DOI: https://doi.org/10.15674/0030-59872019251-60
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Impact of term after injury on the result of anterior cruciate ligament reconstruction

Maksim Golovakha, Inna Didenko

Abstract


The operation of anterior cruciate ligament reconstruction is one of the most frequently performed in orthopedics. However, the proportion of failures remains at the level of 5–15 %, and the percentage of full recovery of physical activity of patients is 60–85 %. Actually, there are two main reasons for unsatisfactory results: damage to the graft with the formation of chronic instability and the development of post-traumatic arthrosis.

Objective is to determine the effect of the period of recovery of anterior cruciate ligament on the risk of developing post-traumatic gonarthrosis.

Methods: the long-term results of treatment of 527 patients operated 2 to 16 years ago were analyzed, according to the IKDC scale — in 367 (69.64 %). The progression of arthrosis was evaluated on the basis of the Kelgren-Lawrence classification in 225 patients (42.69 %). Variation-statistical analysis was performed using the software Statistica, version 13 (TIBCO Software Inc., License JPZ804I382130ARCN10J).

Results: in patients operated during the first 2 months after injury, the results of treatment by the IKDC scale turned out to be better (group A is fully normal — 68.9 % assigned). In persons whose reconstruction of the anterior cruciate ligament was carried out in a period from 2 months to 2 years after injury, the rate on the IKDC scale was 8 % less (p < 0.01). And among patients who were operated in 2 and more years after injury, only 48.6–50.0 % of cases were assigned to group A on the IKDC scale (p < 0.01). In the group of patients to whom anterior cruciate ligament was restored up to 2 months from the moment of injury, the minimum progression of gonarthrosis was determined (20.4 %); from 2 months up to 1 year — 39.1–40.6 %; more than a year — 57.1–68.8 %. The dependence of the progression of gonarthrosis on the period from the moment of injury to the surgical reconstruction of the anterior cruciate ligament is statistically proven.

Conclusions: the progression of gonarthrosis depends on the time elapsed from the moment of the injury to the surgical treatment anterior cruciate ligament reconstruction. Patients operated during the first 8 weeks after injury have a significantly lower probability of progression of gonarthrosis.


Keywords


knee joint; gonarthrosis; anterior instability; ligament repair

References


Magnussen, R. A., Verlage, M., Flanigan, D. C., Kaeding, C. C., & Spindler, K. P. (2015). Patient-reported outcomes and their predictors at minimum 10 years after anterior cruciate ligament reconstruction. Orthopaedic Journal of Sports Medicine, 3 (3), 232596711557370. doi: 10.1177/2325967115573706

Tibor, L., Chan, P. H., Funahashi, T. T., Wyatt, R., Maletis, G. B., & Inacio, M. C. (2016). Surgical technique trends in primary ACL reconstruction from 2007 to 2014. The Journal of Bone and Joint Surgery. American Volume, 98 (13), 1079–1089. doi: 10.2106/jbjs.15.00881

Golovakha, M. L., Orljanski, W., Tytarchuk, R. V., Zasypko, I., Banit, O., & Benedetto, К. (2015). Analysis of the outcomes of different methods for graft fixation at the plasty of the anterior cruciate ligament. Orthopaedics, Traumatology and Prosthetics, 2, 53-59. doi: 10.15674/0030-59872015253-59. (in Russian)

Golovakha, M. L., Banit, O. V., Titarchuk, R. V., Zasypko, I. A., Didenko, I. V., & Orlyanskiy, W. (2015). Results of restoration of complex injuries in ligamentous apparatus of the knee joint. Orthopaedics, Traumatology and Prosthetics, 3, 76–86. doi: 10.15674/0030-59872015378-86. (in Russian)

Orljanski, W. & Golovakha, M. L. (2016). Manual for knee arthroscopy. Zaporozhye: Prosvita. (in Russian)

Gifstad, T., Sole, A., Strand, T., Uppheim, G., Grøntvedt, T., & Drogset, J. O. (2012). Long-term follow-up of patellar tendon grafts or hamstring tendon grafts in endoscopic ACL reconstructions. Knee Surgery, Sports Traumatology, Arthroscopy, 21 (3), 576–583. doi: 10.1007/s00167-012-1947-0

Harris, K. P., Driban, J. B., Sitler, M. R., Cattano, N. M., Balasubramanian, E., & Hootman, J. M. (2017). Tibiofemoral osteoarthritis after surgical or nonsurgical treatment of anterior cruciate ligament rupture: a systematic review. Journal of Athletic Training, 52 (6), 507–517. doi: 10.4085/1062-6050-49.3.89

Sonnery-Cottet, B., Daggett, M., Fayard, J., Ferretti, A., Helito, C. P., Lind, M., & Claes, S. (2017). Anterolateral Ligament Expert Group consensus paper on the management of internal rotation and instability of the anterior cruciate ligament - deficient knee. Journal of Orthopaedics and Traumatology, 18 (2), 91–106. doi: 10.1007/s10195-017-0449-8

Thompson, S. M., Salmon, L. J., Waller, A., Linklater, J., Roe, J. P., & Pinczewski, L. A. (2016). Twenty-year outcome of a longitudinal prospective evaluation of isolated endoscopic anterior cruciate ligament reconstruction with patellar tendon or hamstring autograft. The American Journal of Sports Medicine, 44 (12), 3083–3094. doi: 10.1177/0363546516658041

Lind, M., Lund, B., Faunø, P., Said, S., Miller, L. L., & Christiansen, S. E. (2011). Medium to long-term follow-up after ACL revision. Knee Surgery, Sports Traumatology, Arthroscopy, 20 (1), 166–172. doi: 10.1007/s00167-011-1629-3

Karikis, I., Desai, N., Sernert, N., Rostgard-Christensen, L., & Kartus, J. (2016). Comparison of anatomic double- and single-bundle techniques for anterior cruciate ligament reconstruction using hamstring tendon autografts. The American Journal of Sports Medicine, 44 (5), 1225–1236. doi: 10.1177/0363546515626543

Roy, I. V., Bogdan, S. V., Bayandina, O. I. & Kostogrits, O. O. (2015). Treatment of patelo-femoral pain in patients after revision anterior cruciate ligament surgery. Bulletin of Orthopedics of Traumatology and Prosthetics, 1, 21–26. (in Ukrainian)

Ozturk, B. Y., Maak, T. G., Fabricant, P., Altchek, D. W., Williams, R. J., Warren, R. F., & Allen, A. A. (2013). Return to sports after arthroscopic anterior stabilization in patients aged younger than 25 years. Arthroscopy: The Journal of Arthroscopic & Related Surgery, 29 (12), 1922–1931. doi: 10.1016/j.arthro.2013.09.008

Cha, P. S., Brucker, P. U., West, R. V., Zelle, B. A., Yagi, M., Kurosaka, M., & Fu, F. H. (2005). Arthroscopic double-bundle anterior cruciate ligament reconstruction: an anatomic approach. Arthroscopy, 21 (10), 1275. doi: 10.2147/OAJSM.S72332

Morey, V. M., Nag, H. L., Chowdhury, B., Pannu, C. D., Meena, S., Kumar, K., & Palaniswamy, A. (2016). Arthroscopic anatomic double bundle anterior cruciate ligament reconstruction: Our experience with follow-up of 4 years. Journal of Clinical Orthopaedics and Trauma, 7 (1), 17–22. doi:10.1016/j.jcot.2015.06.003

Ruano, J. S., Sitler, M. R., & Driban, J. B. (2017). Prevalence of radiographic knee osteoarthritis after anterior cruciate ligament reconstruction, with or without meniscectomy: an evidence-based practice article. Journal of Athletic Training, 52 (6), 606–609. doi:10.4085/1062-6050-51.2.14

Benedetto, K. P. (1992). Internationale Knieuntersuchungsbogen. Mitteilungen der Deutschsprachigen Arbeitsgemeinschaft fur Arthroskopie (AGA), 4.

Caprini, J. A. (2011). Identification of patient venous thromboembolism risk across the continuum of care. Clinical and Applied Thrombosis/Hemostasis, 17 (6), 590–599. doi: 10.1177/1076029611404217

Kostrub, A. A. (2015). Rehabilitation after arthroscopic operations at athletes. Kyiv: Nash Format. (in Russian)




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