Background: Additional lateral extra-articular procedures can reduce the risk of failure of primary anterior cruciate ligament reconstruction (ACLR). There is limited evidence on the effect of lateral extra-articular procedures in revision ACL surgery. The purpose of this study was to evaluate the clinical outcome of patients with lateral extra-articular tenodesis (LET) in combination with revision ACLR for combined ACL graft failure and high-grade anterior knee instability.
Methods: Between 2016 and 2018, 75 patients with graft failure after primary ACLR and high-grade anterior knee instability who received revision ACLR were included in the retrospective study. High-grade anterior knee instability was defined as high-grade pivot-shift or side-to-side difference of more than six millimeters in Rolimeter®-testing. An additional modified Lemaire tenodesis was performed in 59 patients during revision ACLR. Seventy-three patients were clinically examined with a minimum of two years after revision surgery.
Results: Failure of the revision ACLR occurred in 8.2% (n = 6) of the cases. LET lead to significant decreased failure rates (five percent vs. 21%, p = .045) and decreased incidence of a positive pivot-shift in patients with revision ACLR and high-grade anterior knee instability in comparison to patients without LET. Also, postoperative functional scores were significantly increased in the group of additional LET.
Conclusions: Additional LET in patients with revision ACLR and high-grade anterior instability significantly reduces the risk of failure of revision ACLR, the incidence of pivot-shift and increases postoperative functional outcome.
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http://dx.doi.org/10.1016/j.knee.2020.06.005 | DOI Listing |
Knee Surg Sports Traumatol Arthrosc
January 2025
Department of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, Tokyo, Japan.
Purpose: This study aimed to investigate whether combining the analysis of different magnetic resonance imaging (MRI) signs enhances the diagnostic accuracy of lateral meniscus posterior root tears (LMPRTs) in patients with anterior cruciate ligament (ACL) injuries. We hypothesised that analysing the cleft, ghost and truncated triangle signs and lateral meniscus extrusion (LME) measurement together would improve the preoperative MRI-based diagnosis of LMPRTs.
Methods: This retrospective study used prospectively collected registry data from two academic centres, including patients undergoing primary or revision ACL reconstruction (ACLR) and LMPRT repair.
Knee Surg Sports Traumatol Arthrosc
January 2025
Department of Molecular Medicine & Surgery, Stockholm Sports Trauma Research Center, Karolinska Institute, Stockholm, Sweden.
Purpose: To investigate the rate and timing for return to football league games after anterior cruciate ligament reconstruction (ACLR) in Swedish players, examining associations with sex, age, level, graft and additional ACL surgery.
Method: Data from the Swedish National Knee Registry (SNKLR) and the Swedish Football Association's IT System (FOGIS) were used. The study cohort comprised 971 football players, 64% males, who underwent primary ACLR.
Knee Surg Sports Traumatol Arthrosc
January 2025
Sportrehab Sports Medicine Clinic, Gothenburg, Sweden.
Purpose: The aims of this study were to compare (1) the rate of anterior cruciate ligament (ACL) revision and (2) subjective knee function using the Knee injury and Osteoarthritis Outcome Score (KOOS) between isolated ACL reconstruction (ACL-R) and ACL-R and concurrent meniscal injury, based on graft selection and meniscal treatment.
Methods: Data from the Swedish National Knee Ligament Registry were extracted in November 2022 for patients who underwent primary ACL-R. Patients were divided into two main groups based on graft choice: hamstring tendon (HT) or patellar tendon (PT) autograft, with four meniscal sub-groups: no injury, resection, repair or left in situ.
BMC Musculoskelet Disord
January 2025
Department of Orthopaedic Surgery, Anam Hospital, Korea University College of Medicine, Seoul, 02841, Republic of Korea.
Background: Anterior cruciate ligament (ACL) injuries are one of the most common sports injuries, accounting for approximately 50% of knee-related injuries. Extracorporeal shockwave therapy (ESWT), in the form of the radial (R-SWT) or focused shockwave (F-SWT), has been shown effective in treating various orthopaedic conditions. Recently, studies have investigated whether ESWT combined with standard rehabilitation may improve outcomes following anterior cruciate ligament reconstruction (ACLR).
View Article and Find Full Text PDFJ Clin Orthop Trauma
February 2025
Department of Orthopaedics, Sir Harkisandas Narottamdas Reliance Foundation Hospital, Mumbai, Maharashtra, India.
Introduction: Arthroscopic Anterior Cruciate Ligament Reconstruction (ACLR) with internal bracing and augmentation using tape-type sutures (TTS) has gained popularity due to its biomechanical advantages. However, concerns have emerged regarding chronic reactive synovitis, which can lead to graft failure and the need for revision surgery. The purpose of this research is to determine the prevalence of chronic reactive synovitis after TTS-reinforced ACLR.
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