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An extra-articular procedure improves the clinical outcome in anterior cruciate ligament reconstruction with hamstrings in female athletes

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Abstract

Purpose

A positive glide is a common finding after ACL reconstructions, especially in women. The aim of this study was to prospectively evaluate the role of Cocker-Arnold’s extra-articular procedure in reducing the incidence of a residual postoperative rotational knee laxity.

Methods

Sixty patients affected by an ACL injury with a +2 (clunk) or +3 (gross shift) pivot-shift test entered this prospective study; they were randomly assigned to group A (control group, hamstrings) or group B (study group, hamstrings plus Cocker-Arnold). Thirty-two patients entered group A and 28 group B. At follow-up, patients underwent clinical evaluation, KT-1000 arthrometer and Lysholm, Tegner, VAS and subjective and objective IKDC form.

Results

At a mean follow-up of 44.6 months, the same expert surgeon reviewed 55 patients (28 group A and 27 group B). The comparison of the results of the evaluation scales used and of the KT-1000 arthrometer did not show statistically significant differences (p > 0.05). Lachman test was negative (S/S) in all the patients of both groups (100 %). A residual positive pivot-shift (glide) was found in 16 patients (57.1 %) of group A and in five patients (18.6 %) of group B (p < 0.05).

Conclusions

The extra-articular MacIntosh procedure modified by Cocker-Arnold in combination with ACL reconstruction significantly reduces the rotational instability of the knee.

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Acknowledgement

We would like to acknowledge Dr. Gianluca Mastrantonio for the statistical analysis and Mrs. Angela Mitchell for the technical support in performing the study.

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Authors and Affiliations

  1. Orthopaedic Unit and “Kirk Kilgour” Sports Injury Centre, S. Andrea Hospital, University of Rome “La Sapienza”, Via Grottarossa 1035, Rome (RM), Italy

    Antonio Pasquale Vadalà, Raffaele Iorio, Angelo De Carli, Alberto Bonifazi, Carlo Iorio, Andrea Gatti, Cristina Rossi & Andrea Ferretti

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  1. Antonio Pasquale Vadalà
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  2. Raffaele Iorio
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  3. Angelo De Carli
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  4. Alberto Bonifazi
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  5. Carlo Iorio
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  6. Andrea Gatti
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  7. Cristina Rossi
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  8. Andrea Ferretti
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Correspondence to Antonio Pasquale Vadalà.

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Vadalà, A.P., Iorio, R., De Carli, A. et al. An extra-articular procedure improves the clinical outcome in anterior cruciate ligament reconstruction with hamstrings in female athletes. International Orthopaedics (SICOT) 37, 187–192 (2013). https://doi.org/10.1007/s00264-012-1571-0

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  • DOI: https://doi.org/10.1007/s00264-012-1571-0

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