Augmentation surgery for handling partial tears of the anterior cruciate ligament: Case series
DOI:
https://doi.org/10.1016/j.rccot.2016.10.008Keywords:
anterior cruciate ligament, augmentation, ruptureAbstract
Introduction: Ruptures of the anterior cruciate ligament (ACL) are becoming more frequent and it is not uncommon to find patients with partial ruptures. Considering that there is nothing better than a native ligament, it remains unclear whether it is useful to preserve the unscathed bundle and reconstruct only the injured.
Materials and methods: Descriptive prospective cohort included patients with partial ACL rupture who underwent augmentation surgery between 2008 and 2012 at the Hospital of San Jose, Bogota. Patients with any knee pathology associated, with inflammatory joint disease and with moderate osteoarthritis were excluded. At 2-years follow-up, clinical and functional tests were performed.
Results: Eleven patients were enrolled with a median age of 36 years old, being mostly male (8/11). The committed bundle and autograft used were in 100% of cases PL and HTH, respectively. On physical examination, there were improvements in the Lachman test, pivot shift test and in KT-1000. About KOOS functional scale, best medians scores were found in the categories of functioning in daily activities (87) and pain (78).
Discussion: ACL augmentation at medium term of follow up (2 years) provides good clinical results, achieving an adequate joint stability and pain relief, similar to those reported in the literature for standard reconstruction.
Evidence level: IV.
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Demirağ B, Ermutlu C, Aydemir F, Durak K. A comparison of clinical outcome of augmentation and standard reconstruction techniques for partial anterior cruciate ligament tears. Eklem Hastalik Cerrahisi. 2012;23:140-4.
Yasuda K, Kondo E, Kitamura N, Kawaguchi Y, Kai S, Tanabe Y. A pilot study of anatomic double-bundle anterior cruciate ligament reconstruction with ligament remnant tissue preservation. Arthroscopy. 2012;28:343-53. https://doi.org/10.1016/j.arthro.2011.08.305
Song GY, Zhang J, Li X, Chen XZ, Li Y, Feng H. Acute anterior cruciate ligament reconstruction with an augmented remnant repair: a comparative macroscopic and biomechanical study in an animal model. Arthroscopy. 2014;30:344-51. https://doi.org/10.1016/j.arthro.2013.11.030
Van Dyck P, De Smet E, Veryser J, Lambrecht V, Gielen JL, Vanhoenacker FM, et al. Partial tear of the anterior cruciate ligament of the knee: injury patterns on MR imaging. Knee Surg Sports Traumatol Arthrosc. 2012;20:256-61. https://doi.org/10.1007/s00167-011-1617-7
Borbon CA, Mouzopoulos G, Siebold R. Why perform an ACL augmentation? Knee Surg Sports Traumatol Arthrosc. 2012;20:245-51. https://doi.org/10.1007/s00167-011-1565-2
Siebold R, Fu FH. Assessment and augmentation of symptomatic anteromedial or posterolateral bundle tears of the anterior cruciate ligament. Arthroscopy. 2008;24:1289-98. https://doi.org/10.1016/j.arthro.2008.06.016
Ochi M, Adachi N, Uchio Y, Deie M, Kumahashi N, Ishikawa M, et al. A minimum 2-year follow-up after selective anteromedial or posterolateral bundle anterior cruciate ligament reconstruction. Arthroscopy. 2009;25:117-22. https://doi.org/10.1016/j.arthro.2008.10.011
Noyes FR, Mooar LA, Moorman CT, McGinniss GH. Partial tears of the anterior cruciate ligament. Progression to complete ligament deficiency. J Bone Joint Surg Br. 1989;71:825-33. https://doi.org/10.1302/0301-620X.71B5.2584255
Bicer EK, Lustig S, Servien E, Selmi TA, Neyret P. Current knowledge in the anatomy of the human anterior cruciate ligament. Knee Surg Sports Traumatol Arthrosc. 2010;18:1075-84. https://doi.org/10.1007/s00167-009-0993-8
Liljedahl SO, Lindvall N, Wetterfors J. Early diagnosis and treatment of acute ruptures of the anterior cruciate ligament; a clinical and arthrographic study of forty-eight cases. J Bone Joint Surg Am. 1965;47:1503-13. https://doi.org/10.2106/00004623-196547080-00004
Kazusa H, Nakamae A, Ochi M. Augmentation technique for anterior cruciate ligament injury. Clin Sports Med. 2013;32:127-40. https://doi.org/10.1016/j.csm.2012.08.012
Fruensgaard S, Johannsen HV. Incomplete ruptures of the anterior cruciate ligament. J Bone Joint Surg Br. 1989;71:526-30. https://doi.org/10.1302/0301-620X.71B3.2722951
Danylchuk KD, Finlay JB, Krcek JP. Microstructural organization of human and bovine cruciate ligaments. Clin Orthop Relat Res. 1978;29:4-8. https://doi.org/10.1097/00003086-197803000-00048
Park SY, Oh H, Park SW, Lee JH, Lee SH, Yoon KH. Clinical outcomes of remnant-preserving augmentation versus double-bundle reconstruction in the anterior cruciate ligament reconstruction. Arthroscopy. 2012;28:1833-41. https://doi.org/10.1016/j.arthro.2012.05.886
Xu Y, Liu J, Kramer S, Martins C, Kato Y, Linde-Rosen M, et al. Comparison of in situ forces and knee kinematics in anteromedial and high anteromedial bundle augmentation for partially ruptured anterior cruciate ligament. Am J Sports Med. 2011;39:272-8. https://doi.org/10.1177/0363546510383479
Ohsawa T, Kimura M, Kobayashi Y, Hagiwara K, Yorifuji H, Takagishi K. Arthroscopic evaluation of preserved ligament remnant after selective anteromedial or posterolateral bundle anterior cruciate ligament reconstruction. Arthroscopy. 2012;28:807-17. https://doi.org/10.1016/j.arthro.2011.11.033
Jung YB, Jung HJ, Siti HT, Lee YS, Lee HJ, Lee SH, et al. Comparison of anterior cruciate ligament reconstruction with preservation only versus remnant tensioning technique. Arthroscopy. 2011;27:1252-8. https://doi.org/10.1016/j.arthro.2011.05.013
Lee BI, Min KD, Choi HS, Kwon SW, Chun DI, Yun ES, et al. Immunohistochemical study of mechanoreceptors in the tibial remnant of the ruptured anterior cruciate ligament in human knees. Knee Surg Sports Traumatol Arthrosc. 2009;17:1095-101. https://doi.org/10.1007/s00167-009-0831-z
Dhillon MS, Bali K, Vasistha RK. Immunohistological evaluation of proprioceptive potential of the residual stump of injured anterior cruciate ligaments (ACL). Int Orthop. 2010;34:737-41. https://doi.org/10.1007/s00264-009-0948-1
Wu B, Zhao Z, Li S, Sun L. Preservation of remnant attachment improves graft healing in a rabbit model of anterior cruciate ligament reconstruction. Arthroscopy. 2013;29:1362-71. https://doi.org/10.1016/j.arthro.2013.05.010
Song GY, Zhang H, Zhang J, Li X, Chen XZ, Li Y, et al. The anterior cruciate ligament remnant: to leave it or not. Arthroscopy. 2013;29:1253-62. https://doi.org/10.1016/j.arthro.2013.03.078
Papalia R, Franceschi F, Vasta S, Di Martino A, Maffulli N, Denaro V. Sparing the anterior cruciate ligament remnant: is it worth the hassle. Br Med Bull. 2012;104:91-111. https://doi.org/10.1093/bmb/ldr053
Adachi N, Ochi M, Uchio Y, Iwasa J, Ryoke K, Kuriwaka M. Mechanoreceptors in the anterior cruciate ligament contribute to the joint position sense. Acta Orthop Scand. 2002;73:330-4. https://doi.org/10.1080/000164702320155356
Sonnery-Cottet B, Lavoie F, Ogassawara R, Scussiato RG, Kidder JF, Chambat P. Selective anteromedial bundle reconstruction in partial ACL tears: a series of 36 patients with mean 24 months follow-up. Knee Surg Sports Traumatol Arthrosc. 2010;18: 47-51. https://doi.org/10.1007/s00167-009-0855-4
Ahn JH, Wang JH, Lee YS, Kim JG, Kang JH, Koh KH. Anterior cruciate ligament reconstruction using remnant preservation and a femoral tensioning technique: clinical and magnetic resonance imaging results. Arthroscopy. 2011;27:1079-89. https://doi.org/10.1016/j.arthro.2011.03.002
Buda R, Ferruzzi A, Vannini F, Zambelli L, Di Caprio F. Augmentation technique with semitendinosus and gracilis tendons in chronic partial lesions of the ACL: clinical and arthrometric analysis. Knee Surg Sports Traumatol Arthrosc. 2006;14: 1101-7. https://doi.org/10.1007/s00167-006-0117-7
Mifune Y, Ota S, Takayama K, Hoshino Y, Matsumoto T, Kuroda R, et al. Therapeutic advantage in selective ligament augmentation for partial tears of the anterior cruciate ligament: results in an animal model. Am J Sports Med. 2013;41:365-73. https://doi.org/10.1177/0363546512471614
Chouteau J, Testa R, Viste A, Moyen B. Knee rotational laxity and proprioceptive function 2 years after partial ACL reconstruction. Knee Surg Sports Traumatol Arthrosc. 2012;20:762-6. https://doi.org/10.1007/s00167-012-1879-8
Papalia R, Franceschi F, Zampogna B, Tecame A, Maffulli N, Denaro V. Surgical management of partial tears of the anterior cruciate ligament. Knee Surg Sports Traumatol Arthrosc. 2014;22:154-65. https://doi.org/10.1007/s00167-012-2339-1
Irrgang JJ. Current status of measuring clinical outcomes after anterior cruciate ligament reconstruction: Are we good enough. Oper Techn Sport Med. 2008;16:119-24. https://doi.org/10.1053/j.otsm.2008.10.013
Hambly K, Griva K. IKDC or KOOS: which one captures symptoms and disabilities most important to patients who have undergone initial anterior cruciate ligament reconstruction. Am J Sports Med. 2010;38:1395-404. https://doi.org/10.1177/0363546509359678
Salavati M, Akhbari B, Mohammadi F, Mazaheri M, Khorrami M. Knee injury and Osteoarthritis Outcome Score (KOOS); reliability and validity in competitive athletes after anterior cruciate ligament reconstruction. Osteoarthritis Cartilage. 2011;19:406-10. https://doi.org/10.1016/j.joca.2011.01.010
Paradowski PT, Witoński D, Kęska R, Roos EM. Cross-cultural translation and measurement properties of the Polish version of the Knee injury and Osteoarthritis Outcome Score (KOOS) following anterior cruciate ligament reconstruction. Health Qual Life Outcomes. 2013;11:107. https://doi.org/10.1186/1477-7525-11-107
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