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Failed ACL reconstruction yielded more anterior tibial subluxation vs primary ACL deficiency
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Recently published results showed patients who experienced failed ACL reconstruction had more anterior tibial subluxation compared with patients with primary ACL deficiency.
Lucas S. McDonald, MD, MPH&TM, and colleagues assigned 186 patients with ACL injuries to one of the following cohorts: intact ACL; acute ACL disruption; chronic ACL disruption; and failed ACL reconstruction. In addition, 26 patients without ACL injury were used as a control group. Researchers used MRI to measure anterior tibial subluxation of the medial and lateral compartments relative to the femoral condyles, as well as performed an MRI evaluation for meniscal tears, chondral defects and injuries to the anterolateral ligament (ALL).
Results showed the mean anterior tibial subluxation in the lateral compartment measured 0.78 mm, 2.81 mm, 3.64 mm and 4.91 mm in the control group, ACL injury group, the chronic ACL injury group and the failed ACL reconstruction group, respectively. Researchers noted 37.5% of patients in the failed ACL reconstruction group had a lateral compartment anterior subluxation of 6 mm or greater and 11.1% had an anterior subluxation of the lateral compartment of 10 mm or greater.
Multivariate regression showed an association between the presence of both medial and lateral chondral defects with a mean 1.09-mm increase in subluxation of the medial compartment. Increased lateral tibia subluxation by 1.611 mm was independently predicted by the combination of medial and lateral meniscal tears. Researchers also noted an association between an injury to the ALL with increased anterior tibial subluxation in both the medial compartment and lateral compartment across all knee states.
Results showed lateral tibial subluxation of 6 mm or greater in 29.4% of knees with ALL injuries. However, multivariate regression analysis showed anterior subluxation of the lateral compartment was not independently predicted by an ALL injury. – by Casey Tingle
Disclosures: McDonald reports no relevant financial disclosures. Please see the full study for a list of all authors’ relevant financial disclosures.
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