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Intraoperative arthrometry in anterior cruciate ligament reconstruction.

Gregory C.R. Keene, Parminder J.S. Jeer, Rehan Gul

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Abstract

Arthrometry has an established role in the measurement of knee laxity in anterior cruciate ligament injury and following reconstruction. The role of routine intraoperative arthrometry in anterior cruciate ligament reconstruction is poorly defined, and this study was designed to test the hypothesis that intraoperative arthrometry provides an objective method of documenting successful knee stabilisation following anterior cruciate ligament reconstruction. A consecutive cohort of 100 patients with unilateral isolated anterior cruciate ligament disruption were prospectively evaluated using a Rolimeter arthrometer. A maximal manual force method was utilised by a single examiner. This allowed for side-to-side comparisons with the uninjured contralateral knee. Analysis of tibial translation was recorded preoperatively with patients both awake and asleep, intraoperatively following anterior cruciate ligament reconstruction, and postoperatively at 2 weeks and 3 months. Statistical analysis was performed using Spearman's correlation coefficients. Intraoperative arthrometry of anterior cruciate ligament reconstructed knees revealed statistically significant correlation with measurements of uninjured knees (p < 0.0001). These findings were reproducible at 2 weeks (p < 0.0001) and at 3 months (p = 0.0002). Based on our findings, we conclude that intraoperative arthrometry can be simple and provide reproducible results. It is a useful method of immediately and objectively documenting successful anterior cruciate ligament reconstruction.

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What this paper is about

Arthrometry has an established role in the measurement of knee laxity in anterior cruciate ligament injury and following reconstruction. The role of routine intraoperative arthrometry in anterior cruciate ligament reconstruction is poorly defined, and this study was designed to test the hypothesis that intraoperative arthrometry provides an objective method of documenting successful knee stabilisation following anterior cruciate ligament reconstruction. A consecutive cohort of 100 patients with unilateral isolated anterior cruciate ligament disruption were prospectively evaluated using a Rolimeter arthrometer. A maximal manual force method was utilised by a single examiner. This allowed for side-to-side comparisons with the uninjured contralateral knee. Analysis of tibial translation was recorded preoperatively with patients both awake and asleep, intraoperatively following anterior cruciate ligament reconstruction, and postoperatively at 2 weeks and 3 months. Statistical analysis was performed using Spearman's correlation coefficients. Intraoperative arthrometry of anterior cruciate ligament reconstructed knees revealed statistically significant correlation with measurements of uninjured knees (p < 0.0001). These findings were reproducible at 2 weeks (p < 0.0001) and at 3 months (p = 0.0002). Based on our findings, we conclude that intraoperative arthrometry can be simple and provide reproducible results. It is a useful method of immediately and objectively documenting successful anterior cruciate ligament reconstruction.

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Available abstract

Arthrometry has an established role in the measurement of knee laxity in anterior cruciate ligament injury and following reconstruction. The role of routine intraoperative arthrometry in anterior cruciate ligament reconstruction is poorly defined, and this study was designed to test the hypothesis that intraoperative arthrometry provides an objective method of documenting successful knee stabilisation following anterior cruciate ligament reconstruction. A consecutive cohort of 100 patients with unilateral isolated anterior cruciate ligament disruption were prospectively evaluated using a Rolimeter arthrometer. A maximal manual force method was utilised by a single examiner. This allowed for side-to-side comparisons with the uninjured contralateral knee. Analysis of tibial translation was recorded preoperatively with patients both awake and asleep, intraoperatively following anterior cruciate ligament reconstruction, and postoperatively at 2 weeks and 3 months. Statistical analysis was performed using Spearman's correlation coefficients. Intraoperative arthrometry of anterior cruciate ligament reconstructed knees revealed statistically significant correlation with measurements of uninjured knees (p < 0.0001). These findings were reproducible at 2 weeks (p < 0.0001) and at 3 months (p = 0.0002). Based on our findings, we conclude that intraoperative arthrometry can be simple and provide reproducible results. It is a useful method of immediately and objectively documenting successful anterior cruciate ligament reconstruction.

Key concepts: Medicine, Anterior cruciate ligament, Anterior cruciate ligament reconstruction, Surgery, Ligament

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