COMPREHENSIVE CLINICAL EVALUATION OF ANTERIOR CRUCIATE LIGAMENT INJURY: PREOPERATIVE ASSESSMENT TO POSTOPERATIVE OUTCOMES
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Keywords
Anterior Cruciate Ligament, ACL Reconstruction, Clinical Evaluation, Lysholm Knee Scoring Scale, Preoperative Assessment, Postoperative Outcomes
Abstract
Introduction: The Anterior Cruciate Ligament (ACL) is pivotal in maintaining knee stability and function, playing a crucial role in the intricate balance of the knee joint. This study navigates through the evolution of ACL understanding, encompassing anatomy, biomechanics, epidemiology, and advancements in surgical techniques. In the contemporary era, heightened sports activity and motorized pursuits contribute to an increased incidence of ACL injuries, making it imperative to explore the preoperative and postoperative facets of clinical evaluation.
Objective: To conduct a comprehensive study assessing both preoperative and postoperative clinical evaluations of patients with anterior cruciate ligament injury.
Materials and Methods: A prospective study was conducted at M R Medical College, affiliated with Basaveshwara Teaching Hospital, Gulbarga, from June 2021- June 2023. Thirty subjects meeting inclusion criteria were included. Preoperative assessments included age, gender, side, and mode of injury. Surgical interventions utilized a variety of graft sources, with a focus on the semitendinosus and gracilis tendons. Postoperative evaluations were conducted at 6 weeks, 3 months, and 6 months, utilizing the Lysholm knee scoring scale for objective and subjective assessments
Results: The study included predominantly male subjects (90%) in the age range of 18 to 40 years. The most common mode of injury was found to be falls (36.7%) and road traffic accidents (33.3%). Preoperative clinical tests (ADT, Lachman, Pivot Shift) demonstrated positive results, while postoperative assessments revealed significant improvement, with all subjects showing negative results.
Conclusion: The study demonstrated substantial postoperative improvement in patients undergoing ACL reconstruction, as evidenced by positive outcomes on clinical assessments and the Lysholm knee scoring scale. The shift from preoperative instability and symptoms to postoperative stability and functional recovery underscores the efficacy of contemporary surgical techniques, particularly those utilizing semitendinosus and gracilis tendons.
References
2. Haimes JL, Wroble RR, Grood ES, Noyes FR; Role of medial structures in the intact and anterior cruciate ligament deficient knee. Limits of motion in the human knee. Am J Sports Med 1994;22:402-9.
3. Markolf KL, Wascher DC, Finerman GAM; Direct in-vitro, measurement of forces in the cruciate ligament. Part II: The effect of section of the posterolateral structures; J Bone and Joint Surg Am 1993;75:A387-394.
4. Frank CB, Jackson DW. Current concepts review. The science of reconstruction of the anterior cruciate ligament; J Bone and Joint Surg Am 1997;79:1556-76.
5. Kanamori A, Woo SL, Ma CB, Zeminski J, Rudy TW, Li G, Livesay GA; The forces in the anterior cruciate ligament and knee kinematics during a simulated pivot shift test: a human cadaveric study using robotic technology. Arthroscopy 2000;16:888-9.
6. Spindler KP, Wright RW. Clinical practice. Anterior cruciate ligament tear. N Engl J Med 2008;359:2135-42.
7. Curl WW, Krome J, Gordon ES. Cartilage injuries: a review of 31516 knee arthroscopies. Arthroscopy 1997;13(4):456-60.
8. Fu FH, Bennett CH, Ma CB;Current trends in anterior cruciate ligament reconstruction: Operative procedures and clinical correlation; Am J of Sports Med 2000;28:124-30.
9. Scranton PE, Bagenstose JE, Lantz BA, et al; Quadruple hamstring anterior cruciate ligament reconstruction: A multicenter study. Arthroscopy 2002;18(7):715-24.
10. Hewett TE, Di Stasi SL, Myer GD. Current concepts for injury prevention in athletes after anterior cruciate ligament reconstruction. Am J Sports Med 2013;41:216-24.
11. Buchner M, Schmeer T, Schmitt H. Anterior cruciate ligament reconstruction with quadrupled semitendinosus tendon- minimum 6 year clinical and radiological follow-up. The Knee 2007;14(4):321-7.
12. Lysholm J, Gillquist J. Evaluation of knee ligament surgery results with special emphasis on use of a scoring scale. Am J Sports Med 1982;10:150-4.
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Dr. Alok C. Patil
Assistant Professor, Department of Orthopaedics, Mahadevappa Rampure Medical College Kalaburagi, Karnataka, India
Dr. Bindusar
Senior Resident, Department of Orthopaedics, Kodagu Institute of Medical Sciences, Kodagu, Karnataka, India.