Generalized Hypermobility, Knee Hyperextension, and Outcomes After Anterior Cruciate Ligament Reconstruction: Prospective, Case-Control Study With Mean 6 Years Follow-up

Larson, Christopher M.; Bedi, Asheesh; Dietrich, Mark E.; Swaringen, Jennifer C.; Wulf, Corey A.; Rowley, David M.; Giveans, M. Russell

doi:10.1016/j.arthro.2017.04.012

Cited by 68 publications

(93 citation statements)

References 15 publications

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“…Patients undergoing ACLR, who have ligamentous hyperlaxity, are reported to have worse functional outcomes, greater postoperative residual instability, and higher failure rates 19,20 . Larson et al demonstrated that almost one third of patients undergoing ACLR with a diagnosis of hyperlaxity experienced graft rupture, contralateral ACL rupture, or excessive laxity.…”

Section: Allr Is Associated With Significantly Improved Knee Stabilitmentioning

confidence: 99%

Clinical Results of Combined ACL and Anterolateral Ligament Reconstruction: A Narrative Review from the SANTI Study Group

et al. 2020

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Lateral extraarticular procedures (LEAPs) in the anterior cruciate ligament (ACL)-injured knee were widely abandoned in the 1990s but have seen a recent resurgence. The aim of this review was to demonstrate that anterolateral ligament reconstruction (ALLR) is associated with evidence of significant advantages and no evidence of historical concerns. A narrative review of the literature was performed. Combined ACL + ALLR is associated with improved outcomes when compared against isolated ACL reconstruction, including a significantly lower risk of ACL graft rupture (hazard ratio [HR]: 0.327, 95% CI: 0.130–0.758), a significantly lower risk of reoperation for secondary meniscectomy following medial meniscal repair at the time of ACL reconstruction (HR: 0.443, 95% CI: 0.218–0.866), significantly increased likelihood of return to the preinjury level of sport following primary (odds ratio [OR]: 1.938, 95% CI: 1.174–3.224) and revision ACL reconstruction (57.1 vs. 25.6%, respectively; p = 0.008), and in chronic ACL injuries, less residual pivot shift (9.1 vs. 35.3%, p = 0.011), and better IKDC (92.7 ± 5.9 vs. 87.1 ± 9.0, p = 0.0013) and Lysholm (95.4 ± 5.3 vs. 90.0 ± 7.1, p < 0.0001) scores, and no evidence of historical concerns. Combined ACLR + ALLR is associated with excellent clinical outcomes with no evidence of the adverse events that led to the historical widespread abandonment of other types of LEAP. Specifically, comparative series have demonstrated significant advantages of ALLR when compared against isolated ACLR with respect to reduced rates of ACL graft rupture, secondary meniscectomy, persistent instability, and significantly improved functional outcomes and improved return to sport metrics.

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Section: Allr Is Associated With Significantly Improved Knee Stabilitmentioning

confidence: 99%

Clinical Results of Combined ACL and Anterolateral Ligament Reconstruction: A Narrative Review from the SANTI Study Group

et al. 2020

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“…Actually, most studies arbitrarily chose cut-off values4 9 12 or used 10° of hyperextension10 11 27 according to the Beighton scale,28 resulting in heterogenous definitions. Furthermore, the measurement methods varied among the literature: a goniometer,9 12 13 heel height from the table13 and a lateral radiograph of the knee 11. In the present study, maximum active knee extension angle during walking was determined by using a highly accurate biplane radiography system (accuracy of 0.9±0.3° for flexion–extension21).…”

Section: Discussionmentioning

confidence: 96%

“…Recently, Larson et al 13 have shown that heel height greater than 5 cm, as a measure of knee hyperextension, was an independent predictor of ACL failure. In contrast, others reported no significant relationship between knee hyperextension and clinical outcomes,9 11 12 supporting the findings of the present study.…”

Section: Discussionmentioning

confidence: 99%

Patient-reported outcome measures following anterior cruciate ligament reconstruction are not related to dynamic knee extension angle

et al. 2018

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“…technique was used in three of 27 studies (two of these studies used the single-incision, transtibial technique in addition to the two-incision technique in their patients). 60,64,76 After 2010, two of four papers described a single-incision with anteromedial portal approach, 80,81 and one of four papers described a transportal retrograde drilling technique, or an "all inside" technique. 83 These results are summarized in ►Table 3, and further information on tunnel location is described in ►Table 4.…”

Section: The Journal Of Knee Surgerymentioning

confidence: 99%

“…11,13,15 In the 1990s, 18 of the 32 studies used BPTB autograft, 21,22,[24][25][26][27][28][29][32][33][34][38][39][40]44,[49][50][51] 14 of 32 studies used hamstring autograft, 28,[30][31][32]35,[37][38][39]42,43,47,48 and eight of 32 studies used BPTB allograft. 26,27,33,36,44,[49][50][51] From 2000 to 2009, 17 of 27 studies used a hamstring autograft, 53-55,57-59,61,63-65,67,68,72,74-76, 79 10 of 27 studies used a BPTB autograft, 53,[55][56][57]60,64,[66][67]…”

Section: Acl Graftsmentioning

confidence: 99%

Journey around the Notch: A Systematic Review on the History of ACL Reconstruction in the United States

et al. 2020

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The evolution of anterior cruciate ligament (ACL) surgery, seemingly circular at times, informs and provides context for past and current controversies in ACL management. The purpose of this systematic review is to objectively summarize the historical course of ACL reconstruction and repair in the United States over the last 40 years. Femoral tunnel drilling and graft selection have evolved dramatically over the last few decades. An initial focus on restoring ACL anatomy was for a period sacrificed for decreased operative morbidity. However, recent developments in operative techniques aim to restore ACL anatomy while also achieving minimal operative morbidity. Despite this historically iterative process, there remains no perfect choice for the treatment of ACL tears. Continued research on ACL repair, anatomic graft placement, graft choice, and augmentation will help our patients over the next generation.

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Generalized Hypermobility, Knee Hyperextension, and Outcomes After Anterior Cruciate Ligament Reconstruction: Prospective, Case-Control Study With Mean 6 Years Follow-up

Cited by 68 publications

References 15 publications

Clinical Results of Combined ACL and Anterolateral Ligament Reconstruction: A Narrative Review from the SANTI Study Group

Clinical Results of Combined ACL and Anterolateral Ligament Reconstruction: A Narrative Review from the SANTI Study Group

Patient-reported outcome measures following anterior cruciate ligament reconstruction are not related to dynamic knee extension angle

Journey around the Notch: A Systematic Review on the History of ACL Reconstruction in the United States

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