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Factors affecting the post-operative over-constraint after anatomic double-bundle anterior cruciate ligament reconstruction.

Factors affecting the post-operative over-constraint after anatomic double-bundle anterior cruciate ligament reconstruction.

Authors :
Kuroda M
Mae T
Otsubo H
Suzuki T
Okimura S
Matsumoto N
Source :
Asia-Pacific journal of sports medicine, arthroscopy, rehabilitation and technology [Asia Pac J Sports Med Arthrosc Rehabil Technol] 2024 Feb 06; Vol. 36, pp. 13-17. Date of Electronic Publication: 2024 Feb 06 (Print Publication: 2024).
Publication Year :
2024

Abstract

Objective: Initial tension at graft fixation is one of key factors for good outcomes in anterior cruciate ligament (ACL) reconstruction. Identifying the pre-operative factors that influence postoperative knee laxity under the anterior tibial load is useful in determining the initial tension at graft fixation. Thus, the purpose of this study was to clarify the pre-operative factors affecting the side-to-side difference in anterior laxity immediately after the anatomic double-bundle ACL reconstruction with a constant initial tension.<br />Methods: Fifty-five patients underwent the anatomic double-bundle ACL reconstruction with hamstring tendon grafts. Anterior tibial displacement (ATD) was measured on both knees using KT-2000 Knee Arthrometer under anterior drawer load of 67 N, 89 N, 134 N and manual maximum load at 30° of flexion before ACL reconstruction under anesthesia, and was also measured on the operated knees under 89 N immediately after ACL reconstruction under anesthesia. Then, side-to-side difference (SSD) before and immediately after ACL reconstruction was calculated. Correlative relation between the SSD immediately after ACL reconstruction and the ATD/the SSD in each condition was analyzed.<br />Results: The side-to-side difference of ATD immediately after surgery was -3.8 ± 1.7 mm (0 to -8mm) in response of 89 N of anterior load. There was correlation between the SSD immediately after ACL reconstruction and all ATD on both knees except for the ATD under manual maximum load on the injured knee, while little correlation between the SSD immediately after ACL reconstruction and that before ACL reconstruction was found. Especially, ATD under 89 N on the opposite knees and ATD under 134 N on the injured knees showed selective correlation with the SSD immediately after surgery in the step-wise multiple regression analysis.<br />Conclusion: As the anterior tibial displacements under 89 N on the contra-lateral knee and under 134 N on the injured knee had a significant correlation with the SSD immediately after ACL reconstruction, those values may be helpful in determining the increase or decrease in initial tension at graft fixation.<br />Competing Interests: All authors have no conflicts of interest.<br /> (© 2024 Asia Pacific Knee, Arthroscopy and Sports Medicine Society. Published by Elsevier (Singapore) Pte Ltd.)

Details

Language :
English
ISSN :
2214-6873
Volume :
36
Database :
MEDLINE
Journal :
Asia-Pacific journal of sports medicine, arthroscopy, rehabilitation and technology
Publication Type :
Academic Journal
Accession number :
38352021
Full Text :
https://doi.org/10.1016/j.asmart.2024.01.002