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Generalised ligamentous laxity and revision ACL surgery: Is there a relation?
Knee 2016 December
BACKGROUND: The aim of the present study was to investigate the relationship between generalised ligamentous laxity (GLL) and requirement for revision anterior cruciate ligament (ACL) reconstruction.
METHODS: The study cohort consisted of 139 patients undergoing primary ACL reconstruction, 44 patients undergoing revision ACL surgery and a control group of 70 patients without any knee ligament injury. A Beighton score of four or more was classified as generalised ligamentous laxity.
RESULTS: The primary and revision ACL surgery groups had an increased incidence of GLL compared to the control group (p<0.05). The revision ACL surgery group also had higher incidence of GLL as compared to primary ACL surgery group (p<0.05). There was a sub group within the revision cohort, who had failure of the original surgery without an identifiable cause (biological failure). The incidence of GLL in this group was significantly higher than the primary surgery group (p<0.05).
CONCLUSIONS: The findings of this study suggest that GLL may be associated with a higher risk of ACL injury and an increased risk of graft failure after primary ACL reconstruction. Based on the results of our study we feel that in the presence of GLL an autogenous graft may not be the best option for either primary or revision ACL reconstruction.
LEVEL OF EVIDENCE: 3 (III).
METHODS: The study cohort consisted of 139 patients undergoing primary ACL reconstruction, 44 patients undergoing revision ACL surgery and a control group of 70 patients without any knee ligament injury. A Beighton score of four or more was classified as generalised ligamentous laxity.
RESULTS: The primary and revision ACL surgery groups had an increased incidence of GLL compared to the control group (p<0.05). The revision ACL surgery group also had higher incidence of GLL as compared to primary ACL surgery group (p<0.05). There was a sub group within the revision cohort, who had failure of the original surgery without an identifiable cause (biological failure). The incidence of GLL in this group was significantly higher than the primary surgery group (p<0.05).
CONCLUSIONS: The findings of this study suggest that GLL may be associated with a higher risk of ACL injury and an increased risk of graft failure after primary ACL reconstruction. Based on the results of our study we feel that in the presence of GLL an autogenous graft may not be the best option for either primary or revision ACL reconstruction.
LEVEL OF EVIDENCE: 3 (III).
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