Clinical and functional evaluation of anterior cruciate ligament tears after anterior cruciate ligament reconstruction
Keywords:
ACLR, Anterior cruciate ligament reconstruction, Sports injury, Arthroscopy
Abstract
Introduction: There have been many studies on ACL reconstruction and its outcome. In our study, we used single bundle reconstruction as the technique for Indian rural population as it is one of the most reliable technique for ACL reconstruction after the injury.
Aim: To study the pattern of clinical and functional evaluation of anterior cruciate ligament injury after anterior cruciate ligament reconstruction.
Objectives: (1) To assess the pattern of anterior cruciate ligament injury and instability caused by it (2) To study the clinical & functional outcome of ACL in arthroscopic ACL reconstruction in patient with ACL tear.
Results: The outcome scores themselves, at the end of 12 months follow up were significantly better in operated patient. We found better knee function and patients were able to do their daily activity normal (as before the injury). Results of our study were compared with other study done worldwide and we also found better results and better life style in post operated patient of ACL. The study concludes that, Arthroscopic ACLR is a good choice for ACL reconstruction and HS grafts were a good choice for reconstruction along with endobutton and screw. This study shows that ACL is one of most important ligament in the knee joint and must be taken care of for a better knee function.
Conclusion: The reconstruction of anterior cruciate ligament tears with hamstring tendon grafts gives a very good clinical and functional outcome.
Downloads
Download data is not yet available.
References
1. Girgis FG, Marshall JL, Monajem A. The cruciate ligaments of the knee joint: anatomical, functional and experimental analysis. Clin Orthop Relat Res. 1975 Jan-Feb;(106):216-31.[pubmed]
2. Petersen W, Zantop T. Anatomy of the anterior cruciate ligament with regard to its two bundles: Clin Orthop Relat Res. 2007 Jan;454:35-47.[pubmed]
3. Kisner C, Colby LA. The knee. Therapeutic exercise: Foundations and techniques, 4th ed. Philadelphia: F.A. Davis Company;2002.
4. Magee DJ. Orthopaedic physical assessment, 4th ed. Philadelphia: Saunders; 2002.
5. Levy DB, Dickey-White HI. Knee Injury, Soft Tissue, e Medicine, Dec 15, 2009.
6. Catalyst: Weak at the Knees - ABCScience.
7. Posthumus M, September AV, O‘Cuinneagain D, van der Merwe W, Schwellnus MP, Collins M (2009) The COL5A1 gene is associated with increased risk of anterior cruciate ligament ruptures in female participants. American Journal of Sports Medicine, 2009 Nov;37(11):2234-40. doi: 10.1177/0363546509338266. Epub 2009 Aug 4.[pubmed]
8. American Academy of Orthopaedic Surgeons, July 2007, Anterior Cruciate Ligament Injury: Surgical Considerations, http://orthoinfo.aaos.org/topic.cfm?topic=A00297# A00297_R4_anchor (July 11,2008).
9. Griffin LY1, Agel J, Albohm MJ, Arendt EA, Dick RW, Garrett WE, Garrick JG, Hewett TE, Huston L, Ireland ML, Johnson RJ, Kibler WB, Lephart S, Lewis JL, Lindenfeld TN, Mandelbaum BR, Marchak P, Teitz CC, Wojtys EM Noncontact Anterior Cruciate Ligament Injuries: Risk Factors and Prevention Strategies. Journal of the American Academy of Orthopaedic Surgeons. 2000 May-Jun;8(3):141-50.[pubmed]
10. The Reliability, Validity, and Responsiveness of the Lysholm Score and Tegner Activity Scale for Anterior Cruciate Ligament Injuries of the KneeKaren K. Briggs, MPH, Jack Lysholm, Am J Sports Med. 2009 May;37(5):890-7. doi: 10.1177/0363546508330143. Epub 2009 Mar 4.[pubmed]
11. Noyes FR, Barber SD, Mooar LA. A rationale for assessing sports activity levels and limitations in knee disorders. Clin Orthop Relat Res. 1989 Sep;(246):238-49.[pubmed]
12. Irrang JJ, Ho H, Harner CD, Fu FH. Use of the International Knee Documentation Committee Guidelines to assess outcome following anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. 1998;6(2):107-14.[pubmed]
13. Odensten M, Gillquist J. Functional anatomy of the anterior cruciate ligament and a rationale for reconstruction. J Bone Joint Surg Am. 1985 Feb;67(2):257-62.[pubmed]
14. Georgoulis AD, Pappa L, Moebius U , Malamou-Mitsi V, Pappa S, Papageorgiou CO, Agnantis NJ, Soucacos PN.. The presence of proprioceptive mechanoreceptors in the remnants of the ruptured ACL as a possible source of re- innervation of the ACL autograft. Knee Surg Sports Traumatol Arthrosc. 2001 Nov;9(6):364-8. Epub 2001 Sep 7.[pubmed]
15. Li G, DeFrate LE, Sun G, et al. In vivo elongation of the anterior cruciate ligament and posterior cruciate ligament during knee flexion. Am J Sports Med.2004;32:1415–1420.[pubmed]
16. Sakane M, Fox RJ, Woo SL-Y Livesay GA, Li G, Fu FH.. In situ forces in the anterior cruciate ligament and its bundles in response to anterior tibial loads. J Orthop Res.1997;15:285–293.[pubmed]
17. Prodromos CC, Fu FH, Howell SM, Johnson DH, Lawhorn K.. Controversies in soft-tissue anterior cruciate ligament reconstruction: grafts, bundles, tunnels, fixation, and harvest. J Am Acad Orthop Surg.2008;16:376–384.[pubmed]
18. Noyes FR, Mooar PA, Matthew DS, Butler DL. The symptomatic anterior cruciate-deficient knee, part I. J Bone Joint Surg Am.1983;65:154–162.[pubmed]
19. Recht MP, Piraino DW, Cohen MA, Parker RD, Bergfeld JA.. Localized anterior arthrofibrosis (cyclops lesion) after reconstruction of the anterior cruciate ligament: MR imaging findings. Am J Roentgenol.1995;165:383–385.[pubmed]
20. Biau DJ, Katsahian S, Kartus J, Harilainen A, Feller JA, Sajovic M, Ejerhed L (December 2009). "Patellar Tendon Versus Hamstring Tendon Autografts for Reconstructing the Anterior Cruciate Ligament". Am J Sports Med 37 (12):2470–8.[pubmed]
21. http://www.aclsurgery.us/patellar-vs-hamstring, november 15,2008
22. Zaricznyj B. Reconstruction of the anterior cruciate ligament of the knee using a doubled tendon graft. Clin Orthop Relat Res.1987;220:162-175.
23. Irrang JJ, Ho H, Harner CD, Fu FH. Use of the International Knee Documentation Committee Guidelines to assess outcome following anterior cruciate ligament reconstruction. Knee Sports Traumatol Arthrosc 1998; 6: 107-14.[pubmed]
24. Lysholm J, Gillquist J. Evaluation of knee ligament surgery results with special emphasis on use of a scoring scale. Am J Sports Med. 1982 May-Jun;10(3):150-4.[pubmed]
25. Tegner Y, Lysholm J. Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res. 1985 Sep;(198):43-9.[pubmed]
26. Noyes FR, Barber SD, Mooar LA. A rationale for assessing sports activity levels and limitations in knee disorders. Clin Orthop Relat Res. 1989 Sep;(246):238-49.[pubmed]
27. Daisuke Araki, Ryosuke Kuroda, Seiji Kubo, Norifumi Fujita, Katsumasa Tei, Koji Nishimoto, Yuichi Hoshino, Takehiko Matsushita, Tomoyuki Matsumoto, Koki Nag.amune, Masahiro Kurosaka. A prospective randomised study of anatomical single- bundle versus double-bundle anterior cruciate ligament reconstruction: quantitative evaluation using an electromagnetic measurement system, International Orthopaedics (SICOT, 2011) March 2011, Volume 35, Issue 3, pp 439–446.
28. Gobbi A Tuy B, Mahajan S, Panuncialman I.Quadrupled bone-semitendinosus anterior cruciate ligament reconstruction: a clinical investigation in a group of athletes. Arthroscopy. 2003 Sep;19(7):691-9, Volume 19, Issue 7, September 2003, Pages 691-699, doi.org/10.1016/S0749-8063(03)00685-6.[pubmed]
29. Eun Kyoo Song, Luke S. Oh, Thomas J. Gill, Guoan Li, Hemanth R. Gadikota and Jong Keun Seon Prospective Comparative Study of Anterior Cruciate Ligament Reconstruction Using the Double-Bundle and Single-Bundle Techniques Am J Sports Med 2009 37:1705. Volume: 37 issue: 9, page(s): 1705-1711.
30. Adachi N, Ochi M, Uchio Y, Iwasa J, Kuriwaka M, Ito Y. Reconstruction of the anterior cruciate ligament: single- versus double-bundle multistranded hamstring tendons, The Bone & Joint Journal 86(4):515-20 · June 2004,DOI: 10.1302/0301-620X.86B4.14856.[pubmed]
31. Biomechanical comparisons of knee stability after anterior cruciate ligament reconstruction between 2 clinically available transtibial procedures: anatomic double bundle versus single bundle Am J Sports Med. 2010 Jul;38(7):1349-58. doi: 10.1177/0363546510361234.[pubmed]
32. Siebold R, Dehler C, Ellert T. Prospective randomized comparison of double-bundle versus single-bundle anterior cruciate ligament reconstruction. Arthroscopy. 2008;24:137–145.[pubmed]
33. Van Eck CF, Lesniak BP, Schreiber VM, Fu FH. Anatomic single- and double-bundle anterior cruciate ligament reconstruction flowchart. Arthroscopy.2010;26:258–268, Clin Orthop Relat Res. 2013 Feb; 471(2): 363–367, Published online 2012 Dec 14. doi: 10.1007/s11999-012-2737-1.[pubmed]
34. Adachi N, Ochi M, Uchio Y, Iwasa J, Kuriwaka M, Ito Y. Reconstruction of the anterior cruciate ligament: single- versus double-bundle multistranded hamstring tendons. J Bone Joint Surg Br. 2004 May;86(4):515-20.[pubmed]
35. Kanaya A, Ochi M, Deie M, Adachi N, Nishimori M, Nakamae A. Intraoperative evaluation of anteroposterior and rotational stabilities in anterior cruciate ligament reconstruction: lower femoral tunnel placed single-bundle versus double-bundle reconstruction. Knee Surg Sports Traumatol Arthrosc, Clin Orthop Relat Res. 2012 Mar; 470(3): 824–834, Published online 2011 Jun 11. doi: 10.1007/s11999-011-1940-9.[pubmed]
36. R. Siebold, T. P. Branch, H. I. Freedberg, C. A. Jacobs. A matched pairs comparison of single- versus double-bundle anterior cruciate ligament reconstructions, clinical results and manual laxity testing Knee Surg Sports Traumatol Arthroscopy, December 2011, Volume 19, Supplement 1, pp 4–11, doi.org/10.1007/s00167-011-1475-3.
37. Eiji Kondo, Kazunori Yasuda, Hirotaka Azuma, Yoshie Tanabe and Tomonori Yagi Prospective Clinical Comparisons of Anatomic Double-Bundle Versus Single-Bundle Anterior Cruciate Ligament Reconstruction Procedures in 328 Consecutive Patients. Am J Sports Med 2008,36:1675. Volume:36 issue: 9, page(s): 1675-1687, doi.org/10.1177/0363546508317123
38. Takeshi Muneta, Koga H, Morito T, Yagishita K, Sekiya I.. Retrospective Study of the Midterm Outcome of Two Bundle Anterior Cruciate Ligament Reconstruction Using Quadrupled Semitendinosus Tendon in Comparison With One-Bundle Reconstruction. Arthroscopy. 2006 Mar; 22(3): 252- 8. Volume 22, Issue 3, March 2006, Pages 252-258, doi.org/10.1016/j.arthro.2005.12.008.[pubmed]
2. Petersen W, Zantop T. Anatomy of the anterior cruciate ligament with regard to its two bundles: Clin Orthop Relat Res. 2007 Jan;454:35-47.[pubmed]
3. Kisner C, Colby LA. The knee. Therapeutic exercise: Foundations and techniques, 4th ed. Philadelphia: F.A. Davis Company;2002.
4. Magee DJ. Orthopaedic physical assessment, 4th ed. Philadelphia: Saunders; 2002.
5. Levy DB, Dickey-White HI. Knee Injury, Soft Tissue, e Medicine, Dec 15, 2009.
6. Catalyst: Weak at the Knees - ABCScience.
7. Posthumus M, September AV, O‘Cuinneagain D, van der Merwe W, Schwellnus MP, Collins M (2009) The COL5A1 gene is associated with increased risk of anterior cruciate ligament ruptures in female participants. American Journal of Sports Medicine, 2009 Nov;37(11):2234-40. doi: 10.1177/0363546509338266. Epub 2009 Aug 4.[pubmed]
8. American Academy of Orthopaedic Surgeons, July 2007, Anterior Cruciate Ligament Injury: Surgical Considerations, http://orthoinfo.aaos.org/topic.cfm?topic=A00297# A00297_R4_anchor (July 11,2008).
9. Griffin LY1, Agel J, Albohm MJ, Arendt EA, Dick RW, Garrett WE, Garrick JG, Hewett TE, Huston L, Ireland ML, Johnson RJ, Kibler WB, Lephart S, Lewis JL, Lindenfeld TN, Mandelbaum BR, Marchak P, Teitz CC, Wojtys EM Noncontact Anterior Cruciate Ligament Injuries: Risk Factors and Prevention Strategies. Journal of the American Academy of Orthopaedic Surgeons. 2000 May-Jun;8(3):141-50.[pubmed]
10. The Reliability, Validity, and Responsiveness of the Lysholm Score and Tegner Activity Scale for Anterior Cruciate Ligament Injuries of the KneeKaren K. Briggs, MPH, Jack Lysholm, Am J Sports Med. 2009 May;37(5):890-7. doi: 10.1177/0363546508330143. Epub 2009 Mar 4.[pubmed]
11. Noyes FR, Barber SD, Mooar LA. A rationale for assessing sports activity levels and limitations in knee disorders. Clin Orthop Relat Res. 1989 Sep;(246):238-49.[pubmed]
12. Irrang JJ, Ho H, Harner CD, Fu FH. Use of the International Knee Documentation Committee Guidelines to assess outcome following anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. 1998;6(2):107-14.[pubmed]
13. Odensten M, Gillquist J. Functional anatomy of the anterior cruciate ligament and a rationale for reconstruction. J Bone Joint Surg Am. 1985 Feb;67(2):257-62.[pubmed]
14. Georgoulis AD, Pappa L, Moebius U , Malamou-Mitsi V, Pappa S, Papageorgiou CO, Agnantis NJ, Soucacos PN.. The presence of proprioceptive mechanoreceptors in the remnants of the ruptured ACL as a possible source of re- innervation of the ACL autograft. Knee Surg Sports Traumatol Arthrosc. 2001 Nov;9(6):364-8. Epub 2001 Sep 7.[pubmed]
15. Li G, DeFrate LE, Sun G, et al. In vivo elongation of the anterior cruciate ligament and posterior cruciate ligament during knee flexion. Am J Sports Med.2004;32:1415–1420.[pubmed]
16. Sakane M, Fox RJ, Woo SL-Y Livesay GA, Li G, Fu FH.. In situ forces in the anterior cruciate ligament and its bundles in response to anterior tibial loads. J Orthop Res.1997;15:285–293.[pubmed]
17. Prodromos CC, Fu FH, Howell SM, Johnson DH, Lawhorn K.. Controversies in soft-tissue anterior cruciate ligament reconstruction: grafts, bundles, tunnels, fixation, and harvest. J Am Acad Orthop Surg.2008;16:376–384.[pubmed]
18. Noyes FR, Mooar PA, Matthew DS, Butler DL. The symptomatic anterior cruciate-deficient knee, part I. J Bone Joint Surg Am.1983;65:154–162.[pubmed]
19. Recht MP, Piraino DW, Cohen MA, Parker RD, Bergfeld JA.. Localized anterior arthrofibrosis (cyclops lesion) after reconstruction of the anterior cruciate ligament: MR imaging findings. Am J Roentgenol.1995;165:383–385.[pubmed]
20. Biau DJ, Katsahian S, Kartus J, Harilainen A, Feller JA, Sajovic M, Ejerhed L (December 2009). "Patellar Tendon Versus Hamstring Tendon Autografts for Reconstructing the Anterior Cruciate Ligament". Am J Sports Med 37 (12):2470–8.[pubmed]
21. http://www.aclsurgery.us/patellar-vs-hamstring, november 15,2008
22. Zaricznyj B. Reconstruction of the anterior cruciate ligament of the knee using a doubled tendon graft. Clin Orthop Relat Res.1987;220:162-175.
23. Irrang JJ, Ho H, Harner CD, Fu FH. Use of the International Knee Documentation Committee Guidelines to assess outcome following anterior cruciate ligament reconstruction. Knee Sports Traumatol Arthrosc 1998; 6: 107-14.[pubmed]
24. Lysholm J, Gillquist J. Evaluation of knee ligament surgery results with special emphasis on use of a scoring scale. Am J Sports Med. 1982 May-Jun;10(3):150-4.[pubmed]
25. Tegner Y, Lysholm J. Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res. 1985 Sep;(198):43-9.[pubmed]
26. Noyes FR, Barber SD, Mooar LA. A rationale for assessing sports activity levels and limitations in knee disorders. Clin Orthop Relat Res. 1989 Sep;(246):238-49.[pubmed]
27. Daisuke Araki, Ryosuke Kuroda, Seiji Kubo, Norifumi Fujita, Katsumasa Tei, Koji Nishimoto, Yuichi Hoshino, Takehiko Matsushita, Tomoyuki Matsumoto, Koki Nag.amune, Masahiro Kurosaka. A prospective randomised study of anatomical single- bundle versus double-bundle anterior cruciate ligament reconstruction: quantitative evaluation using an electromagnetic measurement system, International Orthopaedics (SICOT, 2011) March 2011, Volume 35, Issue 3, pp 439–446.
28. Gobbi A Tuy B, Mahajan S, Panuncialman I.Quadrupled bone-semitendinosus anterior cruciate ligament reconstruction: a clinical investigation in a group of athletes. Arthroscopy. 2003 Sep;19(7):691-9, Volume 19, Issue 7, September 2003, Pages 691-699, doi.org/10.1016/S0749-8063(03)00685-6.[pubmed]
29. Eun Kyoo Song, Luke S. Oh, Thomas J. Gill, Guoan Li, Hemanth R. Gadikota and Jong Keun Seon Prospective Comparative Study of Anterior Cruciate Ligament Reconstruction Using the Double-Bundle and Single-Bundle Techniques Am J Sports Med 2009 37:1705. Volume: 37 issue: 9, page(s): 1705-1711.
30. Adachi N, Ochi M, Uchio Y, Iwasa J, Kuriwaka M, Ito Y. Reconstruction of the anterior cruciate ligament: single- versus double-bundle multistranded hamstring tendons, The Bone & Joint Journal 86(4):515-20 · June 2004,DOI: 10.1302/0301-620X.86B4.14856.[pubmed]
31. Biomechanical comparisons of knee stability after anterior cruciate ligament reconstruction between 2 clinically available transtibial procedures: anatomic double bundle versus single bundle Am J Sports Med. 2010 Jul;38(7):1349-58. doi: 10.1177/0363546510361234.[pubmed]
32. Siebold R, Dehler C, Ellert T. Prospective randomized comparison of double-bundle versus single-bundle anterior cruciate ligament reconstruction. Arthroscopy. 2008;24:137–145.[pubmed]
33. Van Eck CF, Lesniak BP, Schreiber VM, Fu FH. Anatomic single- and double-bundle anterior cruciate ligament reconstruction flowchart. Arthroscopy.2010;26:258–268, Clin Orthop Relat Res. 2013 Feb; 471(2): 363–367, Published online 2012 Dec 14. doi: 10.1007/s11999-012-2737-1.[pubmed]
34. Adachi N, Ochi M, Uchio Y, Iwasa J, Kuriwaka M, Ito Y. Reconstruction of the anterior cruciate ligament: single- versus double-bundle multistranded hamstring tendons. J Bone Joint Surg Br. 2004 May;86(4):515-20.[pubmed]
35. Kanaya A, Ochi M, Deie M, Adachi N, Nishimori M, Nakamae A. Intraoperative evaluation of anteroposterior and rotational stabilities in anterior cruciate ligament reconstruction: lower femoral tunnel placed single-bundle versus double-bundle reconstruction. Knee Surg Sports Traumatol Arthrosc, Clin Orthop Relat Res. 2012 Mar; 470(3): 824–834, Published online 2011 Jun 11. doi: 10.1007/s11999-011-1940-9.[pubmed]
36. R. Siebold, T. P. Branch, H. I. Freedberg, C. A. Jacobs. A matched pairs comparison of single- versus double-bundle anterior cruciate ligament reconstructions, clinical results and manual laxity testing Knee Surg Sports Traumatol Arthroscopy, December 2011, Volume 19, Supplement 1, pp 4–11, doi.org/10.1007/s00167-011-1475-3.
37. Eiji Kondo, Kazunori Yasuda, Hirotaka Azuma, Yoshie Tanabe and Tomonori Yagi Prospective Clinical Comparisons of Anatomic Double-Bundle Versus Single-Bundle Anterior Cruciate Ligament Reconstruction Procedures in 328 Consecutive Patients. Am J Sports Med 2008,36:1675. Volume:36 issue: 9, page(s): 1675-1687, doi.org/10.1177/0363546508317123
38. Takeshi Muneta, Koga H, Morito T, Yagishita K, Sekiya I.. Retrospective Study of the Midterm Outcome of Two Bundle Anterior Cruciate Ligament Reconstruction Using Quadrupled Semitendinosus Tendon in Comparison With One-Bundle Reconstruction. Arthroscopy. 2006 Mar; 22(3): 252- 8. Volume 22, Issue 3, March 2006, Pages 252-258, doi.org/10.1016/j.arthro.2005.12.008.[pubmed]
CITATION
DOI: 10.17511/ijoso.2019.i01.06
Published: 2019-03-31
How to Cite
Thakur, R., Samal, N., Gawande, V., & Kochhal, N. (2019). Clinical and functional evaluation of anterior cruciate ligament tears after anterior cruciate ligament reconstruction. Surgical Review: International Journal of Surgery, Trauma and Orthopedics, 5(1), 33-40. https://doi.org/10.17511/ijoso.2019.i01.06
Section
Original Article
OAI - Open Archives Initiative
Therapoid
