TY  - JOUR
T1  - Anterior Cruciate Ligament Reconstruction in Patients Who Have Excessive Joint Laxity
AU  - Kim, Sung-Jae
AU  - Kim, Tae-Eun
AU  - Lee, Doo-Hyung
AU  - Oh, Kyung-Soo
Y1  - 2008/04/01
N1  - 10.2106/JBJS.F.01173
JO  - The Journal of Bone & Joint Surgery
SP  - 735
EP  - 741
VL  - 90
IS  - 4
N2  - Background: The purpose of the present study was to compare the clinical results of anterior cruciate ligament reconstruction with use of different grafts in patients with or without excessive joint laxity.Methods: We retrospectively studied eighty-three patients (forty-eight men and thirty-five women) who had undergone anterior cruciate ligament reconstruction between June 2002 and August 2004. Of the thirty-one patients who had generalized joint laxity, twenty were managed with an autologous bone-patellar tendon-bone graft and eleven were managed with a four-bundle hamstring (semitendinosus-gracilis tendon) graft. Of the fifty-two patients who had normal joint laxity, thirty-three were managed with a bone-patellar tendon-bone graft and nineteen were managed with a hamstring graft. Clinical results were evaluated by means of an examination at a minimum of twenty-four months after surgery.Results: Among the patients who had normal joint laxity, the mean side-to-side difference in anterior tibial translation on testing with the KT-2000 arthrometer at a minimum of twenty-four months postoperatively was 2.7 ± 1.9 mm in the bone-patellar tendon-bone graft group and 3.5 ± 1.7 mm in the hamstring graft group. This difference was not significant. The mean Lysholm score was 91 ± 7 points in the bone-patellar tendon-bone graft group and 85 ± 10 points in the hamstring graft group (p = 0.492). The side-to-side difference in anterior translation had an inverse correlation with the Lysholm score (ß = —0.604, p < 0.001). Among the patients who had excessive joint laxity, the mean side-to-side difference in anterior tibial translation was 3.4 ± 1.5 mm in the bone-patellar tendon-bone graft group and 4.5 ± 2.0 mm in the hamstring graft group (p = 0.036). The mean Lysholm score was 89 ± 7 points in the bone-patellar tendon-bone group and 79 ± 12 points in the hamstring group (p = 0.015). The side-to-side difference in anterior translation had an inverse correlation with the Lysholm score (ß = —0.708, p < 0.001).Conclusions: In patients who have excessive joint laxity, the two-year outcomes of anterior cruciate ligament reconstruction with bone-patellar tendon-bone grafts are better than those with four-bundle hamstring grafts in terms of both side-to-side anterior laxity and clinical results.Level of Evidence: Therapeutic Level III. See Instructions to Authors for a complete description of levels of evidence.
SN  - 0021-9355
M3  - doi: 10.2106/JBJS.F.01173
UR  - http://dx.doi.org/10.2106/JBJS.F.01173
ER  -