The effect of lateral extra-articular tenodesis on in vivo cartilage contact in combined anterior cruciate ligament reconstruction.
Anterior cruciate ligament
Cartilage contact kinematics
Lateral extra-articular tenodesis
Pivot shift
Residual rotatory instability
Journal
Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
ISSN: 1433-7347
Titre abrégé: Knee Surg Sports Traumatol Arthrosc
Pays: Germany
ID NLM: 9314730
Informations de publication
Date de publication:
Jan 2022
Jan 2022
Historique:
received:
16
11
2020
accepted:
25
01
2021
pubmed:
14
2
2021
medline:
2
2
2022
entrez:
13
2
2021
Statut:
ppublish
Résumé
Lateral extra-articular tenodesis (LET) may confer improved rotational stability after anterior cruciate ligament reconstruction (ACLR). Little is known about how LET affects in vivo cartilage contact after ACLR. The aim of this study was to investigate the effect of LET in combination with ACLR (ACLR + LET) on in vivo cartilage contact kinematics compared to isolated ACLR (ACLR) during downhill running. It was hypothesised that cartilage contact area in the lateral compartment would be larger in ACLR + LET compared with ACLR, and that the anterior-posterior (A-P) position of the contact center on the lateral tibia would be more anterior after ACLR + LET than after ACLR. Twenty patients were randomly assigned into ACLR + LET or ACLR during surgery (ClinicalTrials.gov:NCT02913404). At 6 months and 12 months after surgery, participants were imaged during downhill running using biplane radiography. Tibiofemoral motion was tracked using a validated registration process. Patient-specific cartilage models, obtained from 3 T MRI, were registered to track bone models and used to calculate the dynamic cartilage contact area and center of cartilage contact in both the medial and lateral tibiofemoral compartments, respectively. The side-to-side differences (SSD) were compared between groups using a Mann-Whitney U test. At 6 months after surgery, the SSD in A-P cartilage contact center in ACLR + LET (3.9 ± 2.6 mm, 4.4 ± 3.1 mm) was larger than in ACLR (1.2 ± 1.6 mm, 1.5 ± 2.0 mm) at 10% and 20% of the gait cycle, respectively (p < 0.01, p < 0.05). There was no difference in the SSD in cartilage contact center at 12 months after surgery. There was no difference in SSD of cartilage contact area in the medial and lateral compartments at both 6 and 12 months after surgery. There were no adverse events during the trial. LET in combination with ACLR may affect the cartilage contact center during downhill running in the early post-operation phase, but this effect is lost in the longer term. This suggests that healing and neuromuscular adaptation occur over time and may also indicate a dampening of the effect of LET over time. (337 /350 words) LEVEL OF EVIDENCE: Level II.
Identifiants
pubmed: 33580345
doi: 10.1007/s00167-021-06480-4
pii: 10.1007/s00167-021-06480-4
doi:
Banques de données
ClinicalTrials.gov
['NCT02913404']
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
61-70Informations de copyright
© 2021. European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA).
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