Anterior Cruciate Ligament Reconstruction in Patients with Generalized Joint Laxity.
10.4055/cios.2010.2.3.130
- Author:
Sung Jae KIM
1
;
Praveen KUMAR
;
Sung Hwan KIM
Author Information
1. Yonsei University Arthroscopy & Joint Research Institute and Department of Orthopedic Surgery, Yonsei University Health System, Seoul, Korea. othrohwan@gmail.com
- Publication Type:Review
- Keywords:
Anterior cruciate ligament;
Reconstruction;
Joint instability;
Generalized
- MeSH:
Anterior Cruciate Ligament/*injuries/*surgery;
Bone Transplantation/methods;
Bone-Patellar Tendon-Bone Graft/methods;
Humans;
Joint Instability/*complications/physiopathology;
Range of Motion, Articular;
*Reconstructive Surgical Procedures;
Risk Factors;
Tendons/transplantation;
Treatment Outcome
- From:Clinics in Orthopedic Surgery
2010;2(3):130-139
- CountryRepublic of Korea
- Language:English
-
Abstract:
Generalized joint laxity is a genetically determined component of overall joint flexibility. The incidence of joint laxity in the overall population is approximately 5% to 20%, and its prevalence is higher in females. Recently it was noticed that individuals with generalized joint laxity are not only prone to anterior cruciate ligament injuries but also have inferior results after a reconstruction. Therefore, an anterior cruciate ligament reconstruction in patients with generalized laxity should be undertaken with caution due to the higher expected failure rate from the complexity of problems associated with this condition. It is also necessary to identify the risk factors for the injury as well as for the post operative outcome in this population. A criterion that includes all the associated components is necessary for the proper screening of individuals for generalized joint laxity. Graft selection for an anterior cruciate reconstruction in patients with ligament laxity is a challenge. According to the senior author, a hamstring autograft is an inferior choice and a double bundle reconstruction with a quadriceps tendon-bone autograft yields better results than a single bundle bone-patella tendon-bone autograft. Future studies comparing the different grafts available might be needed to determine the preferred graft for this subset of patients. Improved results after an anterior cruciate ligament reconstruction can be achieved by proper planning and careful attention to each step beginning from the clinical examination to the postoperative rehabilitation.
