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- Ejerhed, L., et al.
(author)
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The effect of anterior cruciate ligament surgery on bone mineral in the calcaneus: a prospective study with a 2-year follow-up evaluation
- 2004
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In: Arthroscopy. - 1526-3231. ; 20:4, s. 352-9
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Journal article (peer-reviewed)abstract
- PURPOSE: The goal of this study was to evaluate the effect of anterior cruciate ligament (ACL) reconstruction on the bone mineral area mass (BMA) in the calcaneus on the injured and noninjured sides. TYPE OF STUDY: A prospective cohort study with sequential assessments of bone mineral in the calcaneus before and after ACL reconstruction. METHODS: Thirty-four consecutive patients with a unilateral ACL rupture underwent arthroscopic reconstruction using patellar tendon autografts. The BMA was assessed bilaterally in the calcaneus using a gamma camera according to the dual-energy photon absorptiometry technique, before surgery and after 6 and 26 months. RESULTS: Thirty-one of 34 patients (20 men and 11 women) underwent all BMA measurements. The median age at index surgery was 27 (16 to 50) years, and the reconstruction was performed 12 (2 to 192) months after the injury. The median preoperative Tegner activity level increased from 3 (2 to 8) to 7 (2 to 9) at 26 months (P <.0001). The BMA in the calcaneus on both the injured and noninjured side decreased by 16% and 17% respectively from the preoperative measurement to the 26-month control (P =.0014; P =.0006). On all occasions, the BMA was lower on the injured side than on the noninjured side (P =.012). CONCLUSIONS: Patients with a unilateral ACL rupture had a lower BMA in the calcaneus on the injured side compared with the noninjured side. Although patients increased activity levels after reconstruction, the BMA in the calcaneus decreased on both the injured and the noninjured side up to 2 years after surgery. LEVEL OF EVIDENCE: Level II-1, prospective cohort study.
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- Sernert, Ninni, 1954, et al.
(author)
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Right and left knee laxity measurements: a prospective study of patients with anterior cruciate ligament injuries and normal control subjects
- 2004
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In: Arthroscopy. - 1526-3231. ; 20:6, s. 564-71
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Journal article (peer-reviewed)abstract
- PURPOSE: The purpose of this study was to analyze and compare knee laxity in a group of patients with a unilateral right anterior cruciate ligament (ACL) rupture and a group of patients with a unilateral left ACL rupture. Another goal was to analyze and compare the knee laxity of the right and left knees in a group of persons without any known knee problems. TYPE OF STUDY: Prospective examination of the same patients preoperatively and 2 years after the reconstruction with examination of the healthy controls at 2 different occasions. METHODS: Group A was composed of 41 patients with a right-sided chronic ACL rupture, and group B was composed of 44 patients with a left-sided chronic ACL rupture. All patients underwent an arthroscopic ACL reconstruction using patellar tendon autograft. Group C was composed of 35 persons without any known knee problems. One experienced physiotherapist performed all the KT-1000 measurements and the clinical examinations. RESULTS: Group A displayed an increased difference in side-to-side laxity between the injured and non-injured side compared with group B in terms of both anterior and total knee laxity. This difference was found to be statistically significant preoperatively (P =.01, anterior; P =.001, total) and at follow-up evaluation 2 years after the index surgery (P =.008, anterior; P =.006, total). In group C, a significant increase was seen in absolute anterior and total laxity in the right knee compared with the left knee when 2 repeated measurements were performed (P <.0001 and P =.003, anterior; P <.0001 and P =.001, total). CONCLUSIONS: The KT-1000 arthrometer revealed a significant increase in laxity measurements in right knees compared with left knees. This difference was found both preoperatively and postoperatively in patients undergoing ACL reconstruction. The same thing was found in a group of persons without any known knee problems. LEVEL OF EVIDENCE: Level II.
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- Svensson, M., et al.
(author)
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Does the patellar tendon normalize after harvesting its central third?: a prospective long-term MRI study
- 2004
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In: Am J Sports Med. - 0363-5465. ; 32:1, s. 34-8
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Journal article (peer-reviewed)abstract
- BACKGROUND: The central third of the patellar tendon is the most frequently used autograft for ACL reconstruction. HYPOTHESIS: The patellar tendon at the donor site would look normal as seen on MRI 6 years after harvesting its central third. METHODS: Nineteen consecutive patients were included in the study. MRI examinations of the donor site were performed at 6 (5 to 10) weeks, 6 (6 to 8) months, 27 (24 to 29) months, and 71 (68 to 73) months postoperatively. The contralateral normal side was examined only on the first occasion. RESULTS: The size of the donor-site gap decreased significantly (P = 0.0001) between 6 weeks and 6 years. In most patients, a thinning of the central part of the patellar tendon was still found at 6 years. The thickness of the peripheral patellar tendon was increased, compared with the contralateral healthy side, until 2 years (P = 0.003). On all occasions, the width was increased compared with the contralateral side (P < 0.015). CONCLUSION: Prospective MRI examinations revealed that the patellar tendon at the donor site had not normalized 6 years after harvesting its central third. The reharvesting of the patellar tendon can therefore not be recommended.
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