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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 11/2019

01-11-2019 | KNEE

Tibial slope and medial meniscectomy significantly influence short-term knee laxity following ACL reconstruction

Authors: David Dejour, Marco Pungitore, Jeremy Valluy, Luca Nover, Mo Saffarini, Guillaume Demey

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 11/2019

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Abstract

Purpose

To determine demographic, anatomic, and surgical factors associated with static and dynamic Anterior Tibial Translation (ATT) following ACL reconstruction. The hypothesis was that both static and dynamic ATT would be greater in knees with high tibial slope or that required meniscectomy.

Methods

The authors prospectively enrolled 280 consecutive patients that had primary ACL reconstruction using hamstring autografts at one center for which preoperative tear type, meniscal tears, and medial tibial slope were documented. A total of 137 were excluded due to concomitant extra-articular tenodesis or surgical antecedents on either knee, and 18 were lost to follow-up, leaving 125 that were evaluated at a minimum of 6 months including: static ATT on monopodal weight-bearing radiographs, and dynamic ATT on differential stress radiographs using the Telos™ device.

Results

Both postoperative static and dynamic ATT were strongly associated with preoperative static and dynamic ATT (respectively, β = 0.068 and β = 0.50, p < 0.001). Multivariable regression confirmed that postoperative static ATT increased with tibial slope (β = 0.24; CI 0.01–0.47; p = 0.042) and in knees that had partial medial meniscectomy (β = 2.05; CI 0.25–3.84; p = 0.025), while dynamic ATT decreased with age (β = − 0.11; CI − 0.16 to − 0.05; p < 0.001), and increased with tibial slope (β = 0.27; CI 0.04–0.49; p = 0.019) and in knees that had partial medial meniscectomy (β = 2.20; CI 0.35–4.05; p = 0.019).

Conclusion

Both static and dynamic ATT following ACL reconstruction increased with tibial slope and in knees that had partial medial meniscectomy. These findings could help surgeons tailor their techniques and ‘à la carte’ rehabilitation protocols, by preserving the menisci and sometimes delaying full weight-bearing and return to sport in patients at risk, and hence improve outcomes and prevent graft failures.

Study design

Cohort study.

Level of evidence

V.
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Metadata
Title
Tibial slope and medial meniscectomy significantly influence short-term knee laxity following ACL reconstruction
Authors
David Dejour
Marco Pungitore
Jeremy Valluy
Luca Nover
Mo Saffarini
Guillaume Demey
Publication date
01-11-2019
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 11/2019
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-019-05435-0

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