Primary repair versus reconstruction of the anterior cruciate ligament: Functional outcomes and postural stability compared with healthy controls
Küçük Resim Yok
Tarih
2025
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Wiley
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
Purpose To compare functional outcomes and postural stability in patients undergoing primary anterior cruciate ligament (ACL) repair or hamstring tendon reconstruction, using healthy individuals as a reference. We hypothesized that primary ACL repair would result in superior subjective knee function and postural stability.Methods This comparative case-control study assessed pain, function, single-leg hop performance and postural stability were assessed using the Visual Analogue Scale (VAS), Lysholm Knee Score, International Knee Documentation Committee (IKDC) Score and Biodex Biosway indices (OSI: overall stability index, API: anteroposterior index, MLI: mediolateral index) in bipedal and single-leg stance. Statistical analyses included one-way analysis of variance (ANOVA) or Kruskal-Wallis tests for group comparisons, with paired t-tests or Wilcoxon signed-rank tests for within-group comparisons, depending on data distribution.Results A total of 113 participants were analyzed: primary repair (primary repair group [PRG], n = 40), reconstruction (reconstruction group [RG], n = 38), and control (control group [CG], n = 35) groups. Mean follow-up was 43.2 +/- 10.1 months in PRG and 43.9 +/- 11.7 months in RG. VAS scores were 1.37 +/- 1.56 in PRG and 1.89 +/- 1.62 in RG (mean difference [MD] = 0.51, 95% confidence interval [CI]: -0.19 to 1.23, p = 0.15). Lysholm scores were 92.6 +/- 6.95 in PRG and 89.5 +/- 9.09 in RG (MD = -3.02, 95% CI: -6.66 to 0.61, p = 0.10). IKDC scores were significantly higher in PRG (88.2 +/- 9.01) than RG (82.6 +/- 12.1) (MD = 5.63, 95% CI: 0.84 to 10.42, p = 0.02). On the operated side, MLI was lower in PRG (0.2 +/- 0.3) than RG (0.3 +/- 0.2) (MD = -0.05, 95% CI: 0.008 to 0.11, p = 0.02), indicating better mediolateral stability. Single-leg hop distance was shorter in RG (1.40 +/- 0.28 m) and PRG (1.43 +/- 0.27 m) compared with CG (1.62 +/- 0.18 m) (CG vs. RG: MD = 0.22, 95% CI: 0.07 to 0.36; CG vs. PRG: MD = 0.18, 95% CI: 0.03 to 0.33; p = 0.001), despite LSI values exceeding 90% (RG: 93.1 +/- 8.5%; PRG: 95.1 +/- 6.3%).Conclusions Primary anterior cruciate ligament repair provides comparable functional and postural outcomes to reconstruction and may offer superior subjective knee function and mediolateral balance in selected patients.Level of Evidence Level III.
Açıklama
Anahtar Kelimeler
anterior cruciate ligament reconstruction, anterior cruciate ligament repair, knee function, postural stability, single-leg hop test, IKDC score
Kaynak
Knee Surgery Sports Traumatology Arthroscopy
WoS Q Değeri
Q1
Scopus Q Değeri
Q1
