Journal
CLINICAL BIOMECHANICS
Volume 69, Issue -, Pages 1-8Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.clinbiomech.2019.06.012
Keywords
Laxity reduction; Navigation; ACL; Single-bundle; Double-bundle; Single-bundle plus lateral plasty
Categories
Funding
- Italian Ministry of Health, Progetto RF Ministero della Salute [2010-2312173]
- Fondi 5X1000
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Background: Significantly better stability may be achieved with a Single Bundle Lateral Plasty (SBLP) reconstruction compared with the Single Bundle (SB) and Double Bundle (DB) procedures. Methods: The study included 42 patients who underwent ACL reconstruction. Patients were randomly selected for one of the following surgical procedure defining three study groups: Single-Bundle-Lateral-Plasty, Single-Bundle and Double-Bundle procedures. Laxity evaluation was performed with an intraoperative navigation system. Lachman test (AP30), Drawer test (AP90), Varus-Valgus stress test at 0 degrees and 30 degrees knee flexion (VVO, VV30), Internal-External rotation (IE30, IE90), and pivot shift (PS) test are the clinical test executed for the laxity evaluation. Laxity reduction was defined as the difference between laxity before the fixation of the graft used for the reconstruction and the laxity just after its fixation. Findings: For all the analyzed surgical techniques, the pre-reconstruction laxity values were statistically higher (P < 0.05) than the post-reconstruction values for all the analyzed tests. The analysis of the Drawer test and Internal-External rotation at 30 degrees and 90 degrees of knee flexion, highlighted a significant difference at time zero after surgery among the three study groups. The results showed that the SBLP technique had the highest reduction values compared to SB (P-IE(90) = 0.001) and DB (P-AP90 = 0.012; P-IE30 = 0.021; P-IE90 = 0.003) techniques. Interpretation SBLP technique showed significantly superior results in terms of antero-posterior and internalexternal laxity reduction at time-zero after ACL reconstruction.
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