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Knee Surgery, Sports Traumatology, Arthroscopy

Erschienen in:

23.09.2019 | KNEE

Over-the-top ACL reconstruction restores anterior and rotatory knee laxity in skeletally immature individuals and revision settings

verfasst von: Kanto Nagai, Benjamin B. Rothrauff, Ryan T. Li, Freddie H. Fu

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 2/2020

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Abstract

Purpose

To investigate the objective outcomes following anterior cruciate ligament reconstruction (ACLR) with the over-the-top (OTT) technique.

Methods

Thirty-five ACL-deficient patients with mean follow-up of 2.2 years were retrospectively reviewed. This included 14 skeletally immature individuals (age: 14 ± 1 years) who underwent primary OTT ACLR (adolescent group) and 21 skeletally mature individuals (age: 25 ± 8 years) who underwent OTT revision ACLR (revision group). The tibial tunnel was created at the anatomic position for all cases. No lateral extra-articular tenodesis was performed. Before and after surgery, the side-to-side difference (SSD) in anterior laxity was measured using KT-1000 arthrometer. Lachman and pivot-shift tests were assessed according to IKDC grade. The graft failure rate was assessed.

Results

The post-operative SSD in anterior laxity was significantly reduced in the adolescent (pre-op, 3.9 ± 1.8 mm; post-op, 1.2 ± 0.8 mm; p = 0.040) and revision groups (pre-op, 4.2 ± 1.7 mm; post-op, 1.2 ± 1.4 mm; p < 0.001). Postoperative knee laxity measured by Lachman and pivot-shift tests were also significantly improved in both groups. Graft rupture occurred in two patients in the adolescent group (14.3%), and one patient in the revision group (4.8%).

Conclusion

ACLR with the OTT technique restored anterior and rotatory knee laxity in skeletally immature individuals and in revision settings. This one-step procedure may be a good option for skeletally immature individuals and revision settings.

Level of evidence

IV.

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Titel: Over-the-top ACL reconstruction restores anterior and rotatory knee laxity in skeletally immature individuals and revision settings
verfasst von: Kanto Nagai
Benjamin B. Rothrauff
Ryan T. Li
Freddie H. Fu
Publikationsdatum: 23.09.2019
Verlag: Springer Berlin Heidelberg
Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 2/2020
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-019-05719-5

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