The functional outcome of arthroscopic anterior cruciate ligament reconstruction in patients using different graft tension during tibial fixation
10.35460/2546-1621.2018-0056
- Author:
Gabriel Alfonso B JAVIER
1
;
Alberto Ma. V MOLANO
1
Author Information
1. Department of Orthopaedics, University of Santo Tomas Hospital
- Publication Type:Journal Article
- Keywords:
Arthroscopic ACL reconstruction;
Lysholm Scoring Scale;
Graft tension;
Tibial fixation
- MeSH:
Lysholm Knee Score;
Tibia
- From:
Journal of Medicine University of Santo Tomas
2019;3(1):270-276
- CountryPhilippines
- Language:English
-
Abstract:
Background: Anterior Cruciate Ligament (ACL) reconstruction is commonly performed to restore knee
kinematics and halt the progression of osteoarthritis.
A primary variable that could infl uence the outcome
of ACL reconstruction is the tension applied to the
graft at the time of fi xation. If the tension is too great,
an abnormal compressive force could potentially develop across the tibiofemoral joint, hindering knee
motion, and subjecting the articular surfaces to increased stress. If the tension in the graft is too low,
the graft will not be effective in restoring normal kinematics. The Tegner Lysholm Knee Scale is a functional scoring for patients with ligamentous injuries. It is
a patient-reported measure of knee function and is
important for comprehensive assessment conditions
in both the clinical and research context. Our objective was to compare which tension technique (15 lbs graft tension using a Mitek Tensioner™ vs maximal
sustained two-hand technique) would yield better
functional outcome at 6 months and 12 months postoperatively using the Tegner Lysholm Knee Scale.
Methods :Twenty-nine patients who underwent arthroscopic ACL reconstruction at the University of
Santo Tomas Hospital Private Division were randomly divided equally into two groups (group A or group
B). During tibial fi xation, group A would receive 15
lbs graft tension using a Mitek Tensioner and group
B would receive graft tension using the maximal sustained two-handed pull technique. The patients underwent a standard rehabilitation protocol at an institution of their choice and a Lysholm Scoring Scale
and Tegner activity scale were self-administered at 6
months and 12 months after the surgery in order to
assess their functional outcome.
Results :The results showed that the functional outcome scores of group A were higher than group B.
The yielded p-value was 0.10 (6 months), 0.07 (12
months) for group A and 0.27 (6 months), 0.46 (12
months) for group B. The results showed no suffi cient
evidence of a signifi cant difference between the effects of arthroscopic ACL reconstruction with 15 lbs
weight using a Mitek Tensioner (group A) and graft
tension using the maximal sustained two-handed pull technique (group B) in the knee functional outcome of
patients at 6 months and 12 months postoperatively
Conclusion:The functional outcome scores of patients who underwent ACL reconstruction using different graft tension did not show signifi cant results.
Further re-evaluation of patients’ functional outcome
score is necessary after 12 months postoperatively.
The desired tensioning technique of the ACL surgeon
would be at his/her convenience knowing beforehand the pros and cons of each technique.
- Full text:1 JMUST 3.pdf
