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Effects of initial graft tension on clinical outcome after anatomic double-bundle anterior cruciate ligament reconstruction : comparison of two graft tension protocols

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Title: Effects of initial graft tension on clinical outcome after anatomic double-bundle anterior cruciate ligament reconstruction : comparison of two graft tension protocols
Authors: Kondo, Eiji Browse this author →KAKEN DB
Yasuda, Kazunori Browse this author →KAKEN DB
Kitamura, Nobuto Browse this author →KAKEN DB
Onodera, Jun Browse this author
Yokota, Masashi Browse this author
Yagi, Tomonori Browse this author
Iwasaki, Norimasa Browse this author →KAKEN DB
Keywords: Anterior cruciate ligament
Anatomic reconstruction
Double bundle
Graft fixation
Hamstring tendon
Tension
Issue Date: 9-Feb-2016
Publisher: BioMed Central
Journal Title: BMC Musculoskeletal Disorders
Volume: 17
Start Page: 65
Publisher DOI: 10.1186/s12891-016-0909-y
Abstract: Background: In anatomic double-bundle anterior cruciate ligament (ACL) reconstruction, there are great controversies concerning the ideal graft tension protocols. The purpose of this study was to clarify differences in the effect of two graft tension protocols on the clinical outcome after anatomic double-bundle anterior cruciate ligament (ACL) reconstruction by comparing the minimum 2-year clinical results. Methods: Ninety-seven patients with unilateral anatomic double-bundle ACL reconstruction were divided into two groups. In the first 44 patients (Group I), a 40-N tension was applied to each of the two hamstring autografts at 30 degrees of knee flexion, and simultaneously fixed onto the tibia. In the remaining 53 patients (Group II), a 30-N tension was applied to each graft at 10 degrees of knee flexion, and simultaneously fixed onto the tibia. Each patient was examined 2 years after surgery. Results: There wasn't a significant difference in the background of the two groups. There was no significant difference in the postoperative anterior laxity between the two groups. The average was 1.1 mm and 0.9 mm in Groups I and II, respectively. There wasn't any differences between the two groups in Lysholm knee score, International Knee Documentation Committee (IKDC) evaluation and muscle strength. Four patients had loss of knee extension in a range of 5 degrees and 10 degrees in Group I and none of the patients in Group II exhibited any loss in knee extension; which was statistically significant (p = 0.025). Conclusion: The two initial graft tension protocols did not result in any significant differences in the Lysholm knee score and IKDC grade. However, it was noted that the 40-N tension applied to each graft at 30 degrees of knee flexion more significantly induced loss of knee extension in comparison to the 30-N tension applied to each graft at 10 degrees. From a clinical viewpoint, the loss of knee extension is one of the pathological conditions that should be absolutely avoided after ACL reconstruction. Therefore, the 30-N tension applied to each graft at 10 degrees is preferable to the other graft tension protocol.
Rights: http://creativecommons.org/licenses/by/4.0/
Type: article
URI: http://hdl.handle.net/2115/60830
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 近藤 英司

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