Does Severity or Specific Joint Laxity Influence Clinical Outcomes of Anterior Cruciate Ligament Reconstruction?

Kim, Sung-Jae; Moon, Hee Koo; Kim, Sul-Gee; Chun, Yong-Min; Oh, Kyung-Soo

doi:10.1007/s11999-009-0961-0

Cited by 59 publications

(50 citation statements)

References 22 publications

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“…Furthermore, it is well documented in the literature that in a ACL‐deficient knee the menisci play an important role as secondary restraints as well (Noyes et al., ; Johnson & Coen, ). Moreover, in chronic cases a progressive stretching of the secondary restraints, especially on the lateral capsular structures, often occurs (Kim et al., ).…”

Section: Discussionmentioning

confidence: 99%

“…For the previously mentioned reasons, the correct intraoperative evaluation of secondary restraints status remains an important issue. Controversy exists regarding the importance of pre‐reconstruction knee laxity as a potential risk factor for the ACL reconstruction outcome failure (Kim et al., ). Especially, there is a lack of studies focused on the analysis of knee laxity values before ACL reconstruction, and how the latter affect the post‐reconstruction outcome.…”

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confidence: 99%

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

Signorelli

Bonanzinga

Lopomo

et al. 2013

Scandinavian Med Sci Sports

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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.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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

Signorelli

Bonanzinga

Lopomo

et al. 2013

Scandinavian Med Sci Sports

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“…A recent study also reported inferior results after an ACL reconstruction in patients with excessive ligament laxity, but the results were not significant 6). Patients with excessive knee hyperextension showed inferior results after a reconstruction 65). Laxity of the secondary knee restraints and the increased graft impingement against the intercondylar roof might be the contributing factors for the negative effects of knee hyper extension on a reconstructed graft.…”

Section: Reconstruction Options and Graft Selectionmentioning

confidence: 97%

Anterior Cruciate Ligament Reconstruction in Patients with Generalized Joint Laxity

2010

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Generalized joint laxity is a genetically determined component of overall joint flexibility. The incidence of joint laxity in the overall population is approximately 5% to 20%, and its prevalence is higher in females. Recently it was noticed that individuals with generalized joint laxity are not only prone to anterior cruciate ligament injuries but also have inferior results after a reconstruction. Therefore, an anterior cruciate ligament reconstruction in patients with generalized laxity should be undertaken with caution due to the higher expected failure rate from the complexity of problems associated with this condition. It is also necessary to identify the risk factors for the injury as well as for the post operative outcome in this population. A criterion that includes all the associated components is necessary for the proper screening of individuals for generalized joint laxity. Graft selection for an anterior cruciate reconstruction in patients with ligament laxity is a challenge. According to the senior author, a hamstring autograft is an inferior choice and a double bundle reconstruction with a quadriceps tendon-bone autograft yields better results than a single bundle bone-patella tendon-bone autograft. Future studies comparing the different grafts available might be needed to determine the preferred graft for this subset of patients. Improved results after an anterior cruciate ligament reconstruction can be achieved by proper planning and careful attention to each step beginning from the clinical examination to the postoperative rehabilitation.

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“…There is still no consensus on whether knee hyperextension affects the outcomes following ACL-R. Two studies10 13 showed significant associations between knee hyperextension and inferior outcomes following ACL-R. Kim et al 10 investigated the effect of knee hyperextension on postoperative outcomes and found that knee hyperextension of more than 10° is correlated with greater postoperative anterior tibial translation measured by KT-2000 (ρ=0.461) and inferior Lysholm (ρ=−0.285) and IKDC scores (ρ=−0.285). Recently, Larson et al 13 have shown that heel height greater than 5 cm, as a measure of knee hyperextension, was an independent predictor of ACL failure.…”

Section: Discussionmentioning

confidence: 99%

Patient-reported outcome measures following anterior cruciate ligament reconstruction are not related to dynamic knee extension angle

et al. 2018

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Does Severity or Specific Joint Laxity Influence Clinical Outcomes of Anterior Cruciate Ligament Reconstruction?

Cited by 59 publications

References 22 publications

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

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

Anterior Cruciate Ligament Reconstruction in Patients with Generalized Joint Laxity

Patient-reported outcome measures following anterior cruciate ligament reconstruction are not related to dynamic knee extension angle

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