Araştırma Makalesi

The Effectiveness of Anterior Cruciate Ligament Reconstruction on the Patellofemoral Stability and Patellar Height

Cilt: 4 Sayı: 2 31 Mayıs 2023
Özgür Doğan , Batuhan Gencer *, İhsaniye Süer Doğan
PDF İndir
Archives of Current Medical Research Kapak Archives of Current Medical Research
EN

The Effectiveness of Anterior Cruciate Ligament Reconstruction on the Patellofemoral Stability and Patellar Height

Abstract

Background: Considering the critical role the anterior cruciate ligament (ACL) plays in knee biomechanics, it is a logical hypothesis that ACL reconstruction (ACLR) will have positive effects on knee kinematics, and stability. Our objective was to investigate the effect of single-bundle ACLR on patellar height, and patellofemoral balance radiologically and clinically. Methods: In this prospective study, 87 patients operated with hamstring autograft-used single-bundle ACLR were analyzed. History of dislocation, stability-related physical examination findings, Tegner-Lysholm Knee Scoring Scale, and Kujala Anterior Knee Pain Scale were used for functional assessment. All patients underwent pre-and post-operative magnetic resonance imaging and Insall-Salvati (IS) Index, Caton Deschamps Index, Blackburne-Peel Index, and Patella-patellar tendon (P-PT) angles were measured on T1-weighted sagittal section images. Results: A total of 79 patients (90.8%) achieved excellent or good result, according to Tegner-Lysholm Knee Scoring Scale, and the patients' postoperative 1st year mean Kujala Anterior Knee Pain Score was calculated as 90.4 (Range: 79.1 – 96.4). On physical examination, increased passive patellar translation was observed in 2 patients (2.3%), but the J sign was appeared to be negative in all the patients. While all patellar height indices decreased after reconstruction, only the decrease in IS index was statistically significant (p=0.007). Moreover, the P-PT angle was found to be significantly lower after ACLR (p<0.001). Conclusion: Our study is an essential step in demonstrating the relationship between anterior cruciate ligament reconstruction and patellar height. With single-bundle ACLR, sagittal balance improves, patellar height indices decrease, and patients' susceptibility to patellofemoral instability may reduce.

Keywords

Anterior Cruciate Ligament , Knee Joint , Patella , Patellar Ligament , Patellofemoral Joint

Kaynakça

  1. Igoumenou VG, Dimopoulos L, Mavrogenis AF. Patellar Height Assessment Methods: An Update. JBJS Rev. 2019;7(1):e4.
  2. Thompson P, Metcalfe AJ. Current concepts in the surgical management of patellar instability. Knee. 2019;26(6):1171-81.
  3. Hiemstra LA, Page JL,Kerslake S. Patient-Reported Outcome Measures for Patellofemoral Instability: a Critical Review. Curr Rev Musculoskelet Med. 2019;12(2):124-37.
  4. Salem KH,Sheth MR. Variables affecting patellar height in patients undergoing primary total knee replacement. Int Orthop. 2021;45(6):1477-82.
  5. Vampertzis T,Barmpagianni C,Nitis G,Papastergiou S. A study of the possible effect of abnormal patella height on meniscal tears. J Orthop. 2020;22:170-2.
  6. Kaeding CC, Léger-St-Jean B, Magnussen RA. Epidemiology and Diagnosis of Anterior Cruciate Ligament Injuries. Clin Sports Med. 2017;36(1):1-8.
  7. Doğan Ö, Çalışkan E, Gencer B. Clinical Results of Single Bundle Anterior Cruciate Ligament Reconstruction with Hamstring Autograft. Akdeniz Med J. 2019;5(3):504-9.
  8. Noyes FR,Huser LE, Levy MS. The Effect of an ACL Reconstruction in Controlling Rotational Knee Stability in Knees with Intact and Physiologic Laxity of Secondary Restraints as Defined by Tibiofemoral Compartment Translations and Graft Forces. J Bone Joint Surg Am. 2018;100(7):586-97.
  9. Ntagiopoulos PG, Bonin N,Sonnery-Cottet B,Badet R,Dejour D. The incidence of trochlear dysplasia in anterior cruciate ligament tears. Int Orthop. 2014;38(6):1269-75.
  10. Cristiani R,Viheriävaara S,Janarv PM, Edman G,Forssblad M,Stålman A. Knee laxity and functional knee outcome after contralateral ACLR are comparable to those after primary ACLR. Knee Surg Sports TraumatolArthrosc. 2021;29(11):3864-70.

Ayrıntılar

Birincil Dil

İngilizce

Konular

Cerrahi

Bölüm

Araştırma Makalesi

Yazarlar

Yayımlanma Tarihi

31 Mayıs 2023

Gönderilme Tarihi

7 Mart 2023

Kabul Tarihi

3 Mayıs 2023

Yayımlandığı Sayı

Yıl 2023 Cilt: 4 Sayı: 2

DOI

https://doi.org/10.47482/acmr.1261764

IZ

https://izlik.org/JA72WB64PZ

Archives of Current Medical Research (ACMR), araştırmaları ücretsiz sunmanın daha büyük bir küresel bilgi alışverişini desteklediğini göz önünde bulundurarak, tüm içeriğe anında açık erişim sağlar. Kamunun erişimine açık olması, daha büyük bir küresel bilgi alışverişini destekler.

http://www.acmronline.org/