Posterior tibial slope, notch width index and tibial tubercle to trochlear groove distance contribute to development of mucoid degeneration of the anterior cruciate ligament: a systematic review

Vivekanantha, Prushoth; Diao, Yi David; Cohen, Dan; Abouali, Jihad; Hantouly, Ashraf T.; de, Darren

doi:10.1007/s00167-023-07435-7

Cited by 5 publications

(5 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Only one study demonstrated a relationship between r m and PCL rupture. PTS has been investigated thoroughly concerning its role as a risk factor for a variety of pathological conditions of the knee, including primary and secondary ACL tears as well as mucoid degeneration of the ACL [28,29]. There is a lack of consensus surrounding normal and pathological values for PTS.…”

Section: Discussionmentioning

confidence: 99%

Decreased posterior tibial slope is a risk factor for primary posterior cruciate ligament rupture and posterior cruciate ligament reconstruction failure: A systematic review

Nedaie,

Vivekanantha,

O'Hara

et al. 2024

Knee surg. sports traumatol. arthrosc.

Self Cite

View full text Add to dashboard Cite

PurposeTo determine bony knee morphological factors associated with primary posterior cruciate ligament (PCL) rupture or PCL graft failure after PCL reconstruction.MethodsThree databases, namely MEDLINE, PubMed and EMBASE, were searched on 30th May 2023. The authors adhered to the PRISMA and R‐AMSTAR guidelines as well as the Cochrane Handbook for Systematic Reviews of Interventions. Data such as receiver operating characteristic curve parameters, as well as p‐values for comparisons of values between patients with PCL pathology and control patients, were recorded.ResultsNine studies comprising 1054 patients were included. Four studies reported that patients with PCL injury had flatter medial posterior tibial slopes (MTS) than controls, with mean values of 4.3 (range: 3.0–7.0) and 6.5 (range: 5.0–9.2) degrees, respectively. Two studies reported an MTS cutoff value ranging below 3.90–3.93° being a significant risk factor for primary PCL rupture or PCL graft failure. Two studies reported that shallow medial tibial depths were associated with primary PCL rupture, with mean values of 2.1 (range: 2.0–2.2) and 2.6 (range: 2.4–2.7) mm in PCL injury and control groups, respectively. Stenotic intercondylar notches and femoral condylar width were not consistently associated with PCL injuries.ConclusionDecreased MTS is associated with primary PCL rupture and graft failure after PCL reconstruction with values below 3.93° being considered as a significant risk factor. Less common risk factors include shallow medial tibial depth, while femoral condylar width and parameters with regards to the intercondylar notch, such as notch width, notch width index and intercondylar notch volume, demonstrated conflicting associations with primary or secondary PCL injuries.Level of EvidenceLevel III.

show abstract

Section: Discussionmentioning

confidence: 99%

Decreased posterior tibial slope is a risk factor for primary posterior cruciate ligament rupture and posterior cruciate ligament reconstruction failure: A systematic review

Nedaie,

Vivekanantha,

O'Hara

et al. 2024

Knee surg. sports traumatol. arthrosc.

Self Cite

View full text Add to dashboard Cite

show abstract

“…They had retrospectively studied 11 knees that underwent total excision of mucoid-degenerated ACL and noted that 10 knees had medial compartment arthritis and eight had a medial meniscus tear [ 12 ]. Many other bony factors are also implicated in the pathogenesis of the mucoid ACL, such as increased posterior slope, decreased notch width index, increased tibial tuberosity-trochlear groove distance, and trochlear dysplasia [ 20 ]. However, we have not assessed any of those bony factors as several MRIs were not performed in our hospital, limiting the analysis.…”

Section: Discussionmentioning

confidence: 99%

Reconstruction Considerations Following Complete Excision of Mucoid-Degenerated Anterior Cruciate Ligament: A Retrospective Study

Aier,

Das,

Nayak

et al. 2024

Cureus

View full text Add to dashboard Cite

Introduction: Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is an unusual cause of knee pain and restricted movement, predominantly affecting the middle-aged population. Arthroscopic partial or total debridement of the mucoid ACL is the surgical treatment of choice. However, little is discussed in the literature regarding subsequent knee instability and functional outcomes following complete ACL excision. Methods: A retrospective study was conducted on patients who underwent arthroscopic total ACL excision for mucoid ACL. Pre- and post-operatively, the Tegner-Lysholm score, the International Knee Documentation Committee (IKDC) Subjective Knee Form, and subjective functional instability were used to grade the clinical outcomes. Results: Ten out of the 13 patients who underwent complete ACL excision were available for evaluation. All patients presented with knee pain on deep flexion or extension with a painfully limited range of motion. Post-operatively, all patients were relieved of their original pain and dysfunction. The mean post-operative IKDC and Tegner-Lysholm scores were 74.96 and 83.6, respectively. All patients had a Lachman test positive, while only two had a grade 1 pivot shift test positive. Two patients had occasional functional instability only after strenuous exercises. None of the patients underwent subsequent ACL reconstruction. Conclusion: All patients reported improved functional outcomes. Only two out of 10 reported occasional instability during strenuous activity. Therefore, complete debridement of mucoid ACL in sedentary patients is safe and efficacious. However, active young patients may experience instability and require ACL reconstruction if it hinders their daily activities.

show abstract

“…According to these established criteria, comparative studies can receive a maximum of 24 [33]. The quality of comparative studies was classified as follows: 0-6 very low quality, 7-10 low quality, 11-15 fair quality, 16-20 good quality and ≥ 20 high quality [38]. The quality of randomised control trials (RCTs) was assessed using the Detsky Quality Assessment Scale [9].…”

Section: Quality Assessmentmentioning

confidence: 99%

Contralateral hamstring autografts do not provide benefit compared to ipsilateral hamstring autografts in primary or revision anterior cruciate ligament reconstruction: a systematic review

Vivekanantha,

Nedaie,

Hassan

et al. 2023

Knee surg. sports traumatol. arthrosc.

Self Cite

View full text Add to dashboard Cite

Purpose To evaluate the clinical outcomes of primary or revision ACL reconstruction (ACLR) after contralateral hamstring autografts versus ipsilateral hamstring autograft harvest. Methods Three databases (MEDLINE, PubMed and EMBASE) were searched from inception to April 27th, 2023 for studies investigating contralateral hamstring autografts in primary or revision ACLR. The authors adhered to the PRISMA and R-AMSTAR guidelines as well as the Cochrane Handbook for Systematic Reviews of Interventions. Data on demographics, strength measures, patient-reported outcome measures (PROMs), and rates of positive Lachman test, positive pivot-shift test and graft rupture were extracted. PROMs included Lysholm, International Knee Documentation Committee (IKDC) and Tegner scores. Results Nine studies comprising 371 patients were included in this review. In primary ACLR, there were no significant differences between contralateral and ipsilateral groups in isokinetic hamstring torque in the non-ACLR limb or isokinetic quadriceps torque in both limbs when tested at 60, 90, 120 or 180 degrees/second. Isokinetic hamstring torque in the non-ACLR limb was significantly weaker in the contralateral group at six months for primary ACLR; however, these deficits did not persist. There were no significant differences in postoperative median Tegner scores and Lysholm scores between contralateral and ipsilateral groups in primary ACLR. There were no significant differences in postoperative median Tegner, mean Lysholm and IKDC scores between groups in revision ACLR. There were no significant differences in positive Lachman, positive pivot-shift and rupture rates in primary ACLR between groups. Rates of positive Lachman and pivot-shift were slightly higher in the contralateral than ipsilateral group for revision ACLR. Conclusion Contralateral hamstring autografts results in comparable muscle strength to ipsilateral hamstring autografts, with the exception of weaker hamstring strengths in the early postoperative period. Patient-reported outcome measures were similar between the two groups across both primary and revision ACLR, with rates of instability and failure being similar between groups for primary ACLR. Contralateral hamstring grafts do not provide additional benefit when compared to ipsilateral options for either primary or revision ACLR, and should be used only in select circumstances including insufficient ipsilateral hamstring grafts or situations where quadriceps or patella autografts are not optimal. Level of evidence Level IV.

show abstract

Posterior tibial slope, notch width index and tibial tubercle to trochlear groove distance contribute to development of mucoid degeneration of the anterior cruciate ligament: a systematic review

Cited by 5 publications

References 37 publications

Decreased posterior tibial slope is a risk factor for primary posterior cruciate ligament rupture and posterior cruciate ligament reconstruction failure: A systematic review

Decreased posterior tibial slope is a risk factor for primary posterior cruciate ligament rupture and posterior cruciate ligament reconstruction failure: A systematic review

Reconstruction Considerations Following Complete Excision of Mucoid-Degenerated Anterior Cruciate Ligament: A Retrospective Study

Contralateral hamstring autografts do not provide benefit compared to ipsilateral hamstring autografts in primary or revision anterior cruciate ligament reconstruction: a systematic review

Contact Info

Product

Resources

About