Unrepaired lateral meniscus tears lead to remaining pivot-shift in ACL-reconstructed knees View Full Text


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Article Info

DATE

2020-04-23

AUTHORS

Yuichi Hoshino, Yuji Hiroshima, Nobuaki Miyaji, Kanto Nagai, Daisuke Araki, Noriyuki Kanzaki, Kenichiro Kakutani, Takehiko Matsushita, Ryosuke Kuroda

ABSTRACT

PurposeTo compare the postoperative rotatory knee laxity between ACL-reconstructed knees with different meniscus treatments using an electromagnetic pivot-shift measurement.MethodsForty-six patients with unilateral ACL reconstructions were enrolled (21 males/25 females, 25 ± 12 y.o.). Concomitant meniscus tears, if any, were repaired whenever possible during primary ACL reconstruction. At 1 year postoperatively, pivot-shift test was performed under anaesthesia during screw removal surgery and quantitatively evaluated by tibial acceleration using an electromagnetic system. The acceleration was compared between ACL-reconstructed knees with different meniscal treatments: intact, repaired and unrepaired.ResultsA concomitant meniscus tear was found in 28 knees preoperatively: lateral tears in 11 knees, medial tears in 11 knees and both medial and lateral tears in 6 knees. Postoperatively, 19 ACL-reconstructed knees had a repaired meniscus for either medial, lateral or bilateral menisci tears, and 18 knees had intact menisci pre- and post-operatively. Meanwhile, nine lateral meniscus tears were irreparable and treated by partial meniscectomy or left in situ. ACL-reconstructed knees with unrepaired lateral menisci had significantly larger pivot-shift acceleration (0.9 ± 0.7 m/s2) than those with intact menisci (0.5 ± 0.2 m/s2, p < 0.05), whereas rotatory knee laxity was similar between the knees with fully repaired menisci (0.6 ± 0.3 m/s2) and intact menisci (n.s.).ConclusionAn unrepaired lateral meniscus tear in an ACL-reconstructed knee could lead to remaining pivot-shift postoperatively. A concomitant meniscus tear should be repaired during ACL reconstruction to restore normal rotational laxity.Level of evidenceTherapeutic Study, Level III. More... »

PAGES

3504-3510

References to SciGraph publications

  • 2018-10-11. The concomitant lateral meniscus injury increased the pivot shift in the anterior cruciate ligament-injured knee in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • 2010-08-24. A prospective randomised study of anatomical single-bundle versus double-bundle anterior cruciate ligament reconstruction: quantitative evaluation using an electromagnetic measurement system in INTERNATIONAL ORTHOPAEDICS
  • 2014-11-15. The influence of the medial meniscus in different conditions on anterior tibial translation in the anterior cruciate deficient knee in INTERNATIONAL ORTHOPAEDICS
  • 1998-04. Use of the International Knee Documentation Committee guidelines to assess outcome following anterior cruciate ligament reconstruction in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • 2011-12-29. Standardized pivot shift test improves measurement accuracy in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • 2016-07-01. Does meniscus removal affect ACL-deficient knee laxity? An in vivo study in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • 2015-09-05. Quantitative comparison of the pivot shift test results before and after anterior cruciate ligament reconstruction by using the three-dimensional electromagnetic measurement system in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • 2013-12-17. Anatomic single- versus double-bundle ACL reconstruction: a meta-analysis in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • 2019-06-27. Ramp lesions of the medial meniscus are associated with a higher grade of dynamic rotatory laxity in ACL-injured patients in comparison to patients with an isolated injury in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s00167-020-06007-3

    DOI

    http://dx.doi.org/10.1007/s00167-020-06007-3

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1126917092

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/32328696


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    31 schema:datePublishedReg 2020-04-23
    32 schema:description PurposeTo compare the postoperative rotatory knee laxity between ACL-reconstructed knees with different meniscus treatments using an electromagnetic pivot-shift measurement.MethodsForty-six patients with unilateral ACL reconstructions were enrolled (21 males/25 females, 25 ± 12 y.o.). Concomitant meniscus tears, if any, were repaired whenever possible during primary ACL reconstruction. At 1 year postoperatively, pivot-shift test was performed under anaesthesia during screw removal surgery and quantitatively evaluated by tibial acceleration using an electromagnetic system. The acceleration was compared between ACL-reconstructed knees with different meniscal treatments: intact, repaired and unrepaired.ResultsA concomitant meniscus tear was found in 28 knees preoperatively: lateral tears in 11 knees, medial tears in 11 knees and both medial and lateral tears in 6 knees. Postoperatively, 19 ACL-reconstructed knees had a repaired meniscus for either medial, lateral or bilateral menisci tears, and 18 knees had intact menisci pre- and post-operatively. Meanwhile, nine lateral meniscus tears were irreparable and treated by partial meniscectomy or left in situ. ACL-reconstructed knees with unrepaired lateral menisci had significantly larger pivot-shift acceleration (0.9 ± 0.7 m/s2) than those with intact menisci (0.5 ± 0.2 m/s2, p < 0.05), whereas rotatory knee laxity was similar between the knees with fully repaired menisci (0.6 ± 0.3 m/s2) and intact menisci (n.s.).ConclusionAn unrepaired lateral meniscus tear in an ACL-reconstructed knee could lead to remaining pivot-shift postoperatively. A concomitant meniscus tear should be repaired during ACL reconstruction to restore normal rotational laxity.Level of evidenceTherapeutic Study, Level III.
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    40 ACL reconstruction
    41 ACL-reconstructed knees
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    46 acceleration
    47 anesthesia
    48 bilateral menisci tears
    49 concomitant meniscus
    50 concomitant meniscus tear
    51 different meniscal treatments
    52 different meniscus treatments
    53 electromagnetic pivot-shift measurement
    54 electromagnetic system
    55 evidenceTherapeutic study
    56 intact meniscus
    57 knee
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    59 larger pivot-shift acceleration
    60 lateral meniscus
    61 lateral meniscus tears
    62 lateral tears
    63 laxity
    64 level III
    65 levels
    66 measurements
    67 medial tears
    68 meniscal treatment
    69 meniscectomy
    70 meniscus
    71 meniscus tears
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    73 normal rotational laxity
    74 partial meniscectomy
    75 patients
    76 pivot shift test
    77 pivot-shift acceleration
    78 pivot-shift measurement
    79 postoperative rotatory knee laxity
    80 primary ACL reconstruction
    81 reconstruction
    82 removal surgery
    83 rotational laxity
    84 rotatory knee laxity
    85 screw removal surgery
    86 situ
    87 study
    88 surgery
    89 system
    90 tears
    91 test
    92 tibial acceleration
    93 treatment
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    96 years
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