications after an ACL reconstruction was 39%, and the surgical revision rate for any reason was 28%. Problems with the hardware material were more frequent in the hamstring group, leading to an increased rate of surgical revision. Anterior knee pain was initially higher in the patellar tendon group, but there was no significant difference in a 2-year interval. The rerupture rate was statistically higher in the hamstring group.

scholarly journals Prospective and Randomized Clinical Evaluation of Hamstring Versus Patellar Tendon Autograft for Anterior Cruciate Ligament Reconstruction in Soccer Players

2021 ◽  
Vol 9 (9) ◽  
pp. 232596712110281
Author(s):  
Luiz Gabriel Betoni Guglielmetti ◽  
Victor Eduardo Roman Salas ◽  
Pedro Baches Jorge ◽  
Fabrício Roberto Severino ◽  
Aires Duarte ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Patellar Tendon ◽  
Knee Pain ◽  
Anterior Knee Pain ◽  
Cruciate Ligament ◽  
Soccer Players ◽  
Outcome Score ◽  
Anterior Cruciate ◽  
Anterior Knee

Background: Anterior cruciate ligament (ACL) reconstruction is usually performed with autologous bone–patellar tendon–bone (PT) or hamstring tendon (HT) graft. There has been only 1 randomized clinical trial examining ACL reconstruction with these grafts specifically in soccer players, and more studies comparing these graft types within a homogenous cohort such as soccer athletes may better highlight differences in outcomes. Purpose: To compare the results of ACL reconstruction with PT versus HT autograft in soccer players and to evaluate objective and subjective outcomes. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A total of 62 professional or semiprofessional soccer players (mean age, 25.1 years) with ACL injury were randomized to undergo reconstruction with PT or HT autograft by a single orthopaedic surgeon (n = 31 in each group). Outcome measures were recorded preoperatively and at 2 years postoperatively. The primary outcome was the modified Cincinnati Knee Rating System, and secondary outcomes were the objective and subjective International Knee Documentation Committee scores, Lachman test, pivot-shift test, anterior drawer test, and Lysholm score. The following variables were also evaluated postoperatively: return to soccer, level at return, graft rerupture, postoperative complications, anterior knee pain, patellar tendinitis, difficulty sprinting, and loss of kicking power. Results: The PT and HT groups were homogenous in terms of age, sex distribution, injured side, and time from injury to surgery, and there was no difference between them on any preoperative outcome score. At 2 years postoperatively, there were no differences between the groups on any outcome score; however, there were significantly fewer patients with anterior knee pain in the HT group compared with the PT group (7 [22.6%] vs 15 [48.4%], respectively; P = .03). Two patients from each group (2/31; 6.5%) sustained rerupture. Conclusion: There were no differences between soccer players who underwent different types of ACL reconstruction with the exception of anterior knee pain, which was more frequent in players who underwent reconstruction with PT graft. Registration: NCT02642692 ( ClinicalTrials.gov ).

scholarly journals Bilateral Symptomatic Mucoid Degeneration of the Anterior Cruciate Ligament with Anterior Knee Pain but No Limited Knee Flexion

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Koshiro Shimasaki ◽  
Tomokazu Yoshioka ◽  
Akihiro Kanamori ◽  
Masashi Yamazaki
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Pain ◽  
Anterior Knee Pain ◽  
Case Reports ◽  
Cruciate Ligament ◽  
Proton Density ◽  
Valgus Knee ◽  
Mucoid Degeneration ◽  
Anterior Cruciate ◽  
Anterior Knee

Mucoid degeneration of the anterior cruciate ligament (ACL) is a rare cause of anterior knee pain (AKP). Some case reports have been published; however, it is difficult to diagnose and is often underdiagnosed or misdiagnosed because of its pathophysiological ambiguity. We report a rare case of a patient diagnosed with bilateral mucoid degeneration of the ACL with AKP and no limited joint range of motion (ROM). A 59-year-old man with spontaneous right AKP was admitted to our hospital. He first underwent arthroscopic resection of the thickened medial plica protruding far into the medial patellofemoral joint (PFJ) but felt little effectiveness thereafter. He then had an arthroscopic release of the lateral patellar retinaculum because of valgus knee and patellar instability, which resulted in only temporary improvement. Then, the AKP relapsed, this time with limitations in the ROM. Magnetic resonance imaging (MRI0 showed a diffuse, thickened ACL with a high inhomogeneous intensity in the T2-weighted and proton density weighted images and which looked similar to a celery stalk. Based on the patient’s history and MRI findings, we suspected mucoid degeneration of the ACL and subsequently performed arthroscopic excision. At the same time, AKP appeared on the other side. Since the MRI demonstrated a similar celery stalk image as before, the same operation was performed on this side, as well. Finally, AKP and the limitation of the ROM were relieved approximately one month after surgery. Due to the patient only suffering from AKP with a preserved ROM, it took about 14 months to diagnose this disease. It should, therefore, always be considered in cases of AKP alone.

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