Risk factors for knee instability after anterior cruciate ligament reconstruction

Ahn, Ji Hyun; Lee, Sung Hyun

doi:10.1007/s00167-015-3568-x

Cited by 75 publications

(82 citation statements)

References 40 publications

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“…A similar rationale could be applied when dealing with combined laxities. In fact, even though residual valgus laxity after ACL reconstruction with concomitant conservatively treated grade II medial collateral ligament (MCL) lesions has been shown not to affect AP stability (9, 10), grade II MCL lesions were recently recognised as a risk factor for ACL failure with an odds ratio of 13 (11). Lesions of the lateral side of the knee should not be neglected either, as in vitro ACL reconstruction alone does not completely restore knee stability in cases of concomitant ACL and posterolateral corner (PLC) lesions (12).…”

Section: Type Of Lesionmentioning

confidence: 99%

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

Zaffagnini

Grassi

Serra

et al. 2015

jts

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Allowing a patient to return to sport and unrestricted physical activity after ACL injury and reconstruction is one of the most challenging and difficult decisions an orthopaedic surgeon has to make. Indeed, many factors have to be taken into account before it can be considered safe for a patients to load a reconstructed knee. The current literature contains plenty of studies aimed at evaluating return to sport, and the factors that may affect or predict this outcome, e.g. intrinsic factors like genetics, biology, type of lesion, anatomical features, motivation and psychology, and extrinsic factors such as graft type, surgical technique, rehabilitation protocols, and biological support. It is possible that awareness of these issues could help the clinician to optimise outcomes, and possibly avoid failures too, although as yet no universal criteria for resuming sport have been produced.

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Section: Type Of Lesionmentioning

confidence: 99%

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

Zaffagnini

Grassi

Serra

et al. 2015

jts

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“…MCL injury of a grade II or more has been shown to be an independent risk factor for postoperative knee instability after ACL reconstruction. 10 Given the difficulties and potential complications fraught with a medial hamstring harvest in a grade III MCL-ACL combined injured knee, our purpose in this study was to highlight an alternative autograft option. Once establishing the feasibility of using a peroneus longus graft with in vitro testing, our study then aimed to show in vivo data to show the effectiveness and safety of the PLT in ACL reconstruction with concomitant MCL repair is comparable to an accepted gold standard (HT).…”

mentioning

confidence: 99%

Peroneus Longus Tendon Autograft is a Safe and Effective Alternative for Anterior Cruciate Ligament Reconstruction

et al. 2018

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The ipsilateral peroneus longus tendon (PLT) was utilized as an autograft for anterior cruciate ligament (ACL) reconstruction of patients with acute ACL rupture and grade III medial collateral ligament (MCL) injury. We investigated the efficacy and safety of this alternative autograft compared with autologous hamstring tendon (HT). Biomechanical testing of the graft options was performed and compared with the native ACL. Thirty-eight patients with acute ACL ruptures and grade III MCL injuries were treated with ACL reconstruction with a doubled autologous PLT or quadrupled autologous HT. Knee stability and function was evaluated clinically with the Lachman test and KT-2000 arthometer as well as subjectively with functional scores. Effects on the donor ankle were evaluated by biomechanical testing. The ultimate tensile strengths of doubled PLT and quadrupled HT were significantly higher than that of the native ACL and the ultimate tensile strength of doubled PLT was comparable with that of quadrupled HT. There were no significant differences in clinical or functional scores between the two groups. There were no significant differences in pre- and postoperative biomechanical testing of the donor ankle. PLT is a suitable alternative autograft for an ACL reconstruction in patients with a concomitant grade III MCL injury without a significant biomechanical disadvantage to the ankle donor site.

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“…The authors have also quantitated the time from injury to surgery that might suggest transition to inferior resultsd11.5 weeksdwhich has been supported elsewhere in the literature. 5 Finally, they have provided further evidence regarding the detrimental effects of concomitant pathology on clinical outcomes, to which I can also attest. The authors have duly reported the limitations in their investigation, most notably the low statistical power and lack of multiple observers to report the data more reliably and reduce potential recording bias, in addition to the potential lack of consistency in postoperative rehabilitation.…”

Section: See Related Article On Page 220mentioning

confidence: 89%

Editorial Commentary: Prognosticators for Outcomes After Anterior Cruciate Ligament Reconstruction…Time to Beat a Different Dead Horse?

Meredick

2018

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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The outcomes of anterior cruciate ligament reconstruction, be it single or double bundle, continue to be analyzed with exhaustion. There is strong evidence regarding the measurable effects of femoral tunnel position as well as the contributions that age, time to surgery, and concomitant pathology have on outcomes of this procedure. We are surgeons with big egos. We like to think that what we do in surgery is all that dictates the outcome. Maybe it is time to broaden the focus of our investigation.

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Risk factors for knee instability after anterior cruciate ligament reconstruction

Abstract: Retrospective case-control study, Level III.

Cited by 75 publications

References 40 publications

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

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

Peroneus Longus Tendon Autograft is a Safe and Effective Alternative for Anterior Cruciate Ligament Reconstruction

Editorial Commentary: Prognosticators for Outcomes After Anterior Cruciate Ligament Reconstruction…Time to Beat a Different Dead Horse?

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