Torsten Grønbech Nielsen

TY - JOUR

T1 - A high level of knee laxity after anterior cruciate ligament reconstruction results in high revision rates

AU - Fiil, Malthe

AU - Nielsen, Torsten Grønbech

AU - Lind, Martin

N1 - Publisher Copyright: © 2022, The Author(s) under exclusive licence to European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA).

PY - 2022/10

Y1 - 2022/10

N2 - Purpose: The literature indicates a lack of consensus on the correlation between knee laxity after anterior cruciate ligament reconstruction (ACLR) and subjective clinical outcomes and the need for revision surgery. Therefore, using high-volume registry data, this study aimed to describe the relationship between objective knee laxity after ACLR and subjective symptom and functional assessments and the need for revision surgery. The hypothesis was that greater postoperative knee laxity would correlate with inferior patient-reported outcomes and a higher risk for revision surgery. Methods: In this study, 17,114 patients in the Danish knee ligament reconstruction registry were placed into three groups on the basis of objective side-to-side differences in sagittal laxity one year after surgery: group A (≤ 2 mm), Group B (3–5 mm) and Group C (> 5 mm). The main outcome measure was revision rate within 2 years of primary surgery, further outcome measures were the knee injury and osteoarthritis outcome score (KOOS) as well as Tegner activity score. Results: The study found the risk for revision surgery was more than five times higher for Group C [hazard ratio (HR) = 5.51] than for Group A. The KOOS knee-related Quality of Life (QoL) sub-score exhibited lower values when comparing Groups B or C to Group A. In addition, the KOOS Function in Sport and Recreation (Sport/Rec) sub-score yielded lower values for groups B and C in comparison with Group A. Conclusion: These results indicate that increased post-operative sagittal laxity is correlated with an increased risk for revision surgery and might correlate with poorer knee-related QoL, as well as a decreased function in sports. The clinical relevance of the present study is that high knee laxity at 1-year follow-up is a predictor of the risk of revision surgery. Level of evidence: III.

AB - Purpose: The literature indicates a lack of consensus on the correlation between knee laxity after anterior cruciate ligament reconstruction (ACLR) and subjective clinical outcomes and the need for revision surgery. Therefore, using high-volume registry data, this study aimed to describe the relationship between objective knee laxity after ACLR and subjective symptom and functional assessments and the need for revision surgery. The hypothesis was that greater postoperative knee laxity would correlate with inferior patient-reported outcomes and a higher risk for revision surgery. Methods: In this study, 17,114 patients in the Danish knee ligament reconstruction registry were placed into three groups on the basis of objective side-to-side differences in sagittal laxity one year after surgery: group A (≤ 2 mm), Group B (3–5 mm) and Group C (> 5 mm). The main outcome measure was revision rate within 2 years of primary surgery, further outcome measures were the knee injury and osteoarthritis outcome score (KOOS) as well as Tegner activity score. Results: The study found the risk for revision surgery was more than five times higher for Group C [hazard ratio (HR) = 5.51] than for Group A. The KOOS knee-related Quality of Life (QoL) sub-score exhibited lower values when comparing Groups B or C to Group A. In addition, the KOOS Function in Sport and Recreation (Sport/Rec) sub-score yielded lower values for groups B and C in comparison with Group A. Conclusion: These results indicate that increased post-operative sagittal laxity is correlated with an increased risk for revision surgery and might correlate with poorer knee-related QoL, as well as a decreased function in sports. The clinical relevance of the present study is that high knee laxity at 1-year follow-up is a predictor of the risk of revision surgery. Level of evidence: III.

KW - ACL reconstruction

KW - ACL registry

KW - Objective knee laxity

KW - Patient-reported outcome

KW - Revision rate

UR - http://www.scopus.com/inward/record.url?scp=85127228007&partnerID=8YFLogxK

U2 - 10.1007/s00167-022-06940-5

DO - 10.1007/s00167-022-06940-5

M3 - Journal article

C2 - 35333934

AN - SCOPUS:85127228007

VL - 30

SP - 3414

EP - 3421

JO - Knee Surgery, Sports Traumatology, Arthroscopy

JF - Knee Surgery, Sports Traumatology, Arthroscopy

SN - 0942-2056

IS - 10

ER -