Objective laxity and subjective outcomes are more influenced by meniscal treatment than anterior cruciate ligament reconstruction technique at minimum2 years of follow-up
| Autor: | Alberto Grassi, Stefano Di Paolo, Giacomo Dal Fabbro, Osman Nuri Eroglu, Luca Macchiarola, Gian Andrea Lucidi, Stefano Zaffagnini |
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| Přispěvatelé: | Grassi, Alberto, Di Paolo, Stefano, Dal Fabbro, Giacomo, Eroglu, Osman Nuri, Macchiarola, Luca, Lucidi, Gian Andrea, Zaffagnini, Stefano |
| Rok vydání: | 2022 |
| Předmět: |
Laxity
Meniscu Anterior Cruciate Ligament Reconstruction ACL Anterior Cruciate Ligament Injurie Anterior Cruciate Ligament Injuries Pain Knee Injuries Follow-Up Studie Lateral plasty Humans Orthopedics and Sports Medicine Surgery Double bundle Patient-reported outcome Human Follow-Up Studies Meniscectomy |
| Zdroj: | Journal of ISAKOS. 7:54-59 |
| ISSN: | 2059-7754 |
| DOI: | 10.1016/j.jisako.2022.04.006 |
| Popis: | Objective: The purposes of this study were: (1) to compare three different surgical techniques for anterior cruciate ligament (ACL) reconstruction at a minimum 2 years of follow-up in terms of objective laxity and patient-reported outcomes; (2) to inspect the role of meniscal tears and treatment alongside with ACL reconstruction.Methods: 59 patients were randomly assigned to one of the three reconstruction groups according to the ACL reconstruction technique: Double Bundle, Single Bundle, Single Bundle with Lateral Plasty. Autologous hamstring tendons were used in all the ACL reconstruction techniques. Objective laxity tests and KOOS were collected before surgery as a baseline and at a minimum of 2 years of follow-up and compared through a Repeated measure ANOVA. Secondary analysis to evaluate the effect of meniscal treatment on laxity reduction and scores improvement was also conducted using ANOVA. Three laxity evaluations were performed: anterior/posterior displacement at 30 degrees of knee flexion (AP 30), anterior/posterior displacement at 90 degrees of knee flexion (AP 90), and pivot-shift test.Results: Objective laxity and KOOS showed statistically significant improvement at follow-up in all three groups (p < 0.0001) without differences among the techniques. A higher AP 30 (mean difference 2.4 mm, p = 0.0333, ES = 0.66) was found at baseline for the patients with irreparable medial meniscal tear compared to the patients with isolated ACL tear; a statistically significant difference in pain score at two-year follow-up was found between patients who underwent lateral meniscectomy and patients with either meniscal repair (mean difference 6.9 +/- 12.5) or isolated ACL tear (mean difference 6.8 +/- 16.1); patients with reparable meniscal tear had a sta-tistically significant pain score improvement compared to the patients who underwent medial and lateral meniscectomy (mean difference of 9.5 +/- 14.53 and 23.4 +/- 19.2 respectively).Conclusion: Comparable objective laxity and subjective outcomes were found among the three ACL reconstruction techniques at a minimum of 2 years of follow-up. The presence of irreparable medial meniscal tear increased pre-operative laxity (AP 30, mean difference 2.4 +/- 3.6 mm). Patients with meniscal repair presented higher pain relief between baseline and follow-up compared with patients undergoing medial or lateral meniscectomy (mean dif-ference of 9.5 +/- 14.53 and 23.4 +/- 19.2, respectively). |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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