Patellar tendon autograft reconstruction of the anterior cruciate ligament with and without lateral plasty in advanced-stage chronic laxity. A clinical, prospective, randomized, single-blind study using passive dynamic X-rays

• Published in: The knee Vol. 21; no. 1; pp. 58 - 65
• Main Authors: Trichine, Faycal, Alsaati, Ma'ad, Chouteau, Julien, Moyen, Bernard, Bouzitouna, Mahdjoub, Maza, Rabah
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.01.2014; Elsevier Limited; Elsevier
• Subjects: ACL reconstruction; Adult; Advanced-stage chronic laxity; Anterior Cruciate Ligament - physiopathology; Anterior Cruciate Ligament - surgery; Anterior Cruciate Ligament Injuries; Anterior Cruciate Ligament Reconstruction - methods; Arthroscopy; Autografts; Biomechanics; Bone-Patellar Tendon-Bone Grafting; Dynamic X-rays; Engineering Sciences; Extra-articular ilio-tibial band tenodesis; Fascia Lata - transplantation; Femur - diagnostic imaging; Femur - surgery; Gain laxity; Humans; Joint Instability - diagnostic imaging; Joint Instability - physiopathology; Joint Instability - surgery; Knee; Knee Joint - diagnostic imaging; Knee Joint - physiopathology; Knee Joint - surgery; Ligaments; Male; Mechanics; Orthopedics; Physical Therapy Modalities; Postoperative Care; Prospective Studies; Radiography; Single-Blind Method; Skin & tissue grafts; Tendons; Tenodesis; Tibia - diagnostic imaging; Tibia - surgery; Young Adult; ACL reconstruction; Gain laxity; Advanced-stage chronic laxity; Extra-articular ilio-tibial band tenodesis; Dynamic X-rays; KNEE JOINT; TIBIA; OS; ACL RECONSTRUCTION; BIOMECANIQUE; ANTERIOR CRUCIATE LIGAMENT DEFICIENT RECONSTRUCTION; GAIN LAXITY; ANTERIOR CRUCIATE LIGAMENT; FEMUR; ARTHROSCOPY; DYNAMIC X-RAYS; EXTRA-ARTICULAR ILIO-TIBIAL BAND TENODESIS; ADVANCED-STAGE CHRONIC LAXITY
• ISSN: 0968-0160; 1873-5800
• DOI: 10.1016/j.knee.2013.06.001

Abstract Purpose A prospective randomized study was performed to assess the influence of extra-articular ilio-tibial band tenodesis on the results of arthroscopic anterior cruciate ligament (ACL) reconstruction in patients with advanced-stage chronic anterior laxity of the knee. Methods Preoperatively, the two constituent groups of our series of 120 patients: group 1 (Kenneth Jones) and group 2 (Kenneth Jones + extra-articular ilio-tibial band tenodesis) were strictly comparable with regard to demographic data, activity level, interval between the injury and the operation, and even objective laxity. Through radiological measurements made by passive dynamic X-rays, we studied the evolution of the objective laxity on the two compartments (medial and lateral) of the knee before the surgery and in review. Results At 2 years follow-up, there was no significant difference between the two groups in terms of the subjective result, sports, and the overall international knee documentation committee score, however, In terms of objective laxity; Gain laxity obtained after surgery on the lateral compartment, was statistically higher in cases of extra-articular associated plasty (+ 29%), by cons in cases of intra-articular reconstruction alone, the laxity of the lateral compartment was poorly controlled and has continued to evolve despite the plasty of the ACL. Conclusion The indication of an associated extra-articular plasty remains very discussed but we plead for an objective criterion with knowing the importance of preoperative objective laxity especially that of the lateral compartment to decide if it necessary, or not, being associated. Level of evidence Level I, therapeutic prospective randomized trial.