Femoral condyle configuration and its impact on anterior cruciate ligament reconstruction

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Abstract

BACKGROUND:

Rupture of the anterior cruciate ligament (ACL) is one of the most common knee injuries and has substantial impact on knee function. Beside primary ruptures, an increasing number of re-(re-)ruptures occur, representing a therapeutical challenge for the treating surgeon. Several risk factors for re-ruptures have been previously identified, including an increased tibial slope.

OBJECTIVE:

In this study, we investigated the effect of femoral condyle configuration on ACL-ruptures and re-ruptures.

METHODS:

In-vivo magnetic resonance imaging scans of three different groups of patients were compared. Group 1 included patients with an intact ACL on both sides, group 2 included patients with primary, unilateral ACL-rupture, while group 3 included patients with an ACL-re-rupture or re-(re-)rupture. Fourteen different variables were obtained and analyzed regarding their impact on ACL-re-(re-)rupture.

RESULTS:

Overall, 334 knees were investigated. Our data allowed us to define parameters to identify anatomical configurations of bones associated with an increased risk of ACL-re-rupture. Our results show, that patients with ACL-re-rupture show increased radii of the extension facet of the lateral femoral condyle ( $p<$ 0.001) as well as of the extension facet of the medial femoral condyle ( $p<$ 0.001).

CONCLUSION:

We conclude that a spherical femoral condyle form does influence the clinical outcome after ACL-reconstruction.

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Most cited references 32

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Incidence of Anterior Cruciate Ligament Tears and Reconstruction: A 21-Year Population-Based Study.

Aaron J. Krych, Thomas Sanders, Hilal Maradit Kremers … (2016)

The incidence of isolated anterior cruciate ligament (ACL) tears in the general population is not well defined.

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Incidence and risk factors for graft rupture and contralateral rupture after anterior cruciate ligament reconstruction.

Heidi Russell, Sharon L. Salmon, L Pinczewski … (2005)

The aim of this study was to determine the rates of contralateral anterior cruciate ligament (ACL) rupture and of ACL graft rupture after ACL reconstruction using either patellar tendon or hamstring tendon autograft, and to identify any patient characteristics that may increase this risk. Case series. Over a 2-year period, 760 endoscopic ACL reconstructions were performed in 743 patients. Bone-patellar tendon-bone autograft was used in 316 patients and 4-strand hamstring tendon in 427 patients. Those patients with a previous contralateral ACL rupture or those who underwent a simultaneous bilateral ACL reconstruction were excluded, leaving 675 knees (675 patients) for review. Persons not involved in the index operation or the care of the patient conducted follow-up assessment by telephone interview conducted 5 years after surgery. Patients were questioned about the incidence of ACL graft rupture, contralateral ACL rupture, symptoms of instability or significant injury, family history of ACL injury, and activity level according to the International Knee Documentation Committee scale. From our prospective database we obtained further information on graft source, meniscal or articular surface injury, and gender. Binary logistic regression was used to measure the relative association between the measured variables and the risk of graft rupture and contralateral ACL rupture. Five years after primary ACL reconstruction, 612 of the 675 patients (90.7%) were assessed. ACL graft rupture occurred in 39 patients (6%) and contralateral ACL rupture occurred in 35 patients (6%). Three patients suffered both a graft rupture and a contralateral ACL injury. The odds of ACL graft rupture were increased 3-fold by a contact mechanism of initial injury. Return to level 1 or 2 sports increased the risk of contralateral ACL injury by a factor of 10. The risk of sustaining an ACL graft rupture was greatest in the first 12 months after reconstruction. No other studied variable increased the risk of repeat ACL injury. After reconstruction, repeat ACL injury occurred in 12% of patients over 5 years. Twelve months after reconstruction, the ACL graft is at no greater risk than the contralateral ACL, suggesting that adequate graft and muscular function for most activities is achieved by this time. Risk factors for repeat ACL injury identified included a return to competitive side-stepping, pivoting, or jumping sports, and the contact mechanism of the index injury. Female patients were at no greater risk of repeat ACL injury than male patients and graft choice did not affect the rate of repeat ACL injury. Level IV, case series.

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The first results from the Danish ACL reconstruction registry: epidemiologic and 2 year follow-up results from 5,818 knee ligament reconstructions.

Martin Lind, Frank Menhert, Dan B Pedersen (2009)

Anterior cruciate ligament (ACL) reconstruction is presently evolving rapidly. In order to monitor the developments in surgical methods and clinical outcome, a national clinical database for knee ligament reconstructions was established in 2005 in Denmark. This study presents the first data with 2 year follow-up from the Danish ACL registry. All orthopaedic departments performing ACL reconstructions in Denmark, including private clinics, report to the registry. The database includes both surgery- and patient-related data. The surgeon reports anamnestic, objective knee laxity and operative data including graft and implant choices. At 1 year control, complications, reoperations, and objective knee laxity are recorded. The patient registers the Knee injury and Osteoarthritis Outcome Score (KOOS) and Tegner function score preoperatively and at 1, 5 and 10 years follow-up. During the first 30 months, 5,872 knee-ligament reconstructions were registered. A total of 4,972 were primary ACL reconstructions, 443 were ACL revisions and 457 multiligament reconstructions. A total of 85% of all knee ligament reconstruction were reported to the database. A total of 71% of primary ACL reconstruction used hamstring tendon grafts and 21% used patella tendon graft. Meniscus injuries were treated in 35% of all patients. A total of 17% had significant cartilage lesions. At 2 years follow-up 3% of primary reconstructions were revised. Follow-up KOOS demonstrated specific differences between primary ACL, revision ACL, and multiligament reconstructions. Sports/recreation score were 40, 32, 28 and quality of life score were 40, 32, 33 for the respective groups. This study presents the first follow-up data from a national ACL registry. These data will become new international reference materials for outcome measures before and after ACL surgery. The database will enable future monitoring of ACL reconstruction techniques and outcome.

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Author and article information

Journal

Journal ID (nlm-ta): Technol Health Care

Journal ID (iso-abbrev): Technol Health Care

Journal ID (publisher-id): THC

Title: Technology and Health Care

Publisher: IOS Press (Nieuwe Hemweg 6B, 1013 BG Amsterdam, The Netherlands )

ISSN (Print): 0928-7329

ISSN (Electronic): 1878-7401

Publication date (Electronic, preprint): 23 March 2023

Publication date (Electronic, pub): 15 September 2023

Publication date (Electronic, collection): 2023

Volume: 31

Issue: 5

Pages: 1607-1617

Affiliations

[a ]Department for Orthopaedic and Trauma Surgery, Faculty of Medicine, University of Cologne , Cologne, Germany

[b ]Department for Orthopaedic Surgery, St. Josefs-Hospital Wiesbaden, Wiesbaden, Germany

[c ]Department for Orthopaedic Surgery, ATOS MediaPark Klinik, Cologne, Germany

[d ]Radiologie im Mediapark, Cologne, Germany

Author notes

[* ]Corresponding author: David Grevenstein, Department of Orthopaedic and Trauma Surgery, University of Cologne, Kerpener Str. 62, D – 50937 Cologne, Germany. E-mail: david.grevenstein@ 123456uk-koeln.de .

Article

Publisher ID: THC220640

DOI: 10.3233/THC-220640

PMC ID: 10578253

PubMed ID: 36970923

SO-VID: 3c9fea2c-9d9b-4985-a21b-da1b6c3c4db3

License:

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial (CC BY 4.0) License.

Femoral condyle configuration and its impact on anterior cruciate ligament reconstruction

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Abstract

BACKGROUND:

OBJECTIVE:

METHODS:

RESULTS:

CONCLUSION:

Related collections

SICOT-J (Orthopedic surgery and traumatology)

Most cited references 32

Incidence of Anterior Cruciate Ligament Tears and Reconstruction: A 21-Year Population-Based Study.

Incidence and risk factors for graft rupture and contralateral rupture after anterior cruciate ligament reconstruction.

The first results from the Danish ACL reconstruction registry: epidemiologic and 2 year follow-up results from 5,818 knee ligament reconstructions.

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