The effect of anterior cruciate ligament reconstruction on symptoms of pain and instability in patients who have previously undergone meniscectomy: A prereconstruction and postreconstruction comparison

Barrett, Gene R.; Ruff, Cynthia G.

doi:10.1016/s0749-8063(97)90004-9

Cited by 3 publications

(1 citation statement)

References 22 publications

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“…In this study, we used a reconstruction technique, which has been shown to result in clinically satisfactory anterior stability of the knee with isolated ACL injury in previous studies 10,16,18,22. Therefore, we did not test the effect of ACL reconstruction in restoration of anterior stability of the knee with intact meniscus.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Anterior Cruciate Ligament Reconstruction on Kinematics of the Knee With Combined Anterior Cruciate Ligament Injury and Subtotal Medial Meniscectomy: An In Vitro Robotic Investigation

Seon

Gadikota

Kozánek

et al. 2009

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Purpose The aims of this study were to determine: 1) the kinematic effect of subtotal medial meniscectomy on ACL deficient knee and 2) the effect of ACL reconstruction on kinematics of the knee with combined ACL deficiency and subtotal medial meniscectomy under an anterior tibial and a simulated quadriceps loads. Methods Eight human cadaveric knees were sequentially tested using a robotic testing system under 4 conditions: intact, ACL deficiency, ACL deficiency with subtotal medial meniscectomy, and single bundle ACL reconstruction using a bone-patellar tendon-bone graft. Knee kinematics were measured at 0°, 15°, 30°, 60°, and 90° of flex ion under an anterior tibial load of 130 N and a quadriceps muscle load of 400 N. Results Subtotal medial meniscectomy in ACL deficient knee significantly increased anterior and lateral tibial translations under the anterior tibial and quadriceps loads (P < 0.05). These kinematic changes were larger at high flexion (≥ 60°) than at low flexion angles. ACL reconstructio n in knees with ACL deficiency and subtotal medial meniscectomy significantly reduced the increased anterior tibial translation, but could not restore anterior translation to the intact level with differences ranging from 2.6 mm at 0° to 5.5 mm at 30° of flexion. ACL reconstruction did not significantly affect the medial-lateral translation and internal-external tibial rotation in the presence of subtotal meniscectomy. Conclusions Subtotal medial meniscectomy in knees with ACL deficiency altered knee kinematics, especially at high flexion angles. ACL reconstruction significantly reduced the increased tibial translation in knees with combined ACL deficiency and subtotal medial meniscectomy, but could not restore the knee kinematics to the intact knee level. Clinical Relevance This study suggests that meniscus is an important secondary stabilizer against anterior and lateral tibial translations and should be preserved in the setting of ACL reconstruction for restoration of optimal knee kinematics and function.

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Section: Discussionmentioning

confidence: 99%

The Effect of Anterior Cruciate Ligament Reconstruction on Kinematics of the Knee With Combined Anterior Cruciate Ligament Injury and Subtotal Medial Meniscectomy: An In Vitro Robotic Investigation

Seon

Gadikota

Kozánek

et al. 2009

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Tightening elongated ACL grafts by application of bipolar electromagnetic energy (ligament shrinkage)

Spahn

Schindler

2002

Knee surg. sports traumatol. arthrosc.

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In ACL transplants showing elongation with functional deficit but no interruption of structure (Marburg Arthroscopic Score type III) there is the possibility of reinsertion, augmentation, or revision ACL reconstruction to stabilize the joint. Bipolar electromagnetic energy can be used to induce the tightening of elongated ACL transplants. We examined 14 patients with a secondary instability after ACL transplantation (mean 23.6 months). During arthroscopy a type III transplant without signs of nonisometric position was found. The elongated transplants were treated by bipolar application probe. All knees where protected by an unlimited orthosis over a period of 12 weeks. Postoperative follow-up took 9.4 months. There was a significant improvement in subjective discomforts (35.9 to 88.5 points on the Lysholm score), and the Rollimeter test showed a reduction of the ventral tibial translation (13.1 to 2.6 mm). There was a correlation between the degree of chondral damage and a Lysholm score but not between subjective discomforts and the degree of instability. Our findings confirm that elongated ACL transplants can be tightened by applying bipolar electromagnetic energy during rearthroscopy, thus avoiding revision ACL reconstruction in some cases.

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Anterior cruciate ligament reconstruction in patients with or without accompanying injuries

Järvelä

Kannus

Järvinen

2001

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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The effect of anterior cruciate ligament reconstruction on symptoms of pain and instability in patients who have previously undergone meniscectomy: A prereconstruction and postreconstruction comparison

Cited by 3 publications

References 22 publications

The Effect of Anterior Cruciate Ligament Reconstruction on Kinematics of the Knee With Combined Anterior Cruciate Ligament Injury and Subtotal Medial Meniscectomy: An In Vitro Robotic Investigation

The Effect of Anterior Cruciate Ligament Reconstruction on Kinematics of the Knee With Combined Anterior Cruciate Ligament Injury and Subtotal Medial Meniscectomy: An In Vitro Robotic Investigation

Tightening elongated ACL grafts by application of bipolar electromagnetic energy (ligament shrinkage)

Anterior cruciate ligament reconstruction in patients with or without accompanying injuries

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