Clinical Characteristics and Outcomes After Primary ACL Reconstruction and Meniscus Ramp Repair
© The Author(s) 2020..
BACKGROUND: Satisfactory outcomes have been reported after all-inside meniscus ramp repair with combined anterior cruciate ligament reconstruction (ACLR). However, clinical outcomes after ACLR with inside-out meniscus ramp repair are limited.
PURPOSE/HYPOTHESIS: The purpose of this study was to evaluate patient-reported outcomes for patients who underwent ACLR and medial meniscus ramp repair compared with those who underwent isolated ACLR; patients in the 2 groups were matched for age, sex, and sport/activity. The null hypothesis was that there would be no significant differences in clinical outcomes between groups at a minimum of 2 years postoperatively.
STUDY DESIGN: Cohort study; Level of evidence 3.
METHODS: Patients who underwent primary ACLR with bone-patellar tendon-bone (BPTB) autograft by a single surgeon were retrospectively identified. A subgroup of patients with combined ACLR and meniscus ramp repair with a minimum 2-year postoperative follow-up were matched to a cohort who underwent isolated ACLR. Subjective patient-reported questionnaires, knee stability, and return to level of activity/sport were collected.
RESULTS: There were 851 patients who underwent primary ACLR; of these, 158 (18.6%) had medial meniscus ramp lesions confirmed at arthroscopy. The most common clinical characteristics in patients with ramp lesions were chronic injuries (68.4%), contact mechanism (88%), concomitant lateral meniscus tears (63.2%), and concomitant lateral meniscus posterior root tears (22.2%). Further, 50 patients who underwent combined ACLR and meniscus ramp repair with minimum 2-year follow-up were matched to patients who underwent isolated ACLR. Both groups reported significant improvements in subjective outcomes from preoperative to postoperative assessments (P < .001). No significant differences were found in postoperative outcomes for combined ACLR with ramp repair versus isolated ACLR (P > .05). Patients with meniscus ramp repair had increased preoperative knee laxity demonstrated by grade 3 Lachman (44% vs 6%) and pivot-shift (38% vs 12%) test results compared with patients who underwent isolated ACLR (P ≤ .005 for both).
CONCLUSION: This study demonstrates similar clinical outcomes, knee stability on postoperative physical examination, and return-to-sport rates for patients who underwent combined ACLR with BPTB autograft and inside-out meniscus ramp repair versus a matched cohort who underwent isolated ACLR. Clinicians should have a high index of suspicion for the presence of ramp lesions in patients with ACL tears who have a contact mechanism of injury, grade 3 Lachman test result, and concomitant lateral meniscal abnormality.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2020 |
|---|---|
| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:8 |
|---|---|
| Enthalten in: |
Orthopaedic journal of sports medicine - 8(2020), 4 vom: 02. Apr., Seite 2325967120912427 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
DePhillipo, Nicholas N [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
ACL |
|---|
| Anmerkungen: |
Date Revised 14.04.2022 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
|---|
| doi: |
10.1177/2325967120912427 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM310089247 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM310089247 | ||
| 003 | DE-627 | ||
| 005 | 20231225135332.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2020 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1177/2325967120912427 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1033.xml |
| 035 | |a (DE-627)NLM310089247 | ||
| 035 | |a (NLM)32426400 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a DePhillipo, Nicholas N |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Clinical Characteristics and Outcomes After Primary ACL Reconstruction and Meniscus Ramp Repair |
| 264 | 1 | |c 2020 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Revised 14.04.2022 | ||
| 500 | |a published: Electronic-eCollection | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a © The Author(s) 2020. | ||
| 520 | |a BACKGROUND: Satisfactory outcomes have been reported after all-inside meniscus ramp repair with combined anterior cruciate ligament reconstruction (ACLR). However, clinical outcomes after ACLR with inside-out meniscus ramp repair are limited | ||
| 520 | |a PURPOSE/HYPOTHESIS: The purpose of this study was to evaluate patient-reported outcomes for patients who underwent ACLR and medial meniscus ramp repair compared with those who underwent isolated ACLR; patients in the 2 groups were matched for age, sex, and sport/activity. The null hypothesis was that there would be no significant differences in clinical outcomes between groups at a minimum of 2 years postoperatively | ||
| 520 | |a STUDY DESIGN: Cohort study; Level of evidence 3 | ||
| 520 | |a METHODS: Patients who underwent primary ACLR with bone-patellar tendon-bone (BPTB) autograft by a single surgeon were retrospectively identified. A subgroup of patients with combined ACLR and meniscus ramp repair with a minimum 2-year postoperative follow-up were matched to a cohort who underwent isolated ACLR. Subjective patient-reported questionnaires, knee stability, and return to level of activity/sport were collected | ||
| 520 | |a RESULTS: There were 851 patients who underwent primary ACLR; of these, 158 (18.6%) had medial meniscus ramp lesions confirmed at arthroscopy. The most common clinical characteristics in patients with ramp lesions were chronic injuries (68.4%), contact mechanism (88%), concomitant lateral meniscus tears (63.2%), and concomitant lateral meniscus posterior root tears (22.2%). Further, 50 patients who underwent combined ACLR and meniscus ramp repair with minimum 2-year follow-up were matched to patients who underwent isolated ACLR. Both groups reported significant improvements in subjective outcomes from preoperative to postoperative assessments (P < .001). No significant differences were found in postoperative outcomes for combined ACLR with ramp repair versus isolated ACLR (P > .05). Patients with meniscus ramp repair had increased preoperative knee laxity demonstrated by grade 3 Lachman (44% vs 6%) and pivot-shift (38% vs 12%) test results compared with patients who underwent isolated ACLR (P ≤ .005 for both) | ||
| 520 | |a CONCLUSION: This study demonstrates similar clinical outcomes, knee stability on postoperative physical examination, and return-to-sport rates for patients who underwent combined ACLR with BPTB autograft and inside-out meniscus ramp repair versus a matched cohort who underwent isolated ACLR. Clinicians should have a high index of suspicion for the presence of ramp lesions in patients with ACL tears who have a contact mechanism of injury, grade 3 Lachman test result, and concomitant lateral meniscal abnormality | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a ACL | |
| 650 | 4 | |a ACLR | |
| 650 | 4 | |a meniscal repair | |
| 650 | 4 | |a return to sport | |
| 650 | 4 | |a surgical outcomes | |
| 700 | 1 | |a Dornan, Grant J |e verfasserin |4 aut | |
| 700 | 1 | |a Dekker, Travis J |e verfasserin |4 aut | |
| 700 | 1 | |a Aman, Zachary S |e verfasserin |4 aut | |
| 700 | 1 | |a Engebretsen, Lars |e verfasserin |4 aut | |
| 700 | 1 | |a LaPrade, Robert F |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Orthopaedic journal of sports medicine |d 2013 |g 8(2020), 4 vom: 02. Apr., Seite 2325967120912427 |w (DE-627)NLM243038488 |x 2325-9671 |7 nnns |
| 773 | 1 | 8 | |g volume:8 |g year:2020 |g number:4 |g day:02 |g month:04 |g pages:2325967120912427 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1177/2325967120912427 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 8 |j 2020 |e 4 |b 02 |c 04 |h 2325967120912427 | ||