Long-term follow-up of ACL reconstruction with hamstring autograft (original) (raw)
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Journal of Clinical Medicine
Background: This study aimed to assess long-term progression of osteoarthritis (OA) after isolated anterior cruciate ligament (ACL) reconstruction in athletes compared to the healthy contralateral side. Methods: The study included 15 patients and 30 knees with a mean age of 40 years (range, 35–46) years, none of whom had had revision surgery or an injury to the contralateral side. The mean follow-up period was 16.4 years (range, 13–22). Clinical and radiographic assessment included the Tegner activity scale (TAS), International Knee Documentation Committee (IKDC) score, Knee injury and Osteoarthritis Outcome Score (KOOS), and Kellgren and Lawrence (KL) grade. The long-term results of the injured knees were compared with the status of the healthy contralateral side and compared with previously published mid-term results of the same cohort of patients. Results: Patients generally remained clinically asymptomatic or mildly symptomatic at final follow-up, which is reflected by a KOOS pa...
Knee Function and Prevalence of Knee Osteoarthritis after Anterior Cruciate Ligament Reconstruction
The American Journal of Sports Medicine, 2010
BackgroundFew prospective long-term studies of more than 10 years have reported changes in knee function and radiologic outcomes after anterior cruciate ligament (ACL) reconstruction.PurposeTo examine changes in knee function from 6 months to 10 to 15 years after ACL reconstruction and to compare knee function outcomes over time for subjects with isolated ACL injury with those with combined ACL and meniscal injury and/or chondral lesion. Furthermore, the aim was to compare the prevalence of radiographic and symptomatic radiographic knee osteoarthritis between subjects with isolated ACL injuries and those with combined ACL and meniscal and/or chondral lesions 10 to 15 years after ACL reconstruction.Study DesignCohort study; Level of evidence, 2.MethodsFollow-up evaluations were performed on 221 subjects at 6 months, 1 year, 2 years, and 10 to 15 years after ACL reconstruction with bone-patellar tendon-bone autograft. Outcome measurements were KT-1000 arthrometer, Lachman and pivot sh...
Arthroscopy-the Journal of Arthroscopic and Related Surgery, 2008
Purpose: This study was undertaken to evaluate the long-term radiographic appearance and clinical outcome after anterior cruciate ligament (ACL) reconstruction by use of either bone-patellar tendon-bone (BPTB) or hamstring tendon (HT) autografts and to evaluate how associated meniscal injuries affect the prevalence of osteoarthritis (OA). Methods: ACL reconstruction was performed in 124 consecutive patients. Of these patients, 113 (91%) (72 BPTB and 41 HT) returned for a follow-up examination at a median of 86 months (range, 67 to 111 months) after reconstruction. The patients underwent standard weight-bearing radiographic examinations and clinical evaluation. Results: The radiographic assessments showed no significant differences between the graft types in terms of OA classified according to the Ahlbäck and Fairbank rating systems. Overall, 23% of the patients had degenerative changes according to the Ahlbäck system, and 74% had degenerative changes according to the Fairbank system. Associated meniscal injuries increased the prevalence of OA. Clinically, no significant differences were found between the graft types in terms of the Tegner activity test, 1-leg hop test, International Knee Documentation Committee evaluation system, disturbed area of sensitivity, manual Lachman test, KT-1000 laxity test (MEDmetric, San Diego, CA), and knee-walking test. The Lysholm score (P ϭ .02) and knee-walking ability (P ϭ .02) were significantly better in the HT group. Conclusions: At a median of 7 years after ACL reconstruction with either BPTB or HT autografts, the prevalence of OA as seen on standard weight-bearing radiographs and the clinical outcome were comparable. The presence of meniscal injuries increased the prevalence of OA. Level of Evidence: Level III, therapeutic, retrospective comparative study.
Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2015
Aim of this study was to record and compare the functional and activity level as well as the manifestations of osteoarthritis after isolated ACL ruptures between patients with conservative treatment and ACL reconstruction with hamstrings tendon graft. Thirty-two patients diagnosed with ACL rupture were recorded. Clinical examination included the Tegner and Lysholm activity scale, the International Knee Documentation Committee Subjective Form and KT-1000 arthrometer. Narrowing of the medial and lateral joint spaces was assessed using the IKDC knee examination score. Median follow-up was 10.3 years (range 10-11). Fifteen patients were conservatively treated (median age 33 years, range 25-39). Seventeen patients were operated (median age 31 years, range 20-36). There was significant difference between the mean values of IKDC scores in favour of the ACL-reconstruction group of patients, 86.8 (SD 6.5) versus 77.5 (SD 13.8), respectively (p = 0.04). The mean value of anteroposterior tibia...
Knee Surgery, Sports Traumatology, Arthroscopy, 2019
Purpose Due to the increased importance of revision ACL reconstruction, this study aims to evaluate the outcome 4 years after the surgery, compare two revision strategies and identify factors that influence the results. Methods Seventy-nine patients who received a revision ACL reconstruction were retrospectively evaluated. All patients were assessed with an average follow-up of 4.4 years (range 3.3-5.5 years). The results of patients treated with a quadriceps autograft were compared with those treated with a hamstring autograft. Results Ninety-seven percent of patients had a KT-1000 side-to-side difference of ≤ 5 mm (mean 1.7 ± 2.0 mm). Pivot-shift test was absent or minor in 95%. In the SLTH-test, 70% of patients reached 90% of the contralateral side. The mean Lysholm score on follow-up was 83 ± 12 (56% excellent/good). The mean IKDC 2000 subjective evaluation score was 81 ± 14 (58% normal/almost normal). The median Tegner activity score was 6 (range 3-10), a median of 2 levels worse than before the first injury. Return to sport rate was 89% but only 34% of patients reached their pre-injury sport level. Most common cause for this reduction was fear of another injury. Three patients suffered a re-rupture. Patients with a hamstring autograft performed pivoting sports more often, but had worse pivot-shift results compared to those with a quadriceps autograft. No significant influence was seen for other parameters. Young, male patients with a high activity level and no chondral damage had the best results. Conclusion Through revision ACL reconstruction, the goal of stabilizing the knee can be achieved in the majority of patients. However, a good function and a high activity level are significantly less common in these patients. The main reason for this is fear of a renewed ACL-injury. Both quadriceps and hamstring autografts were able to achieve a good outcome. Young, male, patients with a normal BMI, a high activity level and without cartilage damage seem to benefit the most from revision ACL surgery. The discrepancy between the good laxity restoration and the lower activity rate should therefore be a main point in clinical counseling when deciding for or against revision ACL-Reconstruction. Level of evidence III.
Knee extension among patients with damaged anterior cruciate ligament
Medycyna Ogólna i Nauki o Zdrowiu
Introduction and Objective. A common belief is that after an anterior cruciate ligament (ACL) injury, there is a deficit knee range of motion (ROM). Deficit ROM can be caused by swelling, postoperative or postinjury pain. However, in the literature there is a lack of papers proving that there is a deficit of knee joint extension ROM after ACL injury. The aim of the study was to compare the knee joint extension range between the healthy limb and the limb with an anterior cruciate ligament (ACL) injury. Materials and Method. The study was performed on a group of 44 patients aged 18-46 years with ACL injury (non-operative). The diagnosis was made on the basis of functional tests: Lachman test, pivot shift test, anterior drawer test, confirmed by MRI examination. ACL damage was also diagnosed in the MRI report by a radiologist. A Saunders inclinometer was used to measure passive and active knee extension. Results. There was a significant difference in the measurements of knee extension between a healthy limb and a limb with an ACL injury (active extension p=0.0012; passive extension p=0.0122). Conclusions. The limb with ACL injury had a lower range of extension in comparison to the healthy limb. Therefore, treatment focusing on improving the range of extension seems to be beneficial in patients' recovery. It is important to examine both the active and passive knee extension range of motion after ACL damaged.
2020
Background few studies approach with long follow up, meniscal repair at amateur level, specially studying variables as quality of life and failure rate. The purpose of this review is study medium to long-term clinical results in patients at amateur spors level, that have required meniscal sutures at our centre, with or without ACL reconstruction. We evaluate the objective function of the knee, as well as the patients’ return to sports activities, quality of life and the rate of failed repair and study the possible reasons.Methods We retrospectively assessed 92 patients who regularly perform amateur sports activities (Tegner 4 to 7), minimum follow-up period of 2 years, divided into 2 groups: group 1 isolated meniscal suture (43 cases), group 2 associated to ACL reconstruction (49 cases).Results high return to amateur sports rate (92%), which was even higher in the isolated reconstruction group in comparison to the group with associated ACL. We have not found statistically significan...