Anteroposterior glide versus rotating platform low contact stress (LCS) knee arthroplasty: a randomised controlled trial

Walley, Gayle; Datir, Sandeep; Sayana, Murali Krishna; Rahmatalla, Aziz; Remedios, Ian Dos; Wynn-Jones, C.; Bridgman, Stephen; Maffulli, Nicola

doi:10.1186/1471-2474-8-87

Cited by 1 publication

(1 citation statement)

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“…Data is gathered from the tracking sensors through space, relative to the source transmitter. This can be represented as a real-time graph or numerically, as a range of movement [19] . Data is then analysed digitally using the MotionMonitor™ system.…”

Section: Methodsmentioning

confidence: 99%

Does additional reconstruction of the anterolateral ligament during a primary anterior cruciate ligament reconstruction affect tibial rotational laxity - A case series

Shah

Singh

Dugdale

et al. 2017

Annals of Medicine &Amp; Surgery

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BackgroundThe current evidence suggests that rotational stability in not restored in patients with anterior cruciate ligament (ACL) ruptures, despite reconstructive surgery. The graded pivot-shift is a useful clinical test to delineate extent of ligamentous laxity within the knee. Given its lateralised position, we hypothesized that reconstruction of the anterolateral ligament (ALL) would provide restraint to excessive internal rotation, restoring rotational stability.Methods10 patients with MRI confirmed diagnosis of an isolated ACL rupture were included. Patients assigned a grade-3 pivot-shift underwent dual-ligament reconstruction for the ACL and ALL (Group 2), whilst patients with an absent pivot-shift, grade-1 or grade-2 underwent single ligament reconstruction for just the ACL (Group 1). Total range of rotation (TRR) was measured using a 3D-kinematic system at 30°,60°and 90° of knee flexion. Data was collected on the pathology-free contralateral normal knee (CNK), ACL-deficient knee (ADK) and the ACL-reconstructed knee (ARK).ResultsA statistically significant pre-operative difference in TRR between the CNK and ADK was noted between Group 1 and 2 (4.04° vs. 1.53°; p < 0.05). Postoperatively, both groups achieved a TRR that was either equivalent, or surpassed values that were observed on the CNKs. The absolute and percentage reduction in TRR at 30° of knee flexion was significantly higher in Group-2 compared to Group-1 (−8.15° vs. −2.96°; p < 0.001) and (28.04% vs. 13.31%; p < 0.001) respectively.ConclusionOur findings are based primarily in anaesthetized patients, with kinematic values at time-zero postoperatively. Patients presenting with significant rotational instability following a primary ACL injury and assessed to have a grade-3 pivot-shift may benefit from dual-ligament reconstruction. Further research is required to assess long-term patient-centered clinical outcomes.

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Section: Methodsmentioning

confidence: 99%