The effects of excessive pre?operative anterior tibial translation on post?operative knee stability after anterior cruciate ligament reconstruction / 中华骨科杂志

ABSTRACT

Objective To investigate the effects of excessive pre?operative anterior tibial translation (ATT) on post?opera?tive knee stability after anterior cruciate ligament (ACL) reconstruction. Methods From January 2016 to December 2016, a total of 348 patients with noncontact ACL injuries who underwent primary anatomic single?bundle ACL reconstruction were retrospec?tively analyzed. The hamstring autograft was used as the grafted tendon. The ATT relative to the lateral femoral condyle was mea?sured on pre?operative magnetic resonance imaging (MRI) scans. Among them, twenty patients (ATT positive group) who demon?strated>10 mm ATT distance were matched in a 1∶2 fashion to 40 control participants (ATT negative group) with<3 mm ATT dis?tance. All patients were followed for at least 2 years. The post?operative clinical outcomes, including the ATT distance, the KT?1000 side?to?side difference, and the pivot?shift tests were compared between the two groups. Results The ATT distance of the ATT positive group was 13.5±1.3 mm, which was significantly larger than that of the ATT negative group (2.5±1.4 mm) (t=45.435, P=0.013) pre?operatively. At 2?year follow?up, the ATT distance of the ATT positive group was 9.7±1.8 mm, which was significant?ly larger than that of the ATT negative group (0.9±1.6 mm) (t=49.655, P=0.011). Moreover, the KT?1000 side?to?side difference of the ATT positive group was 4.4±1.5 mm, which was also significantly larger than that of the ATT negative group (0.8±1.1 mm) (t=38.945, P=0.014). There was significantly difference in the pivot?shift test between the two groups (ATT positive group 1 grade 0, 18 grade I, 1 grade II vs. ATT negative group 39 grade 0, 1 grade I) (χ2=40.521, P=0.012). Conclusion Excessive ATT could not be completely restored to normal after isolated anatomic single?bundle ACL reconstruction. Compared to the ATT negative group, the ATT positive group has inferior knee stability at 2?year follow?up.