Healio
Healio
September 08, 2015
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Stability was similar after anatomic double-bundle ACLR in knees with differing amounts of hyperextension

Recently published data showed that anatomic double-bundle ACL reconstruction in cases of extreme knee hypertension may result in postoperative rotational and anterior stability that is similar to that of cases of normal or mild knee hypertension. However, second-look arthroscopy results showed superficial laceration of the anteromedial bundle graft occurred in some of the cases in the patients with 10° or less or with more than 10° of hyperextension.

Kenichi Saito, MD, and colleagues 100 patients who underwent anatomic double-bundle ACL reconstruction with semitendinosus tendon grafts for any side-to-side difference (SSD) in anterior tibial translation. They patients underwent the pivot-shift test at 2 years postoperatively to measure their knee rotational stability. The mean follow-up was 28 months.

The investigators measured loss of extension (LOE) with lateral radiographs of the knees in full extension and they assessed graft integrity at 1 to 2 postoperative years postoperative via second-look arthroscopy.

Fifty-eight patients with 10° or less hypertension were in the N group (10° or less hyperextension) and 42 patients with more than 10° hypertension were in the H group. Saito and colleagues compared the two groups’ postoperative clinical outcomes.

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The N and H groups had mean extension angles of 5.8° and 14.7°, respectively. Researchers observed accompanying medial meniscus tears in 25 knees in the N group and in 15 knees in the H group. The groups were not significantly different for mean SSDs and had mean postoperative SSDs of 2.2 mm and 2.8 mm, respectively.

The mean LOE was -0.7° in the N group and 1.3° in the H group. In the H group, there was a significant positive association between LOE and the extension angle of the contralateral knee in the H group.  Superficial lacerations of the anteromedial bundle graft were observed during second-look arthroscopy in 6 knees from the N group and 13 knees from the H group, according to the results. ‒ by Monica Jaramillo

Disclosures: The researchers report no relevant financial disclosures.

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Source:

Saito K, et al. Arthroscopy. 2015; doi:10.1016/j.arthro.2015.01.022.