Comparison of double-bundle anterior cruciate ligament (ACL) reconstruction and single-bundle reconstruction with remnant pull-out suture

Section: Resultsmentioning

confidence: 99%

A systematic review of single- versus double-bundle ACL reconstruction using the anatomic anterior cruciate ligament reconstruction scoring checklist

Desai

Alentorn-Geli

Eck

et al. 2014

“…1a–c). The partial ACL rupture was defined when the continuity of fiber with tension in injured ACL was found from the tibia to femur [32, 37, 59]. The examination of tension was performed using probe and recorded by the senior author.…”

Section: Methodsmentioning

confidence: 99%

“…Anterior cruciate ligament (ACL) reconstruction is the most frequently performed ligament surgery in the knee and has a high surgical success rate in restoring knee joint stability, avoiding long‐term degenerative changes, and improving function [4, 17, 32]. However, surgical reconstruction procedures, such as single bundle, anatomic, or double bundle reconstruction, failed to reproduce native dynamic knee function, resulting in poor long‐term outcomes in 10–20% of patients [3, 17, 22, 55].…”

Section: Introductionmentioning

confidence: 99%

Anterolateral ligament injury has a synergic impact on the anterolateral rotatory laxity in acute anterior cruciate ligament-injured knees

Park

Lee

et al. 2019

Self Cite

Purpose To investigate the prevalence of the anterolateral ligament (ALL) injuries and its role in rotatory laxity in acute anterior cruciate ligament (ACL)-injured knees. Methods Two-hundred and ninety-six consecutive patients with acute ACL injuries were evaluated retrospectively, excluding those with other ligament injury and undetectable path of ALL in MRI. Patients were divided into two groups based on the degree of ACL injury in arthroscopy (complete versus partial group). Logistic regression and discriminant analysis were performed to assess the risk of pivot shift test. Results A total of 169 patients were included (128 with complete and 41 with partial ACL rupture). Overall, 106/169 (62.7%) of ALL injuries were characterized, 87/128 (67.9%) in complete group, and 19/41 (46.3%) in partial group. The incidence of pivot shift was 120/128 (93.8%) and 14/41 (34.1%) in the complete and partial groups, respectively. The odds ratio in the pivot shift of combined ALL injury was found as 3.8 (95% CI 1.8-8.4) with the overall ACL injury, but higher as 17.1 (95% CI 3.1-96.4) with partial group. Higher grade of pivot shift showed a greater incidence of injury of ALL. Degree of ACL injury and ALL injury allowed 87.0% of correct classiication of subsequent anterolateral rotatory laxity. Conclusion Injury to the ALL could have a synergetic efect on anterolateral rotatory laxity in acute ACL-injured knee, however, its efect might be minor in case of complete tear. Careful assessment about combined ALL injury should be considered, especially in knees with high-grade pivot shift in acute ACL-injured knees. Level of evidenceRetrospective prognostic study, Level IV. Keywords Knee • Anterior cruciate ligament • Anterolateral ligament • Pivot shift • Acute anterior cruciate ligament injury Yong-Beom Park and Han-Jun Lee contributed to this article equally.

“…Anterolateral rotatory instability is a risk factor for knee osteoarthritis, failure to return to the previous level of activity, and poor subjective and objective outcome scores after ACL reconstruction [26,50]. However, quantitative analysis of the pivot shift examination is not yet possible owing to the complexity of knee kinematics and the difficulty in creating objective measurement instruments; however despite these limitations, many studies have still been performed [14,23,25,29,37]. Various metrics and devices to describe pivot shift have been reported, including anteroposterior translations [5,17,27,38], medial-lateral translations [27], reduction velocities [17,27], axial rotations [7,34], navigation systems [1,6,9,10,18], electromagnetic systems [7,19,32,58], acceleration devices [38,42], smart phones [24], and image systems [18,39,46].…”

Section: Introductionmentioning

confidence: 99%

Stress radiography at 30° of knee flexion is a reliable evaluation tool for high-grade rotatory laxity in complete ACL-injured knees

Kim

Park

Ham

et al. 2019

Self Cite

Purpose To evaluate the diagnostic value of stress radiography and determine the cutoff values for high‐grade anterolateral rotatory laxity in complete anterior cruciate ligament (ACL)‐deficient knees at different positions. Methods Forty‐two patients with complete ACL rupture (group 1) and 37 normal subjects (group 2) were prospectively enrolled. The amount of anterior translation in the medial (MM) and lateral (LL) distance compartments and the difference between them (LL‐MM distance) were measured using stress radiography at 30°, 45°, 60°, and 90° positions. The area under the receiver operating characteristic curve (AUC) was assessed for the presence of a high‐grade (grade > 2) pivot shift. Results The MM and LL distances in group 1 were significantly different at 30° and 45° positions (P < 0.05). The AUC of the MM (AUC, 0.903) and LL (AUC, 0.901) distances at the 30° position was significantly higher than that of the other positions (P = 0.000); however, the cutoff values were different to diagnose ACL injury (MM vs. LL, 3.1 mm vs. 5.4 mm). A 2.1‐mm cutoff for the LL‐MM distance showed 78.4% sensitivity and 90.3% specificity for detecting the presence of a high‐grade pivot shift (AUC = 0.905, P = 0.000). Conclusion The cutoff values of stress radiography differed according to anatomical references and knee flexion positions. Stress radiography of a 2.1 mm difference in LL‐MM distance at 30° of knee flexion can be a reliable method for high‐grade rotatory laxity in complete ACL‐injured knees. Level of evidence Level 1, diagnostic study.