Article
Instrumented measurement of rotational knee laxity after primary anterior cruciate ligament rupture versus rerupture – A comparative study
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Authors
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Hermann O. Mayr
- Klinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Freiburg, Freiburg, Germany
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Georg Hellbruegge
- Zentrum für Knie-, Hüft- und Schulterchirurgie, Schön Klinik München Harlaching, München, Germany
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Florian Haasters
- Zentrum für Knie-, Hüft- und Schulterchirurgie, Schön Klinik München Harlaching, München, Germany
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Bastian Ipach
- Zentrum für Knie-, Hüft- und Schulterchirurgie, Schön Klinik München Harlaching, München, Germany
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Julian Fürmetz
- Klinik für Allgemeine, Unfall- & Wiederherstellungschirurgie, Klinikum der LMU München, München, Germany
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Anke Bernstein
- Klinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Freiburg, Freiburg, Germany
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Hagen Schmal
- Klinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Freiburg, Freiburg, Germany
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Wolf Christian Prall
- Zentrum für Knie-, Hüft- und Schulterchirurgie, Schön Klinik München Harlaching, München, Germany
| Published: | October 26, 2021 |
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Outline
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Objectives: The aim of the current study was to objectify the rotational laxity after primary anterior cruciate ligament (ACL) rupture and recurrent instability secondary to ACL reconstruction. It is hypothesized that knees with recurrent instability feature a higher internal rotation laxity compared to knees with a primary rupture of the native ACL.
Methods: In a clinical comparative study of successive patients with primary ACL rupture and rerupture after ACL reconstruction were evaluated clinically and by instrumented measurement of the rotational and antero-posterior laxity with the Laxitester® and the KT1000®, respectively. In addition, the examination comprised IKDC 2000 forms, Lysholm Score, and Tegner Activity Scale. Power calculation and statistical analysis were performed (p-value <0.05).
Results and Conclusion: Twenty-four patients with primary ACL rupture and 23 patients with rerupture after ACL reconstruction were included. There was no significant side-to-side difference in anterior translation.In contrast, a significant side-to-side difference of the internal rotation laxity was found with a mean of 8.7 ±8.6° in patients with ACL rerupture compared to 3.6 ±4.5° in patients with primary ACL rupture (p=0.014). A side-to side difference of internal rotational laxity ≥10° was found significantly more frequent in re-ruptures (53.6%) compared to primary ruptures (19.4%; p<0.001). A highly significant relationship between the extent of the pivot-shift phenomenon and side-to-side difference of internal rotation laxity could be demonstrated (p<0.001). IKDC 2000 subjective revealed significantly better scores in patients with primary ACL tear compared to patients with ACL rerupture (56.4 ±7.8 vs. 50.8 ±6.2; p=0.01). Patients with primary ACL tears scored significantly better on the Tegner Activity Scale (p=0.02). No significant differences were seen in the Lysholm Score (p=0.78).
Patients with ACL rerupture feature significantly higher internal rotation laxity of the knee compared to primary ACL rupture. The extend of rotational laxity can precisely be quantified by instrumented measurements. This can be an aid for the indication of an anterolateral ligament graft in revision surgery of the ACL.
