Risk factors for postoperative graft laxity without re-injury after double-bundle anterior cruciate ligament reconstruction in recreational athletes.
Adolescent
Adult
Anterior Cruciate Ligament
/ surgery
Anterior Cruciate Ligament Injuries
/ surgery
Anterior Cruciate Ligament Reconstruction
/ methods
Athletes
Female
Follow-Up Studies
Humans
Knee Joint
/ surgery
Lysholm Knee Score
Male
Middle Aged
Postoperative Period
Reinjuries
Risk Factors
Time Factors
Treatment Outcome
Young Adult
Anterior cruciate ligament reconstruction
Double bundle
Graft laxity
Knee hyperextension
Risk factor
Younger age
Journal
The Knee
ISSN: 1873-5800
Titre abrégé: Knee
Pays: Netherlands
ID NLM: 9430798
Informations de publication
Date de publication:
Jan 2021
Jan 2021
Historique:
received:
01
07
2020
revised:
18
09
2020
accepted:
21
12
2020
pubmed:
24
1
2021
medline:
22
6
2021
entrez:
23
1
2021
Statut:
ppublish
Résumé
Although high activity is a risk factor for graft failure after anterior cruciate ligament (ACL) reconstruction, the risk factors for postoperative laxity after ACL reconstruction in recreational athletes are unknown. We enrolled 91 patients (40 males, 51 females; mean age 29.2 years; mean follow-up 4.3 years) who scored ≤ 6 on the Tegner activity scale, underwent double-bundle ACL reconstruction between 2010 and 2018, and did not experience re-injury. In the stable group (75 patients, <3.0 mm side-to-side difference (SSD) in anterior translation, grade 0 or 1 pivot shift 1 year after surgery) and unstable group (16 patients, ≥3.0 mm SSD, ≥grade 2 pivot shift), multivariate logistic regression analyses adjusted for factors showing P ≤ 0.3 on univariate analysis assessed risk factors for graft laxity. Lysholm score and graft intensity on MRI (Howell grade) were compared at final follow-up. Mean SSD in anterior translation was 0.7 mm (stable group) and 3.3 mm (unstable group). Pivot shift grades were 0 (88%) and 1 (12%) in the stable group, and 0 (12.5%), 1 (50%), and 2 (37.5%) in the unstable group. Multivariate regression analyses showed that younger age and knee hyperextension were significant risk factors for graft laxity (P = 0.018 and 0.0016; cutoffs 18 years old and 8°, respectively). Lysholm scores in both groups were comparable, but graft intensity on MRI demonstrated significantly worse Howell grade in the unstable group (P = 0.002). Younger age and knee hyperextension were risk factors for postoperative graft laxity without re-injury in recreational athletes.
Sections du résumé
BACKGROUND
BACKGROUND
Although high activity is a risk factor for graft failure after anterior cruciate ligament (ACL) reconstruction, the risk factors for postoperative laxity after ACL reconstruction in recreational athletes are unknown.
METHODS
METHODS
We enrolled 91 patients (40 males, 51 females; mean age 29.2 years; mean follow-up 4.3 years) who scored ≤ 6 on the Tegner activity scale, underwent double-bundle ACL reconstruction between 2010 and 2018, and did not experience re-injury. In the stable group (75 patients, <3.0 mm side-to-side difference (SSD) in anterior translation, grade 0 or 1 pivot shift 1 year after surgery) and unstable group (16 patients, ≥3.0 mm SSD, ≥grade 2 pivot shift), multivariate logistic regression analyses adjusted for factors showing P ≤ 0.3 on univariate analysis assessed risk factors for graft laxity. Lysholm score and graft intensity on MRI (Howell grade) were compared at final follow-up.
RESULTS
RESULTS
Mean SSD in anterior translation was 0.7 mm (stable group) and 3.3 mm (unstable group). Pivot shift grades were 0 (88%) and 1 (12%) in the stable group, and 0 (12.5%), 1 (50%), and 2 (37.5%) in the unstable group. Multivariate regression analyses showed that younger age and knee hyperextension were significant risk factors for graft laxity (P = 0.018 and 0.0016; cutoffs 18 years old and 8°, respectively). Lysholm scores in both groups were comparable, but graft intensity on MRI demonstrated significantly worse Howell grade in the unstable group (P = 0.002).
CONCLUSION
CONCLUSIONS
Younger age and knee hyperextension were risk factors for postoperative graft laxity without re-injury in recreational athletes.
Identifiants
pubmed: 33485163
pii: S0968-0160(20)30405-1
doi: 10.1016/j.knee.2020.12.009
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
338-345Informations de copyright
Copyright © 2021 Elsevier B.V. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.