Malthe Fiil1, Torsten Grønbech Nielsen1, Martin Lind2. 1. Department of Orthopedics, Aarhus University Hospital, Palle Juul Jensens, Boulevard 99, 8200, Aarhus N, Denmark. 2. Department of Orthopedics, Aarhus University Hospital, Palle Juul Jensens, Boulevard 99, 8200, Aarhus N, Denmark. martinlind@dadlnet.dk.
Abstract
PURPOSE: The literature indicates a lack of consensus on the correlation between knee laxity after anterior cruciate ligament reconstruction (ACLR) and subjective clinical outcomes and the need for revision surgery. Therefore, using high-volume registry data, this study aimed to describe the relationship between objective knee laxity after ACLR and subjective symptom and functional assessments and the need for revision surgery. The hypothesis was that greater postoperative knee laxity would correlate with inferior patient-reported outcomes and a higher risk for revision surgery. METHODS: In this study, 17,114 patients in the Danish knee ligament reconstruction registry were placed into three groups on the basis of objective side-to-side differences in sagittal laxity one year after surgery: group A (≤ 2 mm), Group B (3-5 mm) and Group C (> 5 mm). The main outcome measure was revision rate within 2 years of primary surgery, further outcome measures were the knee injury and osteoarthritis outcome score (KOOS) as well as Tegner activity score. RESULTS: The study found the risk for revision surgery was more than five times higher for Group C [hazard ratio (HR) = 5.51] than for Group A. The KOOS knee-related Quality of Life (QoL) sub-score exhibited lower values when comparing Groups B or C to Group A. In addition, the KOOS Function in Sport and Recreation (Sport/Rec) sub-score yielded lower values for groups B and C in comparison with Group A. CONCLUSION: These results indicate that increased post-operative sagittal laxity is correlated with an increased risk for revision surgery and might correlate with poorer knee-related QoL, as well as a decreased function in sports. The clinical relevance of the present study is that high knee laxity at 1-year follow-up is a predictor of the risk of revision surgery. LEVEL OF EVIDENCE: III.
PURPOSE: The literature indicates a lack of consensus on the correlation between knee laxity after anterior cruciate ligament reconstruction (ACLR) and subjective clinical outcomes and the need for revision surgery. Therefore, using high-volume registry data, this study aimed to describe the relationship between objective knee laxity after ACLR and subjective symptom and functional assessments and the need for revision surgery. The hypothesis was that greater postoperative knee laxity would correlate with inferior patient-reported outcomes and a higher risk for revision surgery. METHODS: In this study, 17,114 patients in the Danish knee ligament reconstruction registry were placed into three groups on the basis of objective side-to-side differences in sagittal laxity one year after surgery: group A (≤ 2 mm), Group B (3-5 mm) and Group C (> 5 mm). The main outcome measure was revision rate within 2 years of primary surgery, further outcome measures were the knee injury and osteoarthritis outcome score (KOOS) as well as Tegner activity score. RESULTS: The study found the risk for revision surgery was more than five times higher for Group C [hazard ratio (HR) = 5.51] than for Group A. The KOOS knee-related Quality of Life (QoL) sub-score exhibited lower values when comparing Groups B or C to Group A. In addition, the KOOS Function in Sport and Recreation (Sport/Rec) sub-score yielded lower values for groups B and C in comparison with Group A. CONCLUSION: These results indicate that increased post-operative sagittal laxity is correlated with an increased risk for revision surgery and might correlate with poorer knee-related QoL, as well as a decreased function in sports. The clinical relevance of the present study is that high knee laxity at 1-year follow-up is a predictor of the risk of revision surgery. LEVEL OF EVIDENCE: III.
Authors: 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 Journal: Orthop J Sports Med Date: 2020-07-07
Authors: Janina Kaarre; Bálint Zsidai; Eric Narup; Alexandra Horvath; Eleonor Svantesson; Eric Hamrin Senorski; Alberto Grassi; Volker Musahl; Kristian Samuelsson Journal: Curr Rev Musculoskelet Med Date: 2022-07-13