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Bone-patellar tendon-bone autograft could be recommended as a superior graft to hamstring autograft for ACL reconstruction in patients with generalized joint laxity: 2-and 5-year follow-up study

Authors
 Sung-Jae Kim  ;  Chong Hyuk Choi  ;  Sung-Hwan Kim  ;  Su-Keon Lee  ;  Wonyong Lee  ;  Taeyup Kim  ;  Min Jung 
Citation
 Knee Surgery Sports Traumatology Arthroscopy, Vol.26(9) : 2568-2579, 2018 
Journal Title
 Knee Surgery Sports Traumatology Arthroscopy 
ISSN
 0942-2056 
Issue Date
2018
Keywords
Anterior cruciate ligament reconstruction ; Bone–patellar tendon–bone ; Generalized joint laxity ; Graft ; Hamstring ; Risk factor
Abstract
PURPOSE: The present study aimed to compare 2- and 5-year outcomes of ACL reconstruction between patients with and without generalized joint laxity and to perform comparative evaluation between two types of grafts used for ACL reconstruction in patients with generalized joint laxity. METHODS: Two hundred and thirty-seven patients who underwent ACL reconstruction from 2001 to 2008 were included. Patients were classified into two groups according to the presence or the absence of generalized joint laxity, and further subdivided into two subgroups based on the type of graft used: bone-patellar tendon-bone (BPTB) or hamstring. Generalized joint laxity was assessed with the Beighton and Horan criteria using a point scoring system. Stability reflected by the Lachman test, pivot-shift test, and anterior translation measured with KT-2000, and functional outcomes reflected by Lysholm knee score, and International Knee Documentation Committee (IKDC) subjective score were investigated. IKDC objective grade and radiographic grade were also assessed. Clinical assessments were conducted preoperatively and at 2 and 5 years after operation. RESULTS: Two-year follow-up results showed that patients with generalized joint laxity receiving hamstring grafts had poorer outcomes than those without generalized joint laxity. Five-year follow-up results showed that patients with generalized joint laxity experienced poorer outcomes than patients without generalized joint laxity, irrespective of the type of graft. Comparison of grafts used showed that, in patients with generalized joint laxity, BPTB graft provided significantly better stability and functional outcomes than hamstring graft at both 2- and 5-year follow-ups. Comparisons between serial outcomes measured at 2 and 5 years demonstrated that stability and functional outcomes deteriorated over time in patients with generalized joint laxity. CONCLUSIONS: Less satisfactory stability and functional outcomes were noted in patients with generalized joint laxity, compared to patients without generalized joint laxity. Comparisons of stability and functional outcomes after ACL reconstruction in patients with generalized joint laxity between two different grafts demonstrated that BPTB graft achieves better results than hamstring graft.
DOI
10.1007/s00167-018-4881-y
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실)
Yonsei Authors
김성환(Kim, Sung Hwan) ORCID logo https://orcid.org/0000-0001-5743-6241
김태엽(Kim, Taeyup)
이원용(Lee, Won Yong)
정민(Jung, Min)
최종혁(Choi, Chong Hyuk)
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/163532
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