Evidence map›Paper›PMID 33566146›Full record

Trial reportKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2022

Anterior cruciate ligament reconstruction with lateral extraarticular tenodesis better restores native knee kinematics in combined ACL and meniscal injury.

Christopher M Gibbs, Jonathan D Hughes, Adam J Popchak, Daisuke Chiba, Bryson P Lesniak, William J Anderst, Volker Musahl

Abstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Christopher M GibbsUPMC Freddie Fu Sports Medicine Center, Department of Orthopaedic Surgery, University of Pittsburgh, 3200 South Water St, Pittsburgh, PA, 15203, USA. gibbscm2@upmc.edu.ORCID http://orcid.org/0000-0003-4116-3845
Jonathan D HughesUPMC Freddie Fu Sports Medicine Center, Department of Orthopaedic Surgery, University of Pittsburgh, 3200 South Water St, Pittsburgh, PA, 15203, USA.
Adam J PopchakDepartment of Physical Therapy, University of Pittsburgh, Pittsburgh, PA, USA.
Daisuke ChibaUPMC Freddie Fu Sports Medicine Center, Department of Orthopaedic Surgery, University of Pittsburgh, 3200 South Water St, Pittsburgh, PA, 15203, USA.
Bryson P LesniakUPMC Freddie Fu Sports Medicine Center, Department of Orthopaedic Surgery, University of Pittsburgh, 3200 South Water St, Pittsburgh, PA, 15203, USA.
William J AnderstBiodynamics Laboratory, Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA.
Volker MusahlUPMC Freddie Fu Sports Medicine Center, Department of Orthopaedic Surgery, University of Pittsburgh, 3200 South Water St, Pittsburgh, PA, 15203, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo determine if anterior cruciate ligament (ACL) reconstruction (ACLR) with lateral extraarticular tenodesis (LET) is beneficial for restoring knee kinematics with concomitant meniscal pathology causing rotatory knee instability.

methodsTwenty patients with an ACL tear were randomized to either isolated ACLR or ACLR with LET. Patients were divided into four groups based on the surgery performed and the presence of meniscal tear (MT): ACLR without MT, ACLR with MT, ACLR with LET without MT, and ACLR with LET with MT. Kinematic data normalized to the contralateral, healthy knee were collected using dynamic biplanar radiography superimposed with high-resolution computed tomography scans of patients' knees during downhill running. Anterior tibial translation (ATT) and tibial rotation (TR) as well as patient-reported outcome measures (PROMs) were analyzed at 6- and 12-months postoperatively.

resultsAt 6 months, ACLR with LET resulted in significantly decreased ATT at heel strike compared to ACLR (ACLR without MT: 0.3 ± 0.8 mm and ACLR with MT: 1.4 ± 3.1 mm vs. ACLR with LET without MT: - 2.5 ± 3.4 mm and ACLR with LET with MT: - 1.5 ± 1.2 mm ATT, p = 0.02). At 6 months, at toe off ACLR with LET better restored ATT to that of the contralateral, healthy knee in patients with meniscal pathology, while in patients without meniscal pathology, ACLR with LET resulted in significantly decreased ATT (1.0 ± 2.6 mm ATT vs. - 2.6 ± 1.7 mm ATT, p = 0.04). There were no significant differences in kinematics or PROMs between groups at 12 months.

conclusionFor combined ACL and meniscus injury, ACLR with LET restores native knee kinematics at toe off but excessively decreases ATT at heel strike in the early post-operative period (6 months) without altering knee kinematics in the long term. Future large-scale clinical studies are needed to better understand the function of LET and ultimately improve patient outcomes. LEVEL OF EVIDENCE: III.

Indexed as

Anterior Cruciate Ligament InjuriesAnterior Cruciate Ligament ReconstructionJoint InstabilityMeniscusTenodesisBiomechanical PhenomenaHumansKnee JointACL tearKnee kinematicsLETMeniscal injury

Identifiers

PMID33566146

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.