Generalized joint hypermobility does not influence 1-year patient satisfaction or functional outcome after ACL reconstruction.
Anterior cruciate ligament
Anterior cruciate ligament reconstruction
Generalized joint hypermobility
Generalized joint laxity
Knee surgery
Sports medicine
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:
Dec 2022
Dec 2022
Historique:
received:
09
01
2022
accepted:
10
05
2022
pubmed:
9
6
2022
medline:
19
11
2022
entrez:
8
6
2022
Statut:
ppublish
Résumé
The purpose of this study was to evaluate whether generalized joint hypermobility (GJH) influences postoperative results, including return to sport, patientreported outcomes, functional performance (hop tests), muscular strength, and the occurrence of ACL re-injury, in patients 1 year after anterior cruciate ligament (ACL) reconstruction. Data was extracted from a regional rehabilitation-specific registry containing information on patients with ACL injury. Patients between the ages of 16-50 years previously undergoing ACL reconstruction with available 1 year follow-up data were eligible for inclusion. Generalized joint hypermobility was assessed using the Beighton score (BS). Patients were examined one year postoperatively in terms of return to sport, patient-reported outcome, hop tests, muscular strength and the occurrence of reinjury. For purpose of analysis, patients were allocated into two groups, depending on the existence of GJH. The KOOS subscale of sports and recreation was considered the primary outcome. Analyses were performed both dichotomously and by using adjusted logistic regression, to consider potential confounders. A total of 356 patients (41% males) were included, of which 76 (24% male) were categorized as having GJH. Patients with GJH had an inferior limb symmetry index preoperatively in terms of knee extension (mean 81.6 [SD 16.4] vs. 91.4 [SD 15.9], p = 0.02) and flexion strength (mean 91.9 vs. 99.1, p = 0.047) compared to patients without GJH. There was no difference between the groups in terms of the primary outcome, nor in any of the other postoperative outcomes. Nine patients (11.8%) in the group with GJH suffered ACL re-injury, compared with 13 patients (4.6%) in the control group (n.s.). One year after ACL reconstruction the existence of GJH did not affect postoperative patient satisfaction, strength or functional outcome. No conclusive statements can be made regarding the influence of GJH on the risk of ACL re-injury in this particular study. Level II.
Identifiants
pubmed: 35676596
doi: 10.1007/s00167-022-07008-0
pii: 10.1007/s00167-022-07008-0
pmc: PMC9668803
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
4173-4180Informations de copyright
© 2022. The Author(s).
Références
Astur DC, Lara PHS, Santos MA, Oliveira GT, Arliani GG, Cohen M (2018) Influence of joint hipermobility on postoperative results of knee surgery. Acta Ortop Bras 26:19–21
doi: 10.1590/1413-785220182601174568
pubmed: 29977138
pmcid: 6025503
Barber-Westin SD, Noyes FR (2011) Factors used to determine return to unrestricted sports activities after anterior cruciate ligament reconstruction. Arthroscopy 27:1697–1705
doi: 10.1016/j.arthro.2011.09.009
pubmed: 22137326
Beighton P, Solomon L, Soskolne CL (1973) Articular mobility in an African population. Ann Rheum Dis 32:413–418
doi: 10.1136/ard.32.5.413
pubmed: 4751776
pmcid: 1006136
Beischer S, Hamrin Senorski E, Thomee C, Samuelsson K, Thomee R (2018) Young athletes return too early to knee-strenuous sport, without acceptable knee function after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 26:1966–1974
doi: 10.1007/s00167-017-4747-8
pubmed: 29032484
Briggs KK, Lysholm J, Tegner Y, Rodkey WG, Kocher MS, Steadman JR (2009) The reliability, validity, and responsiveness of the Lysholm score and Tegner activity scale for anterior cruciate ligament injuries of the knee: 25 years later. Am J Sports Med 37:890–897
doi: 10.1177/0363546508330143
pubmed: 19261899
Brix N, Ernst A, Lauridsen LLB, Parner E, Stovring H, Olsen J et al (2019) Timing of puberty in boys and girls: a population-based study. Paediatr Perinat Epidemiol 33:70–78
doi: 10.1111/ppe.12507
pubmed: 30307620
Collins NJ, Misra D, Felson DT, Crossley KM, Roos EM (2011) Measures of knee function: international knee documentation committee (IKDC) subjective knee evaluation form, knee injury and osteoarthritis outcome score (KOOS), knee injury and osteoarthritis outcome score physical function short form (KOOS-PS), knee outcome survey activities of daily living scale (KOS-ADL), lysholm knee scoring scale, oxford knee score (OKS), Western ontario and mcmaster universities osteoarthritis index (WOMAC), activity rating scale (ARS), and tegner activity score (TAS). Arthritis Care Res (Hoboken) 63(Suppl 11):S208-228
doi: 10.1002/acr.20632
Gustavsson A, Neeter C, Thomee P, Silbernagel KG, Augustsson J, Thomee R et al (2006) A test battery for evaluating hop performance in patients with an ACL injury and patients who have undergone ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 14:778–788
doi: 10.1007/s00167-006-0045-6
pubmed: 16525796
Hamrin Senorski E, Svantesson E, Beischer S, Grassi A, Krupic F, Thomee R et al (2018) Factors affecting the achievement of a patient-acceptable symptom state 1 year after anterior cruciate ligament reconstruction: a cohort study of 343 patients from 2 registries. Orthop J Sports Med 6:2325967118764317
doi: 10.1177/2325967118764317
pubmed: 29780834
pmcid: 5954350
Ingelsrud LH, Terwee CB, Terluin B, Granan LP, Engebretsen L, Mills KAG et al (2018) Meaningful change scores in the knee injury and osteoarthritis outcome score in patients undergoing anterior cruciate ligament reconstruction. Am J Sports Med 46:1120–1128
doi: 10.1177/0363546518759543
pubmed: 29517924
Juul-Kristensen B, Schmedling K, Rombaut L, Lund H, Engelbert RHH (2017) Measurement properties of clinical assessment methods for classifying generalized joint hypermobility—a systematic review. Am J Med Genet C Semin Med Genet 175:116–147
doi: 10.1002/ajmg.c.31540
pubmed: 28306223
Keays SL, Newcombe P, Keays AC (2020) Generalized joint hypermobility in siblings with anterior cruciate ligament injuries and matched unrelated healthy siblings. Physiother Res Int 25:e1826
doi: 10.1002/pri.1826
pubmed: 31950575
Kim SJ, Choi CH, Kim SH, Lee SK, Lee W, Kim T et al (2018) Bone-patellar tendon-bone autograft could be recommended as a superior graft to hamstring autograft for ACL reconstruction in patients with generalized joint laxity: 2- and 5-year follow-up study. Knee Surg Sports Traumatol Arthrosc 26:2568–2579
doi: 10.1007/s00167-018-4881-y
pubmed: 29502168
Kim SJ, Choi CH, Lee SK, Lee W, An H, Jung M (2018) Minimum two-year follow-up of anterior cruciate ligament reconstruction in patients with generalized joint laxity. J Bone Joint Surg Am 100:278–287
doi: 10.2106/JBJS.17.00767
pubmed: 29462031
Kim SJ, Moon HK, Kim SG, Chun YM, Oh KS (2010) Does severity or specific joint laxity influence clinical outcomes of anterior cruciate ligament reconstruction? Clin Orthop Relat Res 468:1136–1141
doi: 10.1007/s11999-009-0961-0
pubmed: 19582525
Krebs NM, Barber-Westin S, Noyes FR (2021) Generalized joint laxity is associated with increased failure rates of primary anterior cruciate ligament reconstructions: a systematic review. Arthroscopy 37:2337–2347
doi: 10.1016/j.arthro.2021.02.021
pubmed: 33621648
Larson CM, Bedi A, Dietrich ME, Swaringen JC, Wulf CA, Rowley DM et al (2017) Generalized hypermobility, knee hyperextension, and outcomes after anterior cruciate ligament reconstruction: prospective, case-control study with mean 6 years follow-up. Arthroscopy 33:P1852-1858
doi: 10.1016/j.arthro.2017.04.012
Malfait F, Francomano C, Byers P, Belmont J, Berglund B, Black J et al (2017) The 2017 international classification of the Ehlers-Danlos syndromes. Am J Med Genet 175:8–26
doi: 10.1002/ajmg.c.31552
pubmed: 28306229
Neeter C, Gustavsson A, Thomee P, Augustsson J, Thomee R, Karlsson J (2006) Development of a strength test battery for evaluating leg muscle power after anterior cruciate ligament injury and reconstruction. Knee Surg Sports Traumatol Arthrosc 14:571–580
doi: 10.1007/s00167-006-0040-y
pubmed: 16477472
Roos EM, Lohmander LS (2003) The knee injury and osteoarthritis outcome score (KOOS): from joint injury to osteoarthritis. Health Qual Life Outcomes 1:64
doi: 10.1186/1477-7525-1-64
pubmed: 14613558
pmcid: 280702
Stewart DR, Burden SB (2004) Does generalised ligamentous laxity increase seasonal incidence of injuries in male first division club rugby players? Br J Sports Med 38:457–460
doi: 10.1136/bjsm.2003.004861
pubmed: 15273185
pmcid: 1724849
Stijak L, Kadija M, Djulejic V, Aksic M, Petronijevic N, Aleksic D et al (2015) The influence of sex hormones on anterior cruciate ligament ruptures in males. Knee Surg Sports Traumatol Arthrosc 23:3578–3584
doi: 10.1007/s00167-014-3247-3
pubmed: 25160472
Sundemo D, Hamrin Senorski E, Karlsson L, Horvath A, Juul-Kristensen B, Karlsson J et al (2019) Generalised joint hypermobility increases ACL injury risk and is associated with inferior outcome after ACL reconstruction: a systematic review. BMJ Open Sport Exerc Med 5:e000620
doi: 10.1136/bmjsem-2019-000620
pubmed: 31798951
pmcid: 6863654
Tegner Y, Lysholm J (1985) Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res 198:43–49
doi: 10.1097/00003086-198509000-00007
Thomee R, Kaplan Y, Kvist J, Myklebust G, Risberg MA, Theisen D et al (2011) Muscle strength and hop performance criteria prior to return to sports after ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 19:1798–1805
doi: 10.1007/s00167-011-1669-8
pubmed: 21932078
Uhorchak JM, Scoville CR, Williams GN, Arciero RA, St Pierre P, Taylor DC (2003) Risk factors associated with noncontact injury of the anterior cruciate ligament: a prospective four-year evaluation of 859 West Point cadets. Am J Sports Med 31:831–842
doi: 10.1177/03635465030310061801
pubmed: 14623646
Wellsandt E, Failla MJ, Snyder-Mackler L (2017) Limb symmetry indexes can overestimate knee function after anterior cruciate ligament injury. J Orthop Sports Phys Ther 47:334–338
doi: 10.2519/jospt.2017.7285
pubmed: 28355978
pmcid: 5483854