gms | German Medical Science

68. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie
90. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie
45. Tagung des Berufsverbandes der Fachärzte für Orthopädie in Zusammenarbeit mit dem Deutschen Verband für Physiotherapie – Zentralverband der Physiotherapeuten/Krankengymnasten

19. bis 23.10.2004, Berlin

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Evaluation of Antero-Posterior and Rotatory Instability after ACL Reconstruction: a Comparison of Modified Over-the-top Method and Bone Tunnel Method

Meeting Abstract (DGOOC 2004)

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  • presenting/speaker H. Takagi - Showa Univ. Fujigaoka Hospital, Department of Orthopaedic Surgery, Yokohama
  • Y. Mori - Showa Univ. Fujigaoka Hospital, Department of Orthopaedic Surgery, Yokohama
  • A. Fujimoto - Showa Univ. Fujigaoka Rehabilitation Hospital, Department of Orthopaedic Surgery, Yokohama
  • H. Yamashita - Showa Univ. Fujigaoka Rehabilitation Hospital, Department of Orthopaedic Surgery, Yokohama

Deutsche Gesellschaft für Unfallchirurgie. Deutsche Gesellschaft für Orthopädie und orthopädische Chirurgie. Berufsverband der Fachärzte für Orthopädie. 68. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie, 90. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie und 45. Tagung des Berufsverbandes der Fachärzte für Orthopädie. Berlin, 19.-23.10.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04dguE10-1056

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgu2004/04dgu0289.shtml

Published: October 19, 2004

© 2004 Takagi et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Introduction

The purpose of this study is to evaluate antero-posterior (AP) and rotatory instability after ACL reconstruction using the patella tendon and to compare the modified over-the-top method (OT) with the bone tunnel method (BT).

Methods

The OT method or the BT method by inside-out was performed for unilateral ACL injury in 39 patients (OT: 20, BT: 19). Orthopeadic System's knee motion analyzer (CA4000) was used to measure the following items. The total displacement (TD) was measured during the shift from anterior drawing under a weight of 30lbs to posterior drawing under a weight of 20lbs at 20 degrees of flexion. Rotatory instability was sized dynamically by the pivot shift test. This curve was then qualitatively analyzed, and the anterior displacement of the tibia (PS) was measured.

Results

In the OT group, 5 cases showed below -3mm of side-to-side difference in TD. Thirteen cases of the OT group and 9 cases of the BT group showed no instability. In the cases with knee instability, we classified the patients into 3 types: Type A- Cases with both AP and rotatory instability; Type B-Cases with only rotatory instability; and Type C-Cases with only AP instability.

Conclusions

The results of TD suggest that cases in the OT group showed a tendency towards excessive AP stiffness of the knee. Cases with rotatory instability in spite of good AP stability were more common in the BT group. This finding suggests that the difference of the graft position of the femoral side had an influence on rotatory instability.