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- Title
Knee Hyperextension Greater Than 5° Is a Risk Factor for Failure in ACL Reconstruction Using Hamstring Graft.
- Authors
Guimarães, Tales Mollica; Giglio, Pedro Nogueira; Sobrado, Marcel Faraco; Bonadio, Marcelo Batista; Gobbi, Riccardo Gomes; Pécora, José Ricardo; Helito, Camilo Partezani
- Abstract
Background: The degree of knee hyperextension in isolation has not been studied in detail as a risk factor that could lead to increased looseness or graft failure after anterior cruciate ligament (ACL) reconstruction. Purpose: To analyze whether more than 5° of passive knee hyperextension is associated with worse functional outcomes and greater risk of graft failure after primary ACL reconstruction with hamstring tendon autograft. Study Design: Cohort study; Level of evidence, 3. Methods: A cohort of patients who had primary ACL reconstruction with hamstring tendon autografts was divided into 2 groups based on passive contralateral knee hyperextension greater than 5° (hyperextension group) and less than 5° (control group) of hyperextension. Groups were matched by age, sex, and associated meniscal tears. The following data were collected and compared between the groups: patient data (age and sex), time from injury to surgery, passive knee hyperextension, KT-1000 arthrometer laxity, pivot shift, associated meniscal injury and treatment (meniscectomy or repair), contralateral knee ligament injury, intra-articular graft size, follow-up time, occurrence of graft failure, and postoperative Lysholm knee scale and International Knee Documentation Committee subjective form scores. Results: Data from 358 patients initially included in the study were analyzed; 22 were excluded because the time from injury to surgery was greater than 24 months, and 22 were lost to follow-up. From the cohort of 314 patients, 102 had more than 5° of knee hyperextension. A control group of the same size (n = 102) was selected by matching among the other 212 patients. Significant differences in the incidence of graft failure (14.7% vs 2.9%; P =.005) and Lysholm knee scale score (86.4 ± 9.8 vs 89.6 ± 6.1; P =.018) were found between the 2 groups. Conclusion: Patients with more than 5° of contralateral knee hyperextension submitted to single-bundle ACL reconstruction with hamstring tendons have a higher failure rate than patients with less than 5° of knee hyperextension.
- Subjects
KNEE physiology; HAMSTRING muscle surgery; STATISTICS; GRAFT rejection; RANGE of motion of joints; ACQUISITION of data methodology; FUNCTIONAL status; RETROSPECTIVE studies; MANN Whitney U Test; FISHER exact test; MEASUREMENT of angles (Geometry); AUTOGRAFTS; T-test (Statistics); TREATMENT effectiveness; DESCRIPTIVE statistics; MEDICAL records; ANTERIOR cruciate ligament surgery; DATA analysis; DATA analysis software; LONGITUDINAL method; MENISCUS injuries
- Publication
Orthopaedic Journal of Sports Medicine, 2021, Vol 9, Issue 11, p1
- ISSN
2325-9671
- Publication type
Article
- DOI
10.1177/23259671211056325