Lateral meniscal status, chronicity of anterior cruciate ligament (ACL) deficiency, and initial graft tension were associated with abnormal knee laxity after anatomical ACL reconstruction

Purpose: Graft failure or recurrence of instability without obvious trauma remains one of the problems following anterior cruciate ligament (ACL) reconstruction. This retrospective study aimed to identify risk factors for abnormal knee laxity after anatomical ACL reconstruction. Methods: A total of...

Full description

Bibliographic Details
Main Authors: Shuji Taketomi, Ryota Yamagami, Kohei Kawaguchi, Kenichi Kono, Ryo Murakami, Tomofumi Kage, Takahiro Arakawa, Hiroshi Inui, Sakae Tanaka
Format: Article
Language:English
Published: Elsevier 2023-12-01
Series:Journal of Joint Surgery and Research
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2949705122000056
_version_ 1797235495896350720
author Shuji Taketomi
Ryota Yamagami
Kohei Kawaguchi
Kenichi Kono
Ryo Murakami
Tomofumi Kage
Takahiro Arakawa
Hiroshi Inui
Sakae Tanaka
author_facet Shuji Taketomi
Ryota Yamagami
Kohei Kawaguchi
Kenichi Kono
Ryo Murakami
Tomofumi Kage
Takahiro Arakawa
Hiroshi Inui
Sakae Tanaka
author_sort Shuji Taketomi
collection DOAJ
description Purpose: Graft failure or recurrence of instability without obvious trauma remains one of the problems following anterior cruciate ligament (ACL) reconstruction. This retrospective study aimed to identify risk factors for abnormal knee laxity after anatomical ACL reconstruction. Methods: A total of 291 patients who underwent primary anatomical ACL reconstruction were included in this study. Sex, age, body mass index (BMI), time to surgery, medial meniscal status, lateral meniscal status, graft materials, initial graft tension protocol, preoperative and postoperative pivot shift test and side-to-side differences in anterior tibial translation using the arthrometer were reviewed. Abnormal knee laxity was defined as constituting one or both of the following criteria: (i) a side-to-side difference of ≥3 mm by arthrometer; and (ii) a positive pivot shift test, being “glide,” “clunk”, or “gross”. Results: Abnormal knee laxity occurred in 30 patients (10.3%) at a median follow-up of 25 months. Results of univariate analysis indicated that a higher likelihood of abnormal knee laxity was associated with female sex, greater BMI, longer time to surgery, higher initial graft tension protocol, and lateral meniscus resection. Multivariate logistic regression analysis showed that abnormal knee laxity was significantly associated with time to surgery [1-month increase; odds ratio (OR), 1.01], higher initial graft tension protocol (vs. lower tension; OR, 3.5), and lateral meniscus resection (vs. intact and repaired lateral meniscus; OR, 12.8). Conclusion: Higher initial graft tension protocol, chronicity of ACL deficiency, and lateral meniscus resection were risk factors for abnormal knee laxity after anatomical ACL reconstruction. Level of evidence: Level III retrospective prognostic study.
first_indexed 2024-04-24T16:48:52Z
format Article
id doaj.art-dab088baf3d348368bc0963ee8798aa3
institution Directory Open Access Journal
issn 2949-7051
language English
last_indexed 2024-04-24T16:48:52Z
publishDate 2023-12-01
publisher Elsevier
record_format Article
series Journal of Joint Surgery and Research
spelling doaj.art-dab088baf3d348368bc0963ee8798aa32024-03-29T05:51:46ZengElsevierJournal of Joint Surgery and Research2949-70512023-12-01112631Lateral meniscal status, chronicity of anterior cruciate ligament (ACL) deficiency, and initial graft tension were associated with abnormal knee laxity after anatomical ACL reconstructionShuji Taketomi0Ryota Yamagami1Kohei Kawaguchi2Kenichi Kono3Ryo Murakami4Tomofumi Kage5Takahiro Arakawa6Hiroshi Inui7Sakae Tanaka8Corresponding author.; Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, JapanDepartment of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, JapanDepartment of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, JapanDepartment of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, JapanDepartment of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, JapanDepartment of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, JapanDepartment of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, JapanDepartment of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, JapanDepartment of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, JapanPurpose: Graft failure or recurrence of instability without obvious trauma remains one of the problems following anterior cruciate ligament (ACL) reconstruction. This retrospective study aimed to identify risk factors for abnormal knee laxity after anatomical ACL reconstruction. Methods: A total of 291 patients who underwent primary anatomical ACL reconstruction were included in this study. Sex, age, body mass index (BMI), time to surgery, medial meniscal status, lateral meniscal status, graft materials, initial graft tension protocol, preoperative and postoperative pivot shift test and side-to-side differences in anterior tibial translation using the arthrometer were reviewed. Abnormal knee laxity was defined as constituting one or both of the following criteria: (i) a side-to-side difference of ≥3 mm by arthrometer; and (ii) a positive pivot shift test, being “glide,” “clunk”, or “gross”. Results: Abnormal knee laxity occurred in 30 patients (10.3%) at a median follow-up of 25 months. Results of univariate analysis indicated that a higher likelihood of abnormal knee laxity was associated with female sex, greater BMI, longer time to surgery, higher initial graft tension protocol, and lateral meniscus resection. Multivariate logistic regression analysis showed that abnormal knee laxity was significantly associated with time to surgery [1-month increase; odds ratio (OR), 1.01], higher initial graft tension protocol (vs. lower tension; OR, 3.5), and lateral meniscus resection (vs. intact and repaired lateral meniscus; OR, 12.8). Conclusion: Higher initial graft tension protocol, chronicity of ACL deficiency, and lateral meniscus resection were risk factors for abnormal knee laxity after anatomical ACL reconstruction. Level of evidence: Level III retrospective prognostic study.http://www.sciencedirect.com/science/article/pii/S2949705122000056Anatomical anterior cruciate ligament reconstructionAbnormal knee laxityChronic ACL injuryInitial graft tensionMeniscus resection
spellingShingle Shuji Taketomi
Ryota Yamagami
Kohei Kawaguchi
Kenichi Kono
Ryo Murakami
Tomofumi Kage
Takahiro Arakawa
Hiroshi Inui
Sakae Tanaka
Lateral meniscal status, chronicity of anterior cruciate ligament (ACL) deficiency, and initial graft tension were associated with abnormal knee laxity after anatomical ACL reconstruction
Journal of Joint Surgery and Research
Anatomical anterior cruciate ligament reconstruction
Abnormal knee laxity
Chronic ACL injury
Initial graft tension
Meniscus resection
title Lateral meniscal status, chronicity of anterior cruciate ligament (ACL) deficiency, and initial graft tension were associated with abnormal knee laxity after anatomical ACL reconstruction
title_full Lateral meniscal status, chronicity of anterior cruciate ligament (ACL) deficiency, and initial graft tension were associated with abnormal knee laxity after anatomical ACL reconstruction
title_fullStr Lateral meniscal status, chronicity of anterior cruciate ligament (ACL) deficiency, and initial graft tension were associated with abnormal knee laxity after anatomical ACL reconstruction
title_full_unstemmed Lateral meniscal status, chronicity of anterior cruciate ligament (ACL) deficiency, and initial graft tension were associated with abnormal knee laxity after anatomical ACL reconstruction
title_short Lateral meniscal status, chronicity of anterior cruciate ligament (ACL) deficiency, and initial graft tension were associated with abnormal knee laxity after anatomical ACL reconstruction
title_sort lateral meniscal status chronicity of anterior cruciate ligament acl deficiency and initial graft tension were associated with abnormal knee laxity after anatomical acl reconstruction
topic Anatomical anterior cruciate ligament reconstruction
Abnormal knee laxity
Chronic ACL injury
Initial graft tension
Meniscus resection
url http://www.sciencedirect.com/science/article/pii/S2949705122000056
work_keys_str_mv AT shujitaketomi lateralmeniscalstatuschronicityofanteriorcruciateligamentacldeficiencyandinitialgrafttensionwereassociatedwithabnormalkneelaxityafteranatomicalaclreconstruction
AT ryotayamagami lateralmeniscalstatuschronicityofanteriorcruciateligamentacldeficiencyandinitialgrafttensionwereassociatedwithabnormalkneelaxityafteranatomicalaclreconstruction
AT koheikawaguchi lateralmeniscalstatuschronicityofanteriorcruciateligamentacldeficiencyandinitialgrafttensionwereassociatedwithabnormalkneelaxityafteranatomicalaclreconstruction
AT kenichikono lateralmeniscalstatuschronicityofanteriorcruciateligamentacldeficiencyandinitialgrafttensionwereassociatedwithabnormalkneelaxityafteranatomicalaclreconstruction
AT ryomurakami lateralmeniscalstatuschronicityofanteriorcruciateligamentacldeficiencyandinitialgrafttensionwereassociatedwithabnormalkneelaxityafteranatomicalaclreconstruction
AT tomofumikage lateralmeniscalstatuschronicityofanteriorcruciateligamentacldeficiencyandinitialgrafttensionwereassociatedwithabnormalkneelaxityafteranatomicalaclreconstruction
AT takahiroarakawa lateralmeniscalstatuschronicityofanteriorcruciateligamentacldeficiencyandinitialgrafttensionwereassociatedwithabnormalkneelaxityafteranatomicalaclreconstruction
AT hiroshiinui lateralmeniscalstatuschronicityofanteriorcruciateligamentacldeficiencyandinitialgrafttensionwereassociatedwithabnormalkneelaxityafteranatomicalaclreconstruction
AT sakaetanaka lateralmeniscalstatuschronicityofanteriorcruciateligamentacldeficiencyandinitialgrafttensionwereassociatedwithabnormalkneelaxityafteranatomicalaclreconstruction