Do pre‐operative knee laxity values influence post‐operative ones after anterior cruciate ligament reconstruction?

Abstract

The objective of this study was to verify whether pre-reconstruction laxity condition effects post-reconstruction outcome. A total of 100 patients who underwent navigated Anterior Cruciate Ligament (ACL) reconstruction were included in the study and knee laxity analysed retrospectively. The knee was assessed in six different laxity tests before and after ACL reconstruction, namely antero-posterior (AP) and internal-external (IE) at 30° and 90°, and varus-valgus (VV) rotations at 0° and 30° of flexion. For each test, the least square (LS) fitting line based on pre-operative-to-post-operative laxity value was calculated. To what degree the post-operative laxity value is explainable by the corresponding pre-operative condition was evaluated by the LS line slope. Post-operatively, for each single patient, the grade of laxity decreased at any evaluated test. The strongest influence of pre-operative-to-post-operative laxity values was found during IE30 and IE90 tests. While AP30 and VV0 tests seem to be those in which the post-reconstruction laxity was barely affected by the pre-surgery condition. The analysis of the global laxity reduction confirms the previous results. Following this hypothesis, our study remarks on the importance of combined lesions to secondary restraints and the importance of fully understanding the residual laxity to optimize the surgical technique.

Factors Associated With High-Grade Lachman, Pivot Shift, and Anterior Drawer at the Time of Anterior Cruciate Ligament Reconstruction

“…There has been very little prior work evaluating the impact of patient demographic factors on pre-reconstruction knee laxity. Pre167 operative rotational knee laxity has been shown to strongly correlate with post168 operative rotational laxity,(21) and increased post-reconstruction laxity has been demonstrated to correlate with lower patient satisfaction(22) and Lysholm scores. (23) It is therefore important to understand factors associated with high171 grade laxity that may allow identification of populations at higher risk for poorer outcomes.…”

Return to sport after ACL reconstruction: how, when and why? A narrative review of current evidence

“…A similar concept, with regard to the need to take into account individual characteristics and lesion patterns, that of "pre-operative laxity". It has in fact been demonstrated in vivo that ACL reconstruction is able to reduce AP laxity regardless of the pre-operative laxity value, while rotational laxity shows higher postoperative values in patients with higher pre-operative laxity (14). Finally, concomitant lesions such as cartilage injuries, are a fundamental variable in the final return to sport decision, as even isolated cartilage procedures like ACI or microfractures usually need a longer recovery time compared with ACL reconstruction, i.e.…”

Revision anterior cruciate ligament reconstruction: clinical outcome and evidence for return to sport

“…The anterior cruciate ligament (ACL) plays a key role in knee stability by limiting anterior tibial translation on the femur and restraining rotation, as well as by resisting varus and valgus joint forces [77]. ACL tears are common and affect mostly young active patients, i.e.…”