PMID- 34952186
OWN - NLM
STAT- MEDLINE
DCOM- 20220608
LR  - 20220830
IS  - 1526-3231 (Electronic)
IS  - 0749-8063 (Linking)
VI  - 38
IP  - 6
DP  - 2022 Jun
TI  - Anterior Cruciate Ligament Patellar Tendon Autograft Fixation at 0 degrees  Versus 30 degrees  
      Results in Improved Activity Scores and a Greater Proportion of Patients 
      Achieving the Minimal Clinical Important Difference For Knee Injury and 
      Osteoarthritis Outcome Score Pain: A Randomized Controlled Trial.
PG  - 1969-1977
LID - S0749-8063(21)01109-9 [pii]
LID - 10.1016/j.arthro.2021.12.018 [doi]
AB  - PURPOSE: The aim of the current study was to determine the effect of the knee 
      flexion angle (KFA) during tibial anterior cruciate ligament (ACL) graft fixation 
      on patient-reported outcomes, graft stability, extension loss, and reoperation 
      after anatomic single-bundle ACL reconstruction. METHODS: All 169 included 
      patients (mean age 28.5 years, 65% male) were treated with anatomic single-bundle 
      ACL reconstruction using patellar tendon autograft and were randomized to tibial 
      fixation of the ACL graft at either 0 degrees  (n = 85) or 30 degrees  (n = 84). The primary 
      outcome was the Knee Injury and Osteoarthritis Outcome Score (KOOS) 2 years after 
      surgery. Secondary outcomes were the Marx Activity Scale (MAS), the rate of 
      reoperation, and physical examination findings at 1 year, including KT-1000 and 
      side-to-side differences in knee extension. RESULTS: The follow-up rate was 82% 
      (n = 139) for the primary outcome. Graft failure rate at 2 years was 1% (n = 2, 1 
      per group). ACL tibial graft fixation at 0 degrees  or 30 degrees  did not have a significant 
      effect on KOOS scores at 2 years after ACLR. Patients whose graft was fixed at a 
      knee flexion angle of 0 degrees  had greater scores on the MAS (mean 9.6 95% confidence 
      interval [CI] 8.5 to 10.6, versus 8.0, 95% CI 6.9 to 9.1; P = .04), and a greater 
      proportion achieved the minimal clinical important difference (MCID) for the KOOS 
      pain subdomain (94% versus 81%; P = .04). There was no significant difference in 
      knee extension loss, KT-1000 measurements, or reoperation between the 2 groups. 
      CONCLUSION: In the setting of anatomic single-bundle ACLR using patellar tendon 
      autograft and anteromedial portal femoral drilling, there was no difference in 
      KOOS scores between patients fixed at 0 degrees  and 30 degrees . Patient fixed in full extension 
      did demonstrate higher activity scores at 2 years after surgery and a greater 
      likelihood of achieving the MCID for KOOS pain. LEVEL OF EVIDENCE: II, 
      prospective randomized trial.
CI  - Copyright (c) 2021 Arthroscopy Association of North America. Published by Elsevier 
      Inc. All rights reserved.
FAU - Chahal, Jaskarndip
AU  - Chahal J
AD  - University of Toronto Orthopaedics Sports Medicine, Woman's College Hospital, 
      University of Toronto, Toronto, Ontario, Canada. Electronic address: 
      jchahal@utosm.com.
FAU - Whelan, Daniel B
AU  - Whelan DB
AD  - University of Toronto Orthopaedics Sports Medicine, Woman's College Hospital, 
      University of Toronto, Toronto, Ontario, Canada.
FAU - Hoit, Graeme
AU  - Hoit G
AD  - University of Toronto Orthopaedics Sports Medicine, Woman's College Hospital, 
      University of Toronto, Toronto, Ontario, Canada.
FAU - Theodoropoulos, John
AU  - Theodoropoulos J
AD  - University of Toronto Orthopaedics Sports Medicine, Woman's College Hospital, 
      University of Toronto, Toronto, Ontario, Canada.
FAU - Ajrawat, Prabjit
AU  - Ajrawat P
AD  - University of Toronto Orthopaedics Sports Medicine, Woman's College Hospital, 
      University of Toronto, Toronto, Ontario, Canada.
FAU - Betsch, Marcel
AU  - Betsch M
AD  - University of Toronto Orthopaedics Sports Medicine, Woman's College Hospital, 
      University of Toronto, Toronto, Ontario, Canada.
FAU - Docter, Shgufta
AU  - Docter S
AD  - University of Toronto Orthopaedics Sports Medicine, Woman's College Hospital, 
      University of Toronto, Toronto, Ontario, Canada.
FAU - Dwyer, Tim
AU  - Dwyer T
AD  - University of Toronto Orthopaedics Sports Medicine, Woman's College Hospital, 
      University of Toronto, Toronto, Ontario, Canada.
LA  - eng
SI  - ClinicalTrials.gov/NCT03875807
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20211222
PL  - United States
TA  - Arthroscopy
JT  - Arthroscopy : the journal of arthroscopic & related surgery : official 
      publication of the Arthroscopy Association of North America and the International 
      Arthroscopy Association
JID - 8506498
SB  - IM
CIN - Arthroscopy. 2022 Jun;38(6):1978-1979. PMID: 35660189
CIN - J Bone Joint Surg Am. 2022 Aug 17;104(16):1505. PMID: 35700077
MH  - Adult
MH  - Anterior Cruciate Ligament/surgery
MH  - *Anterior Cruciate Ligament Injuries/surgery
MH  - Autografts
MH  - Female
MH  - Humans
MH  - Knee Joint/surgery
MH  - Male
MH  - *Osteoarthritis
MH  - Pain
MH  - *Patellar Ligament/transplantation
MH  - Prospective Studies
EDAT- 2021/12/25 06:00
MHDA- 2022/06/09 06:00
CRDT- 2021/12/24 20:11
PHST- 2021/04/16 00:00 [received]
PHST- 2021/12/06 00:00 [revised]
PHST- 2021/12/12 00:00 [accepted]
PHST- 2021/12/25 06:00 [pubmed]
PHST- 2022/06/09 06:00 [medline]
PHST- 2021/12/24 20:11 [entrez]
AID - S0749-8063(21)01109-9 [pii]
AID - 10.1016/j.arthro.2021.12.018 [doi]
PST - ppublish
SO  - Arthroscopy. 2022 Jun;38(6):1969-1977. doi: 10.1016/j.arthro.2021.12.018. Epub 
      2021 Dec 22.