2023 ISAKOS Biennial Congress ePoster
Isolated Anatomic Reconstruction of Anterior Cruciate Ligament in Sportsmen with High Pivot Shift Grade: Is it Enough for Rotational Stability?
Mohamed Amine Gharbi , MD, Tunis TUNISIA
Moatassem Belleh Jelassi, MD TUNISIA
Houssem Eddine Chahed, MD TUNISIA
Ahmed Zendeoui, MD, Tunis, Tunis TUNISIA
Anis Tebourbi, MD, Tunis TUNISIA
Ramzi Bouzidi, PhD, La Marsa, Tunis TUNISIA
Khelil Ezzaouia, PhD, La Marsa, Tunis TUNISIA
Mouadh Nefiss, MD, La Marsa,Tunis TUNISIA
Mongi Slim Marsa University Hospital Center, Tunis, Tunis, TUNISIA
FDA Status Not Applicable
Summary
Isolated anatomic reconstruction after acute ACL injury may allow a reliable control of anteroposterior as well as rotational stability of the knee with satisfying functional results in amateur sportsmen with high pivot shift grade.
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Abstract
Background
Rotational instability of the knee remains an issue after anterior cruciate ligament (ACL) reconstruction. In fact, the association of antero-lateral ligament reconstruction seems to yield to better outcomes in patients with high grade pivot shift, however it remains a topic of discussion.
Objective
Our aim was to evaluate functional outcomes as well as clinical residual laxity after isolated anatomic ACL reconstruction in amateur sportsmen with high grade pivot shift.
Methods
Our retrospective study included 74 non-professional athletic patients participating in pivoting sports with at least grade II pivot shift who have had primary anatomic single-bundle reconstruction with hamstrings tendon graft for isolated acute ACL injury with minimum follow-up of two years.
Results
The mean time between injury and surgery was 4 months. At the last follow-up, 5% of our patients still have anterior residual laxity at the Lachman Test and 8% still have positive pivot shift (4 patients Grade I and 2 patients Grade II). Mean Lysholm-Tegner score was 70.6 ± 5.2 before the surgery and 92.3 ± 4.7 after the surgery. The mean IKDC score was 61.2 ± 4.3 before the surgery and 95.3 ± 2.4 after the surgery. 72% of patients have returned to their athletic activity with mean time interval of 8 months. Only shorter time interval between trauma and surgery was statistically associated to a better functional result.
Conclusion
Isolated anatomic ACL reconstruction was found to be effective in improving outcomes and allows a reliable control of anteroposterior as well as rotatory stability of the knee with satisfying functional results in amateur sportsmen with high pivot shift grade. Furthermore, additional reconstruction with anterolateral ligament maybe not mandatory, however reduction of the time interval between trauma and surgery is recommended for a better result.