Incidence and risk factors of joint stiffness after Anterior Cruciate Ligament reconstruction

Wang, Bin; Zhong, Jianqiao; Xu, Xiaolong; Shang, Jie; Lin, Nan; Lu, Huading

doi:10.1186/s13018-020-01694-7

Cited by 20 publications

(20 citation statements)

References 63 publications

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“… 20 , 23 Before this, however, other etiologies of stiffness should be eliminated, especially infection and complex regional pain syndrome. 23 , 33 In our daily practice, it is proposed to offer patients anterior arthrolysis if there is a lack of extension at 6 months postsurgery, and this was the protocol used this study.…”

Section: Discussionmentioning

confidence: 99%

Association of COVID-19 Lockdown With Increased Rate of Cyclops Syndrome in Patients With Unexpected Home-Based Self-Guided Rehabilitation After ACL Reconstruction

Bouguennec

Orce

Laboudie

et al. 2023

Orthopaedic Journal of Sports Medicine

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Background: The risk of cyclops syndrome increases significantly after anterior cruciate ligament (ACL) reconstruction (ACLR) if complete extension is not recovered before the sixth postoperative week. The lockdown in France due to the COVID-19 pandemic led to an absence of supervised rehabilitation, requiring unexpected self-rehabilitation in patients who underwent ACLR just before lockdown. Purpose: To determine the rate of cyclops syndrome after ACLR in patients who underwent self-rehabilitation during lockdown. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 75 patients receiving a hamstring graft for ACLR during the COVID-19 pandemic between February 10, 2022, and March 16, 2020, carried out self-rehabilitation during part of their first 6 postoperative weeks using exercise videos on a dedicated website. Clinical examination was performed at a minimum 1-year follow-up with International Knee Documentation Committee (IKDC), Lysholm, Tegner, and ACL–Return to Sport after Injury (ACL-RSI) scores. This group was compared with a matched-pair control group of 72 patients who underwent surgery in 2019 and completed postoperative supervised rehabilitation with a physical therapist. Rates and reasons for second surgery (arthrolysis, meniscal procedure) were also recorded. Results: In the COVID group (n = 72; 3 patients were lost to follow-up), the mean follow-up was 14.5 ± 2.1 months (range, 13-21) and rate of reoperation for clinical cyclops syndrome was 11.1% (n = 8). The rate of cyclops syndrome was significantly lower (1.4%) in the control group ( P = .01). In the COVID group, 8 patients underwent anterior arthrolysis at a mean of 8.6 months after the primary surgery, and 4 patients underwent another surgical intervention (meniscal procedure [n = 3], device removal [n = 1]). In the COVID group, mean Lysholm was 86.6 ± 14.1 (range, 38-100), Tegner was 5.6 ± 2.3 (range, 1-10), subjective IKDC was 80.3 ± 14.7 (range, 32-100) and ACL-RSI score was 77.3 ± 19.7 (range, 33-100). Conclusion: The rate of cyclops syndrome after ACLR was significantly greater in the COVID group versus the matched controls. The dedicated website was not effective at supporting self-guided rehabilitation and could benefit from interactive improvements so it is at least as effective as supervised rehabilitation.

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Section: Discussionmentioning

confidence: 99%

Association of COVID-19 Lockdown With Increased Rate of Cyclops Syndrome in Patients With Unexpected Home-Based Self-Guided Rehabilitation After ACL Reconstruction

Bouguennec

Orce

Laboudie

et al. 2023

Orthopaedic Journal of Sports Medicine

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“…A recent meta-analysis has reported that female gender was the only risk factor for joint stiffness after ACLR (odds ratio [OR], 1.96; p < 0.00001). 9 A great number of factors, such as the interval from injury to surgery, patient demographic factors, anatomical factors of the knee, surgical…”

Section: Accepted Manuscriptmentioning

confidence: 99%

“…A recent systematic review reported that gender was the only identified risk factor for joint stiffness after ACLR, showing a lower incidence in men than in women (OR: 0.51, p < 0.00001). 9 However, the authors finally assessed only four risk factors: gender, time interval from injury to surgery, graft type, and concomitant surgery with meniscal tear; they did not evaluate other potential risk factors, such as the age, BMI, and postoperative rehabilitation programs due to insufficient data from the included studies. This may suggest a lack of evidence with respect to the association between the age and incidence of loss of knee ROM after ACLR.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Risk Factors of Loss of Knee Range of Motion after Primary Anterior Cruciate Ligament Reconstruction following Preoperative Recovery of Knee Range of Motion

et al. 2022

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The loss of knee range of motion (ROM) is not an uncommon complication after anterior cruciate ligament reconstruction (ACLR). However, the risk factors of loss of knee ROM remain debatable. The purpose of this study was to evaluate the incidence and risk factors of loss of knee ROM at 12 months after primary ACLR performed after regaining full knee ROM preoperatively. Consecutive patients who underwent primary ACLR after regaining full ROM between January 2014 and January 2020 were retrospectively reviewed. Patients who received a surgical arthrolysis within 12 months after ACLR or those who had a loss of knee ROM at 12 months postoperatively were defined as the loss of ROM group. Possible risk factors of loss of knee ROM, including patient demographic, preoperative, surgical, and postoperative factors, were assessed. The notch wide index and radiographic parameters of the tibial spines; medial tibial spine height (MTSH)/tibial length (TL), lateral tibial spine height (LTSH)/TL, and tibial spine width (TSW)/TL, were also assessed. A total of 141 patients (141 knees) were included (mean age, 25.8 ± 11.4 years; male/female, 56/85). Of the 141 patients, 3 received surgical arthrolysis within 12 months, and 23 had a loss of knee ROM at 12 months after ACLR. Compared patients with and without loss of knee ROM, significant differences were found in the age (p = 0.04), LTSH/TL (p = 0.02), and TSW/TL (p = 0.02). A multivariate regression analysis showed that the age (odds ratio [OR]; 1.05, 95% confidence interval [CI]: 1.01-1.09, p = 0.02), LTSH/TL (OR: 1.44, 95% CI: 1.01-2.1, p = 0.04), and TSW/TL (OR: 0.79, 95% CI: 0.65-0.97, p = 0.02) were identified as significant independent risk predictors of loss of knee ROM. This study showed that the incidence of loss of knee ROM at 12 months after primary ACLR was 18.4% (26/141). An older age, a higher LTSH/TL and a smaller TSW/TL may be associated with loss of knee ROM at 12 months after ACLR.

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“…Injuries to the anterior cruciate ligament (ACL) are debilitating [ 1 , 2 ] and are becoming increasingly common among active individuals [ 3 – 5 ]. Although the mechanism leading to ACL injury has not been established, identifying risk factors help prevent noncontact ACL injury and achieve optimal outcomes in ACL reconstruction.…”

Section: Introductionmentioning

confidence: 99%

Increased lateral and medial femoral posterior radius ratios are risk factors for anterior cruciate ligament injury

Fan

Jiang

et al. 2022

BMC Musculoskelet Disord

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Background Many studies have shown that distal femoral sagittal morphological characteristics have a clear relationship with knee joint kinematics. The aim of this study was to determine the relationship between distal femoral sagittal morphological characteristics and noncontact anterior cruciate ligament (ACL) injury. Methods A retrospective case-control study of 148 patients was conducted. Two age- and sex-matched cohorts (each n = 74) were analysed: a noncontact ACL injury group and a control group. Several characteristics were compared between the two groups, including the lateral femoral posterior radius (LFPR), medial femoral posterior radius (MFPR), lateral height of the distal femur (LH), medial height of the distal femur (MH), lateral femoral anteroposterior diameter (LFAP), medial femoral anteroposterior diameter (MFAP), lateral femoral posterior radius ratio (LFPRR), and medial femoral posterior radius ratio (MFPRR). Receiver operating characteristic (ROC) analysis was used to evaluate the significance of the LFPRR and MFPRR in predicting ACL injury. Results Compared with patients in the control group, patients in the ACL injury group had an increased LFPR, MFPR, MFAP, LFPRR, and MFPRR. ROC analysis revealed that an increased LFPRR above 31.7% was associated with noncontact ACL injury, with a sensitivity of 78.4% and a specificity of 58.1%; additionally. an increased MFPRR above 33.4% was associated with noncontact ACL injury, with a sensitivity of 58.1% and a specificity of 70.3%. Conclusion This study showed that increased LFPRR and increased MFPRR are risk factors for developing noncontact ACL injury. These data could thus help identify individuals susceptible to ACL injuries.

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Incidence and risk factors of joint stiffness after Anterior Cruciate Ligament reconstruction

Cited by 20 publications

References 63 publications

Association of COVID-19 Lockdown With Increased Rate of Cyclops Syndrome in Patients With Unexpected Home-Based Self-Guided Rehabilitation After ACL Reconstruction

Association of COVID-19 Lockdown With Increased Rate of Cyclops Syndrome in Patients With Unexpected Home-Based Self-Guided Rehabilitation After ACL Reconstruction

Risk Factors of Loss of Knee Range of Motion after Primary Anterior Cruciate Ligament Reconstruction following Preoperative Recovery of Knee Range of Motion

Increased lateral and medial femoral posterior radius ratios are risk factors for anterior cruciate ligament injury

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