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...
Main Authors: | , , , , , , , , |
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Format: | Article |
Language: | English |
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Elsevier
2023-12-01
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Series: | Journal of Joint Surgery and Research |
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Online Access: | http://www.sciencedirect.com/science/article/pii/S2949705122000056 |
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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. |
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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 |
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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 |
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