Meniscal resection increases the risk of residual knee laxity even in patients undergoing anatomic double-bundle anterior cruciate ligament reconstruction with eight strands of hamstring autografts

Purpose To compare the midterm clinical outcomes of different meniscal surgeries in patients undergoing anatomic double-bundle anterior cruciate ligament reconstruction (DB-ACLR) with eight strands of hamstring (HT8) autografts and explore the potential predictive risk factors for residual knee laxi...

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Published in:Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA sports traumatology, arthroscopy : official journal of the ESSKA, 2023-07, Vol.31 (7), p.2784-2793
Main Authors: Ye, Zipeng, Wu, Chenliang, Xu, Junjie, Chen, Jiebo, Qiao, Yi, Wu, Xiulin, Xie, Guoming, Dong, Shikui, Zhao, Jinzhong
Format: Article
Language:English
Subjects:
Anterior cruciate ligament
Arthroscopy
Autografts
Equivalence
Grafting
Knee
Ligaments
Magnetic resonance imaging
Medicine
Medicine & Public Health
Meniscus
Orthopedics
Patients
Regression analysis
Risk factors
Rupture
Sports Medicine
Strands
Surgery
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Summary:Purpose To compare the midterm clinical outcomes of different meniscal surgeries in patients undergoing anatomic double-bundle anterior cruciate ligament reconstruction (DB-ACLR) with eight strands of hamstring (HT8) autografts and explore the potential predictive risk factors for residual knee laxity. Methods From 2010 to 2017, a total of 410 patients who underwent anatomic trans-tibial DB-ACLR with HT8 autografts (169 patients without meniscal surgery, 105 patients with meniscal repair, and 136 patients with meniscal resection) were included in this study. The equivalent graft diameter was introduced to make the total graft size of DB-ACLR comparable with that of single-bundle ACLR and calculated as the square root of the quadratic sum of the diameter for each bundle. Residual laxity was defined as excessive anterior tibial translation or residual pivot shift at any follow-up visit, while graft rupture was confirmed by second-look arthroscopy or magnetic resonance imaging. Results The mean follow-up period was 8.3 ± 2.2 years. The mean equivalent graft diameter was 9.9 ± 0.7 mm. Graft rupture was confirmed in 16 (3.9%) patients, while residual laxity was detected in 72 (17.6%) patients (34 [25.0%] in the meniscal resection group vs. 22 [13.0%] in the no meniscal surgery group, p  = 0.021). In the multivariate logistic regression analysis, high-grade preoperative knee laxity (odds ratio OR 2.04, p  = 0.020), equivalent graft diameter 
ISSN:0942-2056
1433-7347
DOI:10.1007/s00167-022-07231-9