Instability of the Knee Joint Before and After Reconstruction of the Anterior Cruciate Ligament According to the Questionnaire
- Authors: Akhpashev A.A.1, Skvortsov D.V.1,2,3
-
Affiliations:
- Federal Research and Clinical Center of Specialized Medical Care and Medical Technologies
- The Russian National Research Medical University named after N.I. Pirogov
- Federal Center of Brain Research and Neurotechnologies
- Issue: Vol 14, No 3 (2023)
- Pages: 20-26
- Section: Original Study Articles
- URL: https://journals.rcsi.science/clinpractice/article/view/253931
- DOI: https://doi.org/10.17816/clinpract346689
- ID: 253931
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Abstract
Background: The instability of the knee joint after a rupture of the anterior cruciate ligament in recent decades has acquired the character of a meme among Russian orthopedists with a very wide use and meaning. Aim: In this study, we tried to find out how often the phenomenon of instability occurs and how it can be associated with joint injury. Methods: The method of questioning, collecting anamnesis in patients at the primary orthopedic appointment and in patients after surgical reconstruction by the method of questioning was used. Results: The data collected in 433 patients with a verified rupture of the anterior cruciate ligament showed that 77% experienced a feeling of instability in the knee joint, and 19% did not experience them at all. Arthroscopic reconstruction was performed in 297 patients, 71 of them were surveyed. The period of time from surgery to questioning was 6.5 years on average. Not all patients can note the moment of injury. Even if there was an injury to the knee joint, 10% of patients do not note the development of instability immediately after injury. The duration of the sensation of instability in the knee joint after injury varies from one week to a year or more. The very moment of joint instability is accompanied by pain in more than half of the cases. At the same time, 12% of the respondents had no pain. A third of the respondents had never noted episodes of instability in the knee joint before surgical reconstruction. But 11% had such episodes daily. In the postoperative period, 27% note the recurrence of joint instability at different times. Conclusions: Thus, an ACL tear does not equal knee instability. Instability is not a condition, but a short-term episode that occurs during the period of support and leads to buckling of the limb.
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##article.viewOnOriginalSite##About the authors
Alexander A. Akhpashev
Federal Research and Clinical Center of Specialized Medical Care and Medical Technologies
Author for correspondence.
Email: akhpashev@gmail.com
ORCID iD: 0000-0002-2938-5173
SPIN-code: 9965-1828
MD, PhD
Russian Federation, MoscowDmitry V. Skvortsov
Federal Research and Clinical Center of Specialized Medical Care and Medical Technologies; The Russian National Research Medical University named after N.I. Pirogov; Federal Center of Brain Research and Neurotechnologies
Email: dskvorts63@mail.ru
ORCID iD: 0000-0002-2794-4912
SPIN-code: 6274-4448
MD, PhD, Dr. Sci. (Med.), Professor
Russian Federation, Moscow; Moscow; MoscowReferences
- Fu FH, van Eck CF, Tashman S, et al. Anatomic anterior cruciate ligament reconstruction: A changing paradigm. Knee Surg Sports Traumatol Arthrosc. 2015;23(3):640–648. doi: 10.1007/s00167-014-3209-9
- Gabriel MT, Wong EK, Woo SL, et al. Distribution of in situ forces in the anterior cruciate ligament in response to rotatory loads. J Orthop Res. 2004;22(1):85–89. doi: 10.1016/S0736-0266(03)00133-5
- Hasegawa T, Otani TF, Takeda KF, et al. Anterior cruciate ligament reconstruction does not fully restore normal 3d knee kinematics at 12 months during walking and walk-pivoting: A longitudinal gait analysis study. J Appl Biomech. 2015;31(5):330–339. doi: 10.1123/jab.2014-0175
- McCluskey G, Blackburn TA. Classification of knee ligament instabilities. Physical Therapy. 1980;60(12):1575–1577. doi: 10.1093/ptj/60.12.1575
- Zaffagnini S, Roberti T, Sarsina D, et al. Rotatory Knee Instability. UPMC Center for Sports Medicine, Pittsburgh, Pennsylvania, USA, 2017. 331 p. doi: 10.1007/978-3-319-32070-0_28
- Lohmander LS, Ostenberg A, Englund M, Roos H. High prevalence of knee osteoarthritis, pain, and functional limitations in female soccer players twelve years after anterior cruciate ligament injury. Arthritis Rheum. 2004;50(10):3145–3152. doi: 10.1002/art.20589
- Bressy G, Lustig S, Neyret P, Servien E. Instabilités du genou. EMC Appareil locomoteur. 2015;10(4):1–16. doi: 10.1016/S0246-0521(15)66293-3
- Boeth H. Evaluation and characterization of knee joint instability in ACL deficient patients. Berlin, 2013. doi: 10.14279/DEPOSITONCE-3827
- Andriacchi TP, Dyrby CO. Interactions between kinematics and loading during walking for the normal and ACL deficient knee. J Biomech. 2005;38(2):293–298. doi: 10.1016/j.jbiomech.2004.02.010
- Gao B, Zheng NN. Alterations in three-dimensional joint kinematics of anterior cruciate ligament-deficient and reconstructed knees during walking. Clin Biomech (Bristol, Avon). 2010;25(3):222–229. doi: 10.1016/j.clinbiomech.2009.11.006
- Musahl V, Hoshino Y, Becker R, Karlsson J. Rotatory knee laxity and the pivot shift. Knee Surg Sports Traumatol Arthrosc. 2012;20(4):601–602. doi: 10.1007/s00167-011-1844-y
- Morooka TA, Hamai S, Miura H, et al. Dynamic activity dependence of in vivo normal knee kine- matics. J Orthop Res. 2008;26(4):428–434. doi: 10.1002/ jor.20488
- Van Eck CF, van den Bekerom MP, Fu FH, et al. Methods to diagnose acute anterior cruciate ligament rupture: A meta-analysis of physical examinations with and without anaesthesia. Knee Surg Sports Traumatol Arthrosc. 2013;21(8):1895–1903. doi: 10.1007/s00167-012-2250-9
- Barber SD, Noyes FR, Mangine RE, et al. Quantitative assessment of functional limitations in normal and anterior cruciate ligament-deficient knees. Clin Orthop Relat Res. 1990;(255):204–214.
- Cross MJ, Wootton JR, Bokor DJ, Sorrenti SJ. Acute repair of injury to the anterior cruciate ligament. A long-term followup. Am J Sports Med. 1993;21(1):128–131. doi: 10.1177/036354659302100121
- Harter RA, Osternig LR, Singer KM, et al. Long-term evaluation of knee stability and function following surgical reconstruction for anterior cruciate ligament insufficiency. Am J Sports Med. 1988;16(5):434–443. doi: 10.1177/036354658801600502
- Kocher MS, Steadman JR, Briggs KK, et al. Relationships between objective assessment of ligament stability and subjective assessment of symptoms and function after anterior cruciate ligament reconstruction. Am J Sports Med. 2004; 32(3):629–634. doi: 10.1177/0363546503261722
- Seto JL, Orofino AS, Morrissey MC, et al. Assessment of quadriceps/hamstring strength, knee ligament stability, functional and sports activity levels five years after anterior cruciate ligament reconstruction. Am J Sports Med. 1988; 16(2):170–180. doi: 10.1177/036354658801600215
- Goyal K, Tashman S, Wang JH, et al. In vivo analysis of the isolated posterior cruciate ligament-deficient knee during functional activities. Am J Sports Med. 2012;40(4):777–785. doi: 10.1177/0363546511435783
- Tashman S, Araki D. Effects of anterior cruciate ligament reconstruction on in vivo, dynamic knee function. Clin Sports Med. 2013;32(1):47–59. doi: 10.1016/j. csm.2012.08.006
- Tashman S, Collon D, Anderson K, et al. Abnormal rotational knee motion during running after anterior cruciate ligament reconstruction. Am J Sports Med. 2004;32(4):975–983. doi: 10.1177/0363546503261709
- Tashman S, Kolowich P, Collon D, et al. Dynamic function of the ACL-reconstructed knee during running. Clin Orthop Relat Res. 2007;(454):66–73. doi: 10.1097/BLO.0b013e31802bab3e
- Cross MJ. Clinical terminology for describing knee instability. Sports Med Arthroscopy Rev. 1996;(4):313–318.
- Rudolph KS, Axe MJ, Buchanan TS, et al. Dynamic stability in the anterior cruciate ligament deficient knee. Knee Surg Sports Traumatol Arthrosc. 2001;9(2):62–71. doi: 10.1007/s001670000166
- Rudolph KS, Snyder-Mackler L. Effect of dynamic stability on a step task in ACL deficient individuals. J Electromyogr Kinesiol. 2004;14(5):565–575. doi: 10.1016/j.jelekin.2004.03.002