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Knee laxity modifications after ACL rupture and surgical intra- and extra-articular reconstructions: intra-operative measures in reconstructed and healthy knees
- Source :
- Knee Surgery, Sports Traumatology, Arthroscopy
- Publication Year :
- 2015
- Publisher :
- Springer Berlin Heidelberg, 2015.
-
Abstract
- Purpose Quantifying the effects of anterior cruciate ligament (ACL) deficiency on knee joint laxity is fundamental for understanding the outcomes of its reconstruction techniques. The general aim of this study was to determine intra-operatively the main modifications in knee laxity before and after standard isolated intra-articular and additional extra-articular anterolateral reinforcement. Our main hypothesis was that laxity abnormalities, particularly axial rotation, can still result from these ACL reconstruction techniques. Methods Thirty-two patients with primary ACL deficiency were analysed by a navigation system immediately before and after each of the two reconstructions. Laxity measurements in terms of knee translations and rotations were taken during the anteroposterior drawer test, with internal–external rotation at 20° and 90° of flexion, and varus–valgus and pivot-shift tests. All these laxity measures were also taken originally from the contralateral healthy knee. Results With respect to the contralateral healthy knee, in the ACL-deficient knee significantly increased laxity (expressed in %) was found in the medial compared with that of the lateral compartment, respectively, 115 and 68 % in the drawer test at 20° flexion, and 55 and 46 % at 90° flexion. In the medial compartment, a significant 35 % increment was also observed for the coupled tibial anteroposterior translation during axial knee rotation at 20° of flexion. After isolated intra-articular reconstruction, normal values of anteroposterior laxity were found restored in the pivot-shift and drawer tests in the lateral compartment, but not fully in the medial compartment. After the reinforcement, laxity in the medial compartment was also found restored in the axial rotation test at 20° flexion. Conclusion In ACL reconstruction, with respect to the contralateral knee, intra-articular plus additional anterolateral reinforcement procedures do not restore normal joint laxity. This combined procedure over-constrained the lateral compartment, while excessive laxity still persists at the medial one. Level of evidence III.
- Subjects :
- Anterolateral ligament
musculoskeletal diseases
Joint Instability
medicine.medical_specialty
Anterior cruciate ligament reconstruction
Rotation
medicine.medical_treatment
Anterior cruciate ligament
Knee kinematics
Knee compartments
Drawer test
Joint laxity
03 medical and health sciences
Intraoperative Period
0302 clinical medicine
medicine
Humans
Extra-Articular
Orthopedics and Sports Medicine
Knee
Range of Motion, Articular
Orthodontics
Anterolateral reinforcement
030222 orthopedics
Anterior Cruciate Ligament Reconstruction
business.industry
Compartment (ship)
Anterior Cruciate Ligament Injuries
030229 sport sciences
Contralateral healthy knee
musculoskeletal system
Biomechanical Phenomena
ACL reconstruction
medicine.anatomical_structure
Treatment Outcome
Case-Control Studies
Orthopedic surgery
Surgery
Laxity measurements
business
Extra-articular procedure
human activities
Subjects
Details
- Language :
- English
- ISSN :
- 14337347 and 09422056
- Volume :
- 25
- Issue :
- 9
- Database :
- OpenAIRE
- Journal :
- Knee Surgery, Sports Traumatology, Arthroscopy
- Accession number :
- edsair.doi.dedup.....3f644c474d24444aa3365ae9a4db07d2