The effects of lateral extra-articular tenodesis on postoperative knee stability in patients with anterior cruciate ligament injury combined with high grade pivot-shift phenomenon
10.3760/cma.j.cn115530-20250225-00082
- VernacularTitle:关节外肌腱固定术对合并高度轴移现象的前交叉韧带损伤患者术后膝关节稳定性的影响
- Author:
Zhaoxiang TANG
1
;
Qiankun NI
1
;
Jingtong LYU
1
;
Miduo MU
1
;
Baoyun XU
1
;
Lin GUO
1
Author Information
1. 陆军军医大学第一附属医院（重庆西南医院）运动医学中心，重庆 400038
- Publication Type:Journal Article
- Keywords:
Athletic injuries;
Knee joint;
Anterior cruciate ligament;
Lateral extra-articular tenodesis;
High grade pivot-shift phenomenon;
Anterior tibial translatio
- From:
Chinese Journal of Orthopaedic Trauma
2025;27(5):395-402
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the effects of anterior cruciate ligament (ACL) reconstruction combined with lateral extra-articular tenodesis (LET) on the postoperative knee stability in the patients with ACL injury combined with high grade pivot-shift phenomenon.Methods:A retrospective study was conducted to analyze the 62 patients with primary ACL injury and high-grade pivot-shift phenomena who had been treated and followed up for at least 1 year at Sports Medicine Center, The First Affiliated Hospital, Army Medical University between January 2021 and December 2022. There were 37 males and 25 females, with an age of (29.3±7.0) years. By the different treatment methods, the patients were divided into a trial group of 25 cases treated by ACL reconstruction plus LET and a control group of 37 cases treated by ACL reconstruction only. The International Knee Documentation Committee (IKDC) subjective score, knee Lysolm score, anterior-posterior stability of the knee (KT-1000 side-to-side disparity), rotational stability (axial shift test), and anterior subluxation of the lateral compartment (ASLC) were compared between preoperation and 1 year postoperation, as well as between the 2 groups.Results:There were no significant differences between the 2 groups in the preoperative general data, indicating comparability ( P>0.05). Surgical procedures went on uneventfully in all patients. At 1 year postoperatively in the trial group, the IKDC subjective score [(86.0±7.2) points] and Lysholm score [(87.1±6.0) points] were significantly higher than those in the control group [(81.8±6.8) points and (82.1±5.5) points], and the side-to-side disparity [0.7 (0.0, 2.0) mm] was significantly smaller than that in the control group [2.3 (0.0, 4.0) mm], the percentage of postoperative residual pivot-shift positivity [8.0% (2/25)] was significantly lower than that in the control group [32.4% (12/37)], and the ASLC [(4.5±2.6) mm] was significantly smaller than that in the control group [(6.2±2.6) mm] (all P<0.05). At 1 year postoperatively in both groups, the of IKDC subjective score,Lysolm score, side-to-side disparity, axial shift test, and ASLC were significantly better than the preoperative values ( P<0.05). Conclusion:In the treatment of the patients with ACL injury plus high grade pivot-shift phenomenon, compared with ACL reconstruction alone, ACL reconstruction plus LET enhances their postoperative knee stability and functional outcomes, reduces their residual rotational laxity, and improves their ASLC.
