Anterior cruciate ligament repair versus reconstruction: A kinematic analysis

Chahla, Jorge; Nelson, Trevor; Dallo, Ignacio; Yalamanchili, Dheeraj; Eberlein, Sam A.; Limpisvasti, Orr; Mandelbaum, Bert R.; Metzger, Melodie F.

doi:10.1016/j.knee.2019.10.020

Cited by 16 publications

(21 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, two difficulties in our patient cohort were also noticed: (1) residual laxity, especially regarding the ACL and collateral ligaments; and (2) postoperative stiffness due to arthrofibrosis requiring arthroscopic arthrolysis during the follow-up period. In that regard, whether ligament reconstruction or repair provides greater stability, reduces arthrofibrosis and consequently improves the outcomes remains a matter of debate [ 7 , 14 , 32 , 48 ]. Regarding the residual laxity of the ACL, Heitmann et al mentioned a hybrid technique involving ACL reconstruction and bracing of the other ruptured ligaments as a promising option [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Anatomical repair and ligament bracing of Schenck III and IV knee joint dislocations leads to acceptable subjective and kinematic outcomes

Rosteius

Jettkant

Rausch

et al. 2021

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

Purpose The aim of this study was to analyze the outcomes of anatomical repair and ligament bracing for Schenck III and IV knee dislocation (KD). Methods The results of 27 patients (15 and 12 cases of Schenck III and IV KD, respectively) after a mean follow-up of 18.1 ± 12.1 months (range 6–45 months) were retrospectively reviewed. Twenty-two patients suffered high-kinetic-energy accidents, whereas five patients suffered ultralow-velocity (ULV) trauma due to obesity. The outcome measures were the Lysholm score, Hospital for Special Surgery (HSS) knee score, Knee Society Score (KSS), Knee Injury and Osteoarthritis Outcome Score (KOOS) and Short Form 36 (SF-36) score. A kinematic 3D gait analysis with five walking trials was performed to compare the patients and healthy controls. Results The mean KSS, HSS score, Lysholm score, and KOOS were 77.4 ± 14.4, 84.6 ± 11.2, 81.5 ± 10.4, and 67.3 ± 16.8, respectively. No intra- or postoperative complications occurred. The mean range of motion deficiency compared to the healthy side was 24.4 ± 18.5°. Ten patients had first-degree residual laxity of the anterior cruciate ligament; 12 and 2 patients had first- and second-degree residual laxity of the collateral ligament, respectively. Five patients underwent additional arthroscopic arthrolysis due to arthrofibrosis at an average of 6.2 ± 1.9 months (range 4–9 months) after the initial surgery. The 3D gait analysis showed no major differences in joint stability or movement between the patients and healthy controls. Only the ULV trauma patients had significantly lower outcome scores and showed larger kinematic deviations in joint movement during the gait analysis. Conclusion Anatomical repair with ligament bracing is a suitable surgical procedure in the treatment of KD and provides evidence in clinical practice with the benefit of early, definitive repair and preservation of the native ligaments. Patients reach acceptable subjective and objective functional outcomes, including mainly normalized gait patterns during short-term follow-up, with only minor changes in kinematics and spatial–temporal characteristics. Obese patients who suffered ULV trauma showed significantly inferior outcomes with larger deviations in joint kinematics. Level of evidence Level III.

show abstract

Section: Discussionmentioning

confidence: 99%

Anatomical repair and ligament bracing of Schenck III and IV knee joint dislocations leads to acceptable subjective and kinematic outcomes

Rosteius

Jettkant

Rausch

et al. 2021

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

show abstract

“…Specimens were loaded onto a custom apparatus with the femur rigidly clamped and the potted tibia secured to a hinged testing frame that accommodates knee flexion from 0 to 90 , as previously described. [17][18][19][20][21] Positional data of the tibia relative to the femur were obtained using a 3-dimensional motion tracking system (Optotrak Certus, Northern Digital Inc., Ontario, Canada) with infrared diodes attached to the femur and tibia (Fig 2).…”

Section: Biomechanical Testingmentioning

confidence: 99%

Posterior Lateral Meniscal Root Tears Increase Strain on the Reconstructed Anterior Cruciate Ligament: A Cadaveric Study

Uffmann

ElAttrache

Nelson

et al. 2021

Arthroscopy, Sports Medicine, and Rehabilitation

Self Cite

View full text Add to dashboard Cite

“…[ 29 ] used a bridge-enhanced ACL repair (BEAR) technique [ 72 , 73 ]. Biomechanically, ACL repair achieved similar anterior tibial translation to noninjured knees at 30° and 90° compared with ACL-reconstructed knees [ 74 ]. However, this difference was less than a millimeter, which may be considered as not clinically relevant [ 74 ].…”

Section: Discussionmentioning

confidence: 99%

“…Biomechanically, ACL repair achieved similar anterior tibial translation to noninjured knees at 30° and 90° compared with ACL-reconstructed knees [ 74 ]. However, this difference was less than a millimeter, which may be considered as not clinically relevant [ 74 ]. In knees with insufficient or ruptured ACL, the amount of tibial anterior translation over the femur is fourfold greater than in a healthy joint [ 75 ].…”

Section: Discussionmentioning

confidence: 99%

Reduced knee laxity and failure rate following anterior cruciate ligament reconstruction compared with repair for acute tears: a meta-analysis

et al. 2023

View full text Add to dashboard Cite

Background Following anterior cruciate ligament (ACL) tears, both repair and reconstruction may be performed to restore joint biomechanics and proprioception. The present study compared joint laxity, patient-reported outcome measures (PROMs), and rate of failure following primary repair versus reconstruction for ACL ruptures. Methods This meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Pubmed, Google scholar, Embase, and Web of Science were accessed in September 2022. All the clinical investigations comparing repair versus reconstruction for primary ACL tears were accessed. Studies reporting data on multiple ligament injuries settings were not eligible. Results Data from eight articles (708 procedures) were collected. The mean length of the follow-up was 67.3 ± 119.4 months. The mean age of the patients was 27.1 ± 5.7 years. Thirty-six percent (255 of 708 patients) were women. The mean body mass index (BMI) was 24.3 ± 1.1 kg/m2. The mean time span from injury to surgery was 36.2 ± 32.3 months. There was comparability at baseline with regards to instrumental laxity, Lachman test, International Knee Document Committee (IKDC), and Tegner Scale (P > 0.1). Similarity between ACL reconstruction and repair was found in IKDC (P = 0.2) and visual analog scale (VAS) satisfaction (P = 0.7). The repair group demonstrated greater mean laxity (P = 0.0005) and greater rate of failure (P = 0.004). Conclusion ACL reconstruction may yield greater joint stability and lower rate of failure compared with surgical repair. Similarity was found in PROMs. Level of evidence: III

show abstract

Anterior cruciate ligament repair versus reconstruction: A kinematic analysis

Cited by 16 publications

References 31 publications

Anatomical repair and ligament bracing of Schenck III and IV knee joint dislocations leads to acceptable subjective and kinematic outcomes

Anatomical repair and ligament bracing of Schenck III and IV knee joint dislocations leads to acceptable subjective and kinematic outcomes

Posterior Lateral Meniscal Root Tears Increase Strain on the Reconstructed Anterior Cruciate Ligament: A Cadaveric Study

Reduced knee laxity and failure rate following anterior cruciate ligament reconstruction compared with repair for acute tears: a meta-analysis

Contact Info

Product

Resources

About