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Orthop J Sports Med. 2020 Jul 07;8(7):2325967120926159. doi: 10.1177/2325967120926159. eCollection 2020 Jul.

Patient-Reported and Quantitative Outcomes of Anatomic Anterior Cruciate Ligament Reconstruction With Hamstring Tendon Autografts.

Orthopaedic journal of sports medicine

Theresa Diermeier, Sean J Meredith, James J Irrgang, Stefano Zaffagnini, Ryosuke Kuroda, Yuichi Hochino, Kristian Samuelsson, Clair Nicole Smith, Adam Popchak, Volker Musahl, Andrew Sheean, Jeremy M Burnham, Jayson Lian, Clair Smith, Adam Popchak, Elmar Herbst, Thomas Pfeiffer, Paulo Araujo, Alicia Oostdyk, Daniel Guenther, Bruno Ohashi, James J Irrgang, Freddie H Fu, Kouki Nagamune, Masahiro Kurosaka, Ryosuke Kuroda, Yuichi Hochino, Alberto Grassi, Giulio Maria Marcheggiani Muccioli, Nicola Lopomo, Cecilia Signorelli, Federico Raggi, Stefano Zaffagnini, Alexandra Horvath, Eleonor Svantesson, Eric Hamrin Senorski, David Sundemo, Haukur Bjoernsson, Mattias Ahlden, Neel Desai, Kristian Samuelsson, Jon Karlsson

Affiliations

  1. Investigation performed at the University of Pittsburgh, Pittsburgh, Pennsylvania, USA.

PMID: 32685564 PMCID: PMC7343370 DOI: 10.1177/2325967120926159

Abstract

BACKGROUND: The pivot-shift test has become more consistent and reliable and is a meaningful outcome measurement after anterior cruciate ligament reconstruction (ACLR).

PURPOSE/HYPOTHESIS: The purpose of this investigation was to assess patient-reported outcomes (PROs) and the quantitative pivot shift (QPS) preoperatively, at time zero immediately after anatomic ACLR, and after 24 months as well as the relationship between PROs and the QPS. It was hypothesized that anatomic ACLR would restore rotatory stability measured by the pivot-shift test and that QPS measurements would be positively correlated with PROs.

STUDY DESIGN: Cohort study; Level of evidence, 2.

METHODS: The ACL-injured and contralateral uninjured knees from 89 of 107 (83.2%) enrolled patients at 4 international centers were evaluated using a standardized pivot-shift test. Tibial acceleration was assessed with an inertial sensor, and lateral compartment translation was measured using an image analysis system preoperatively, at time zero immediately postoperatively, and at follow-up after 2 years. PROs were assessed at 12 and 24 months postoperatively with the International Knee Documentation Committee (IKDC) subjective knee form, Cincinnati Knee Rating System (CKRS), Marx activity rating scale, and activity of daily living score (ADLS).

RESULTS: The mean patient age at surgery was 27 years (range, 15-45 years). A positive pivot shift preoperatively (side-to-side difference in tibial acceleration, 2.6 ± 4.0 m/s

CONCLUSION: Anatomic ACLR resulted in significantly improved and acceptable PROs at 2-year follow-up and a low failure rate. Anatomic ACLR restored QPS measurements of anterior tibial translation and tibial acceleration to those of the contralateral knee immediately after surgery while still under anesthesia, but there was no correlation between the QPS preoperatively or at time zero after ACLR and PROs at 2-year follow-up.

© The Author(s) 2020.

Keywords: ACL; acceleration; anterior cruciate ligament; image analysis; inertial sensor; pivot shift; rotatory knee instability; translation

Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: This study was funded by an International Society for Arthoscopy, Knee Surgery and Orthopedic

References

  1. Am J Sports Med. 2010 Sep;38(9):1788-94 - PubMed
  2. Knee Surg Sports Traumatol Arthrosc. 2013 Aug;21(8):1895-903 - PubMed
  3. Am J Sports Med. 2016 Nov;44(11):2820-2826 - PubMed
  4. Comput Methods Biomech Biomed Engin. 2016;19(2):217-28 - PubMed
  5. Knee Surg Sports Traumatol Arthrosc. 2012 Apr;20(4):703-7 - PubMed
  6. Am J Sports Med. 2004 Apr-May;32(3):629-34 - PubMed
  7. Knee Surg Sports Traumatol Arthrosc. 1993;1(3-4):226-34 - PubMed
  8. Am J Sports Med. 2007 Feb;35(2):223-7 - PubMed
  9. Knee Surg Sports Traumatol Arthrosc. 2012 Apr;20(4):767-77 - PubMed
  10. Ann Rheum Dis. 2005 Jan;64(1):29-33 - PubMed
  11. Knee Surg Sports Traumatol Arthrosc. 2017 Oct;25(10):3004-3011 - PubMed
  12. Knee Surg Sports Traumatol Arthrosc. 2012 Apr;20(4):737-42 - PubMed
  13. Acta Orthop Scand. 2004 Oct;75(5):594-9 - PubMed
  14. Knee Surg Sports Traumatol Arthrosc. 1998;6(2):107-14 - PubMed
  15. Knee Surg Sports Traumatol Arthrosc. 2018 Aug;26(8):2362-2370 - PubMed
  16. Am J Sports Med. 2019 Feb;47(2):277-284 - PubMed
  17. J Bone Joint Surg Am. 2013 Oct 16;95(20):e153 - PubMed
  18. Orthop J Sports Med. 2018 Dec 18;6(12):2325967118812364 - PubMed
  19. Knee Surg Sports Traumatol Arthrosc. 2019 May;27(5):1514-1519 - PubMed
  20. Joints. 2014 Aug 01;2(3):124-9 - PubMed
  21. Arthroscopy. 2011 Mar;27(3):380-90 - PubMed
  22. Clin Orthop Relat Res. 1980 Mar-Apr;(147):45-50 - PubMed
  23. Am J Sports Med. 2016 Sep;44(9):2393-8 - PubMed
  24. J Bone Joint Surg Br. 1987 Mar;69(2):294-9 - PubMed
  25. J Sport Rehabil. 2019 Feb 1;28(2):171-179 - PubMed
  26. Arch Orthop Trauma Surg. 1992;111(4):228-9 - PubMed
  27. Clin Orthop Relat Res. 1987 Mar;(216):141-50 - PubMed
  28. Knee Surg Sports Traumatol Arthrosc. 2013 Apr;21(4):975-80 - PubMed
  29. Knee Surg Sports Traumatol Arthrosc. 2018 May;26(5):1319-1325 - PubMed
  30. Am J Sports Med. 2016 Dec;44(12):3126-3131 - PubMed
  31. Knee Surg Sports Traumatol Arthrosc. 2019 Feb;27(2):646-651 - PubMed
  32. Knee Surg Sports Traumatol Arthrosc. 2018 May;26(5):1399-1405 - PubMed
  33. Knee Surg Sports Traumatol Arthrosc. 2010 Aug;18(8):1128-44 - PubMed
  34. Clin Sports Med. 2013 Jan;32(1):61-70 - PubMed
  35. Knee Surg Sports Traumatol Arthrosc. 2018 Dec;26(12):3762-3769 - PubMed
  36. Am J Sports Med. 2016 Dec;44(12):3077-3082 - PubMed
  37. Knee Surg Sports Traumatol Arthrosc. 2012 Apr;20(4):732-6 - PubMed
  38. Am J Sports Med. 2001 Mar-Apr;29(2):213-8 - PubMed
  39. Am J Sports Med. 1999 Jul-Aug;27(4):402-16 - PubMed

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