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Greater knee joint laxity remains in teenagers after anatomical double-bundle anterior cruciate ligament reconstruction compared to young adults

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

There is paucity in studies regarding double-bundle anterior cruciate ligament reconstruction (DB-ACLR) in teenagers. The purpose of this study is to investigate clinical outcome after DB-ACLR and analyze whether any differences exist between teenagers and young adults.

Methods

A retrospective study was performed between 2009 and 2017. Teenagers were defined as patients between 15 and 19 years and young adults between 20 and 25 years old. Isolated anterior cruciate ligament (ACL) injuries with DB-ACLR with minimum two-year follow up were included. Pre and post-operative Lysholm score, Tegner activity scale, KT-2000 arthrometer, manual pivot-shift grade, were assessed with post-operative one-leg hop test, isokinetic knee extensor strength test at 60°/sec, International Knee Documentation Committee Score (IKDC score), and re-injury rate.

Results

One-hundred and thirty-one patients, 75 patients in the teenage group (Group A) and 56 patients in the young adult group (Group B), were enrolled. Lysholm score was significantly lower in Group A (89.6 ± 21.1) compared to Group B (95.9 ± 4.6) (p = 0.04). Side to side difference in KT-2000 arthrometer (2.3 ± 2.2 mm vs 1.0 ± 2.3 mm, Group A vs Group B, respectively, p < 0.01) and ratio of post-operative positive pivot shift was significantly greater in Group A (30.7%) compared to Group B (7.1%) (p < 0.01). No significant difference was seen in re-injury rate (n.s.).

Conclusion

Teenage patients have a greater tendency for residual knee joint laxity after DB-ACLR. Although teenagers and patients in the early twenties are close in age, characteristic in knee joint laxity may be different and, therefore, may require attention upon surgery and post-operative follow-up.

Level of evidence

III.

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Funding

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Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan

    Yuta Nakanishi, Takehiko Matsushita, Kanto Nagai, Daisuke Araki, Noriyuki Kanzaki, Yuichi Hoshino, Tomoyuki Matsumoto, Takahiro Niikura & Ryosuke Kuroda

Authors
  1. Yuta Nakanishi
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  2. Takehiko Matsushita
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  3. Kanto Nagai
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  4. Daisuke Araki
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  5. Noriyuki Kanzaki
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  6. Yuichi Hoshino
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  7. Tomoyuki Matsumoto
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  8. Takahiro Niikura
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  9. Ryosuke Kuroda
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Contributions

YN designed the study and wrote the initial draft of the manuscript. TM contributed to analysis and interpretation of data and assisted in the preparation of the manuscript. NK, KN, YH, TM, and RK contributed to data collection and interpretation and critically reviewed the manuscript. All authors approved the final version of the manuscript and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Takehiko Matsushita.

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Conflict of interest

No funding was received for the completion of this manuscript. There are no possible conflicts of interest associated with this manuscript.

Ethical standards

The study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Research involving human participants

The study was performed in accordance with the ethical standards of the institutional research committee (the Institutional Review Board of Kobe University (ID No. B190055).

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Nakanishi, Y., Matsushita, T., Nagai, K. et al. Greater knee joint laxity remains in teenagers after anatomical double-bundle anterior cruciate ligament reconstruction compared to young adults. Knee Surg Sports Traumatol Arthrosc 28, 2663–2667 (2020). https://doi.org/10.1007/s00167-020-05910-z

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