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Double-bundle anterior cruciate ligament reconstruction using autologous hamstring tendon hybrid grafts in a patient with hypermobile Ehlers-Danlos Syndrome : A case report

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Title: Double-bundle anterior cruciate ligament reconstruction using autologous hamstring tendon hybrid grafts in a patient with hypermobile Ehlers-Danlos Syndrome : A case report
Authors: Hishimura, Ryosuke Browse this author
Kondo, Eiji Browse this author →KAKEN DB
Matsuoka, Masatake Browse this author →KAKEN DB
Iwasaki, Koji Browse this author →KAKEN DB
Kawaguchi, Yasuyuki Browse this author
Suzuki, Yuki Browse this author
Onodera, Tomohiro Browse this author →KAKEN DB
Momma, Daisuke Browse this author →KAKEN DB
Iwasaki, Norimasa Browse this author →KAKEN DB
Issue Date: Mar-2022
Publisher: Elsevier
Journal Title: Knee
Volume: 35
Start Page: 81
End Page: 86
Publisher DOI: 10.1016/j.knee.2022.02.005
Abstract: Background: Ehlers-Danlos syndrome (EDS) is a connective tissue disorder characterized by skin hyperextensibility, joint hypermobility, and tissue friability. Hypermobile type Ehlers-Danlos syndrome (hEDS) is considered one of the EDS subtypes characterized by generalized joint hypermobility. Although there have been a few case reports which described surgical considerations for anterior cruciate ligament (ACL) reconstructions in patients with other types of EDS, no reports have described those in patients with hEDS. Case presentation: We report a case of ACL injury in an 18-year-old male patient with hEDS. The patient was successfully treated with an anatomic double-bundle ACL reconstruction using autologous hamstring tendon hybrid grafts which consist of hamstring tendons connected in a series with commercially available polyester tape. The autogenous tendon portion of the anteromedial and posterolateral bundles were composed of 4 and 2 strands of hamstring tendons, respectively. After 2 weeks of knee joint immobilization, continuous passive motion exercise of the knee joint and partial weight-bearing was allowed. A hinged knee brace was used for a period of 5 months postoperatively. Second-look arthroscopy at 30 months showed that the ACL graft had no laceration and an excellent coverage of the synovium. At 36 months after surgery, the side-to-side differences in the anterior laxity was remarkably improved. The operated knee showed negative Lachman test and had a full range of motion. Conclusions: To the best of our knowledge, this represents the first report of anatomic double-bundle ACL reconstruction in patients with hEDS and demonstrates excellent clinical and functional outcomes. (C) 2022 Elsevier B.V. All rights reserved.
Rights: © 2022, Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International
Type: article (author version)
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 近藤 英司

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