ACL reconstruction with lateral extra-articular tenodesis using a continuous graft : 10-year outcomes of 50 cases
Copyright © 2020 Elsevier Masson SAS. All rights reserved..
BACKGROUND: Persistence of pivot shift is the main problem after isolated intra-articular anterior cruciate ligament (ACL) reconstruction. Adding lateral extra-articular tenodesis (LET) to the ACL procedure increases the knee's stability by controlling rotational laxity. The aim of this study was to evaluate the long-term clinical and radiological outcomes of combined ACL reconstruction with LET using a continuous hamstring graft as a first-line procedure.
MATERIAL AND METHODS: Fifty patients were reviewed at 10 years postoperative. Subjective outcome scores -IKDC, Lysholm, KOOS and Tegner- were collected. A clinical and radiological assessment was done. The knees' anteroposterior laxity was measured with a rollimeter.
RESULTS: The mean IKDC subjective score was 85.5, the mean Lysholm score was 90.2 and 80% of patients had a score graded as good or very good. No pivot shift was present in 94% of patients and there was a firm endpoint in the Lachman test in 86% of patients. There was a flexion deficit>5° in 5 patients and an extension deficit of 10° in one patient. Most patients (56%) had resumed their physical activities at the same level as before the surgery. Signs of osteoarthritis were found in 26% of patients (16% were Ahlback stage 1 and 10% were stage 2). There was only one graft failure. These good outcomes are consistent with other published studies on combined ACL-LET. There was neither significant stiffness, nor a higher rate of secondary osteoarthritis relative to ACL reconstruction only, particularly in the lateral tibiofemoral compartment.
CONCLUSION: Adding primary LET to ACL reconstruction improves control of rotational laxity over time without increasing the complication rate.
LEVEL OF EVIDENCE: IV, retrospective study without control group.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2020 |
|---|---|
| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:106 |
|---|---|
| Enthalten in: |
Orthopaedics & traumatology, surgery & research : OTSR - 106(2020), 5 vom: 15. Sept., Seite 929-935 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Meynard, Pierre [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
ACL reconstruction |
|---|
| Anmerkungen: |
Date Completed 24.06.2021 Date Revised 24.06.2021 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.otsr.2020.04.007 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM311140238 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM311140238 | ||
| 003 | DE-627 | ||
| 005 | 20231225141623.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2020 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.otsr.2020.04.007 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1037.xml |
| 035 | |a (DE-627)NLM311140238 | ||
| 035 | |a (NLM)32534897 | ||
| 035 | |a (PII)S1877-0568(20)30164-X | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Meynard, Pierre |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a ACL reconstruction with lateral extra-articular tenodesis using a continuous graft |b 10-year outcomes of 50 cases |
| 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 Completed 24.06.2021 | ||
| 500 | |a Date Revised 24.06.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2020 Elsevier Masson SAS. All rights reserved. | ||
| 520 | |a BACKGROUND: Persistence of pivot shift is the main problem after isolated intra-articular anterior cruciate ligament (ACL) reconstruction. Adding lateral extra-articular tenodesis (LET) to the ACL procedure increases the knee's stability by controlling rotational laxity. The aim of this study was to evaluate the long-term clinical and radiological outcomes of combined ACL reconstruction with LET using a continuous hamstring graft as a first-line procedure | ||
| 520 | |a MATERIAL AND METHODS: Fifty patients were reviewed at 10 years postoperative. Subjective outcome scores -IKDC, Lysholm, KOOS and Tegner- were collected. A clinical and radiological assessment was done. The knees' anteroposterior laxity was measured with a rollimeter | ||
| 520 | |a RESULTS: The mean IKDC subjective score was 85.5, the mean Lysholm score was 90.2 and 80% of patients had a score graded as good or very good. No pivot shift was present in 94% of patients and there was a firm endpoint in the Lachman test in 86% of patients. There was a flexion deficit>5° in 5 patients and an extension deficit of 10° in one patient. Most patients (56%) had resumed their physical activities at the same level as before the surgery. Signs of osteoarthritis were found in 26% of patients (16% were Ahlback stage 1 and 10% were stage 2). There was only one graft failure. These good outcomes are consistent with other published studies on combined ACL-LET. There was neither significant stiffness, nor a higher rate of secondary osteoarthritis relative to ACL reconstruction only, particularly in the lateral tibiofemoral compartment | ||
| 520 | |a CONCLUSION: Adding primary LET to ACL reconstruction improves control of rotational laxity over time without increasing the complication rate | ||
| 520 | |a LEVEL OF EVIDENCE: IV, retrospective study without control group | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a ACL reconstruction | |
| 650 | 4 | |a Anterolateral ligament | |
| 650 | 4 | |a Anterolateral reconstruction | |
| 650 | 4 | |a Hamstring | |
| 650 | 4 | |a Osteoarthritis | |
| 650 | 4 | |a Rotational laxity | |
| 700 | 1 | |a Pelet, Hugo |e verfasserin |4 aut | |
| 700 | 1 | |a Angelliaume, Audrey |e verfasserin |4 aut | |
| 700 | 1 | |a Legallois, Yohan |e verfasserin |4 aut | |
| 700 | 1 | |a Lavignac, Pierre |e verfasserin |4 aut | |
| 700 | 1 | |a De Bartolo, Rafael |e verfasserin |4 aut | |
| 700 | 1 | |a Fabre, Thierry |e verfasserin |4 aut | |
| 700 | 1 | |a Costes, Stéphane |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Orthopaedics & traumatology, surgery & research : OTSR |d 2009 |g 106(2020), 5 vom: 15. Sept., Seite 929-935 |w (DE-627)NLM186754043 |x 1877-0568 |7 nnns |
| 773 | 1 | 8 | |g volume:106 |g year:2020 |g number:5 |g day:15 |g month:09 |g pages:929-935 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.otsr.2020.04.007 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 106 |j 2020 |e 5 |b 15 |c 09 |h 929-935 | ||