Extension deficit after anterior cruciate ligament reconstruction: Is arthroscopic posterior release a safe and effective procedure?

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• 作者：Guido Wierer^a ; ^b ; ^{wierer@gmail.com} ; Armin Runer^b ; ^c ; ^{Armin.Runer@rolmail.net} ; Peter Gfö ; ller^b ; ^{p.gfoeller@gelenkpunkt.com} ; Christian Fink^b ; ^d ; ^{c.fink@gelenkpunkt.com} ; Christian Hoser^b ; ^{c.hoser@gelenkpunkt.com}
• 关键词：ACL ; Extension deficit ; Flexion contracture ; Arthroscopic release ; Capsulotomy
• 刊名：The Knee
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：24
• 期：1
• 页码：49-54
• 全文大小：736 K
• 卷排序：24

文摘

Postoperative extension deficits following anterior cruciate ligament (ACL) reconstruction can cause major limitation during daily life. The purpose of this study was to evaluate the efficiency of an all-arthroscopic approach and posterior capsule release for the treatment of persistent knee extension deficits following ACL reconstruction.MethodsBetween 2009 and 2013 a total of 10 patients with knee flexion contractures after ACL reconstruction were assessed following an all-arthroscopic approach and posterior capsulotomy. The clinical outcomes were reviewed using the range of motion (ROM), Tegner Activity Level, Lysholm score and visual analogue pain scale (VAS).ResultsFour women and six men with a median age of 34 years (range: 17 to 49 years) were included in the study. The median follow-up period was 25 months (range: 14 to 69 months). The median preoperative extension deficit was 15° (range: 10 to 20°) compared to the normal contralateral knee. Postoperatively at final follow-up the median extension deficit was one degree (range: 0 to five degrees) (P < 0.01). The median preoperative Lysholm score improved from 52 (range: 32 to 67) to 92 (range: 84 to 100) postoperatively (P < 0.01), while the median Tegner Activity Level improved from three (range: two to six) to six (range: three to seven) respectively (P < 0.02). The median VAS status for pain decreased from five (range: one to 10) to one (range: 0 to three) (P < 0.01). No complications were observed.ConclusionsArthroscopic posterior capsulotomy is a safe and effective additional procedure in the treatment of persistent knee extension deficits following ACL reconstruction with excellent results regarding ROM and subjective outcomes.Level of evidenceLevel IV.