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Evaluation of the short-term outcomes of anatomic ACL reconstruction with hamstring autograft in patients with generalized joint laxity: A retrospective case–control study

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Abstract

Purpose

The outcomes of anterior cruciate ligament reconstruction (ACLR) in patients with generalized joint laxity (GJL) are not clearly understood. In this study, we compared the outcomes of ACLR with quadruple hamstring autograft between GJL and non-GJL patients.

Methods

In a retrospective case–control study, 36 patients with GJL, according to the Beighton and Horan Joint Mobility Index, who underwent ACLR surgery, were included. Forty-four group-matched non-GJL patients were included in the control group. The mean follow-up of the patients was 20.65 ± 6.93‏ months. The outcomes of ACLR were evaluated by the Lachman test, pivot shift test, anterior tibial translation and KT-1000 side-to-side difference, and International Knee Documentation Committee (IKDC) scale.

Results

The results of the Lachman and pivot shift test were not significantly different between the GJL and non-GJL patients (P = 0.67 and P = 0.27, respectively). The mean anterior tibial translation was 7.06 ± 1.41 mm in the GJL group and 6.11 ± 1.53 mm in the non-GJL group (P = 0.006). The mean KT-1000 side-to-side difference was 2.25 ± 1.31 mm in the case and 2.5 ± 1.44 mm in the control group (P = 0.42). The mean IKDC score of the patients was not significantly different between the GJL and non-GJL groups (66.1 ± 20.6 vs. 69.9 ± 16.1, P = 0.35). ACLR failure occurred in 2 (5.5%) patients of the GJL group and no patients of the control group (P = 0.21).

Conclusion

The present findings suggest ACLR with quadruple hamstring autograft as an adequate treatment for GJL patients, at least in short-term follow-up.

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References

  1. Kim S-J, Kumar P, Kim S-H (2010) Anterior cruciate ligament reconstruction in patients with generalized joint laxity. Clin Orthop Surg 2(3):130–139. https://doi.org/10.4055/cios.2010.2.3.130

    Article  PubMed  PubMed Central  Google Scholar 

  2. Nicholas JA (1970) Injuries to knee ligaments. Relationship to looseness and tightness in football players. Jama 212(13):2236–9. https://doi.org/10.1001/jama.212.13.2236

    Article  CAS  PubMed  Google Scholar 

  3. Acasuso Díaz M, Collantes Estévez E, Sánchez Guijo P (1993) Joint hyperlaxity and musculoligamentous lesions: study of a population of homogeneous age, sex and physical exertion. Br J Rheumatol 32(2):120–122. https://doi.org/10.1093/rheumatology/32.2.120

    Article  PubMed  Google Scholar 

  4. Ramesh R, Von Arx O, Azzopardi T, Schranz PJ (2005) The risk of anterior cruciate ligament rupture with generalised joint laxity. J Bone Joint Surg Br 87(6):800–803. https://doi.org/10.1302/0301-620x.87b6.15833

    Article  CAS  PubMed  Google Scholar 

  5. Myer GD, Ford KR, Paterno MV, Nick TG, Hewett TE (2008) The effects of generalized joint laxity on risk of anterior cruciate ligament injury in young female athletes. Am J Sports Med 36(6):1073–1080. https://doi.org/10.1177/0363546507313572

    Article  PubMed  PubMed Central  Google Scholar 

  6. Kramer LC, Denegar CR, Buckley WE, Hertel J (2007) Factors associated with anterior cruciate ligament injury: history in female athletes. J Sports Med Phys Fit 47(4):446–454

    CAS  Google Scholar 

  7. Jackson DW, Simon TM (2002) Donor cell survival and repopulation after intraarticular transplantation of tendon and ligament allografts. Microsc Res Tech 58(1):25–33. https://doi.org/10.1002/jemt.10118

    Article  CAS  PubMed  Google Scholar 

  8. Kim SJ, Lee SK, Choi CH, Kim SH, Kim SH, Jung M (2014) Graft selection in anterior cruciate ligament reconstruction for smoking patients. Am J Sports Med 42(1):166–172. https://doi.org/10.1177/0363546513505191

    Article  PubMed  Google Scholar 

  9. Hardin JA, Voight ML, Blackburn TA, Canner GC, Soffer SR (1997) The effects of “decelerated” rehabilitation following anterior cruciate ligament reconstruction on a hyperelastic female adolescent: a case study. J Orthop Sports Phys Ther 26(1):29–34. https://doi.org/10.2519/jospt.1997.26.1.29

    Article  CAS  PubMed  Google Scholar 

  10. Kim SJ, Kim TE, Lee DH, Oh KS (2008) Anterior cruciate ligament reconstruction in patients who have excessive joint laxity. J Bone Joint Surg Am 90(4):735–741. https://doi.org/10.2106/jbjs.f.01173

    Article  PubMed  Google Scholar 

  11. Sundemo D, Hamrin Senorski E, Karlsson L, Horvath A, Juul-Kristensen B, Karlsson J et al (2019) Generalised joint hypermobility increases ACL injury risk and is associated with inferior outcome after ACL reconstruction: a systematic review. B MJ Open Sport Exerc Med 5(1):e000620. https://doi.org/10.1136/bmjsem-2019-000620

    Article  Google Scholar 

  12. Beighton P, Solomon L, Soskolne CL (1973) Articular mobility in an African population. Ann Rheum Dis 32(5):413–418. https://doi.org/10.1136/ard.32.5.413

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Strauss MJ, Varatojo R, Boutefnouchet T, Condello V, Samuelsson K, Gelber PE et al (2019) The use of allograft tissue in posterior cruciate, collateral and multi-ligament knee reconstruction. Knee Surg Sports Traumatol Arthrosc 27(6):1791–1809. https://doi.org/10.1007/s00167-019-05426-1

    Article  PubMed  Google Scholar 

  14. Outerbridge RE, Dunlop JA (1975) The problem of chondromalacia patellae. Clin Orthop Relat res 110:177–196

    Article  Google Scholar 

  15. Kim S-J, Choi CH, Lee S-K, Lee W, An H, Jung M (2018) Minimum two-year follow-up of anterior cruciate ligament reconstruction in patients with generalized joint laxity. J Bone Joint Surg Am 100(4):278–287

    Article  PubMed  Google Scholar 

  16. Kilinc BE, Kara A, Celik H, Oc Y, Camur S (2016) Evaluation of the accuracy of Lachman and anterior drawer tests with KT1000 in the follow-up of anterior cruciate ligament surgery. J Exerc Rehabil 12(4):363–367. https://doi.org/10.12965//jer.1632622.311

    Article  PubMed  PubMed Central  Google Scholar 

  17. Samitier G, Marcano AI, Alentorn-Geli E, Cugat R, Farmer KW, Moser MW (2015) Failure of anterior cruciate ligament reconstruction. Arch Bone Joint Surg 3(4):220–240

    PubMed  PubMed Central  Google Scholar 

  18. Ebrahimzadeh MH, Makhmalbaf H, Golhasani-Keshtan F, Rabani S, Birjandinejad A (2015) The international knee documentation committee (IKDC) subjective short form: a validity and reliability study. Knee Surg Sports Traumatol Arthrosc 23(11):3163–3167. https://doi.org/10.1007/s00167-014-3107-1

    Article  PubMed  Google Scholar 

  19. Irrgang JJ, Anderson AF, Boland AL, Harner CD, Kurosaka M, Neyret P et al (2001) Development and validation of the international knee documentation committee subjective knee form. Am J Sports Med 29(5):600–613. https://doi.org/10.1177/03635465010290051301

    Article  CAS  PubMed  Google Scholar 

  20. Kim SJ, Moon HK, Kim SG, Chun YM, Oh KS (2010) Does severity or specific joint laxity influence clinical outcomes of anterior cruciate ligament reconstruction? Clin Orthop Relat Res 468(4):1136–1141. https://doi.org/10.1007/s11999-009-0961-0

    Article  PubMed  Google Scholar 

  21. Kim SJ, Choi CH, Kim SH, Lee SK, Lee W, Kim T et al (2018) Bone-patellar tendon-bone autograft could be recommended as a superior graft to hamstring autograft for ACL reconstruction in patients with generalized joint laxity: 2- and 5-year follow-up study. Knee Surg Sport Traumatol Arthrosc 26(9):2568–2579. https://doi.org/10.1007/s00167-018-4881-y

    Article  Google Scholar 

  22. Larson CM, Bedi A, Dietrich ME, Swaringen JC, Wulf CA, Rowley DM et al (2017) Generalized hypermobility, knee hyperextension, and outcomes after anterior cruciate ligament reconstruction: prospective, case-control study with mean 6 years follow-up. Arthroscopy 33(10):1852–1858. https://doi.org/10.1016/j.arthro.2017.04.012

    Article  PubMed  Google Scholar 

  23. Liu Z, Jiang J, Yi Q, Teng Y, Liu X, He J et al (2022) An increased posterior tibial slope is associated with a higher risk of graft failure following ACL reconstruction: a systematic review. Knee Surg Sports Traumatol Arthrosc 30(7):2377–2387. https://doi.org/10.1007/s00167-022-06888-6

    Article  PubMed  Google Scholar 

  24. Rosso F, Bonasia DE, Cottino U, Cambursano S, Dettoni F, Rossi R (2018) Factors affecting subjective and objective outcomes and return to play in anterior cruciate ligament reconstruction: a retrospective cohort study. Joints 6(1):23–32. https://doi.org/10.1055/s-0038-1636931

    Article  PubMed  PubMed Central  Google Scholar 

  25. Gupta R, Singhal A, Malhotra A, Soni A, Masih GD, Raghav M (2020) Predictors for anterior cruciate ligament (ACL) re-injury after successful primary ACL reconstruction (ACLR). Malays Orthop J 14(3):50–56. https://doi.org/10.5704/moj.2011.009

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Bone and Joint Reconstruction Research Center, Department of Orthopedics, School of Medicine, Iran University of Medical Sciences, Tehran, 1157637131, Iran

    Nima Hosseinzadeh, Mehdi Mohammadpour, Mehdi Moghtadaei, Hossein Farahini, Ahmad Khazanchin, Shirin Nasiri & Amir Khazanchin

  2. Shafa Orthopedic Hospital, Baharestan Square, Mojahedin-e-Islam St, Shafa Yahyaian Educational and Medical Center, Iran University of Medical Science, Tehran, 1157637131, Iran

    Amir Khazanchin

Authors
  1. Nima Hosseinzadeh
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  2. Mehdi Mohammadpour
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Correspondence to Amir Khazanchin.

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Conflict of interest

Nima Hosseinzadeh, Mehdi Mohammadpour, Mehdi Moghtadaei, Hossein Farahini, Ahmad Khazanchin, Shirin Nasiri, and Amir Khazanchin declare that they have no conflict of interest.

Ethical approval

This study was approved by the review board of our institute under the code IR.IUMS.REC 1395.9311242006. Patients provided written consent before participation in the study.

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Hosseinzadeh, N., Mohammadpour, M., Moghtadaei, M. et al. Evaluation of the short-term outcomes of anatomic ACL reconstruction with hamstring autograft in patients with generalized joint laxity: A retrospective case–control study. Eur J Orthop Surg Traumatol 33, 2049–2055 (2023). https://doi.org/10.1007/s00590-022-03390-0

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