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

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  • 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:datePublished 2020-04-23
    32 schema:datePublishedReg 2020-04-23
    33 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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    46 anesthesia
    47 concomitant meniscus
    48 concomitant meniscus tear
    49 electromagnetic system
    50 evidenceTherapeutic study
    51 intact meniscus
    52 knee
    53 knee laxity
    54 lateral meniscus
    55 lateral meniscus tears
    56 lateral tears
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    58 level III
    59 levels
    60 measurements
    61 medial tears
    62 meniscal treatment
    63 meniscectomy
    64 meniscus
    65 meniscus tears
    66 meniscus treatment
    67 partial meniscectomy
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    69 pivot shift test
    70 primary ACL reconstruction
    71 reconstruction
    72 removal surgery
    73 rotational laxity
    74 rotatory knee laxity
    75 situ
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