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Anterior Cruciate Ligament Reconstruction: Clinical Advances and Prognosis
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Anterior Cruciate Ligament Reconstruction: Clinical Advances and Prognosis

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Orthopedics".

Deadline for manuscript submissions: closed (28 May 2024) | Viewed by 1470

Special Issue Editors

Dr. Georgios Komnos

E-Mail Website
Guest Editor
The Department of Orthopedic Surgery, Faculty of Medicine, School of Health Sciences, University of Hospital of Larissa, 41110 Larissa, Greece
Interests: hip arthroplasty; knee fracture; sports medicine; knee arthroplasty; ACL reconstruction
Prof. Dr. Michael Hantes

E-Mail Website
Guest Editor
School of Health Sciences, University of Thessaly, Larisa, Greece
Interests: orthopedic surgery; knee; shoulder; ankle; arthroscopic surgery

Special Issue Information

Dear Colleagues,

Anterior Cruciate Ligament Reconstruction (ACLR) remains one of the most common surgical interventions in orthopaedics and sports medicine. Although more patients return to full activity without significant complications, there is still a continuous need for the evolution and improvement of existing techniques. Furthermore, there is still a lot of controversy regarding the ideal graft, while novel techniques have emerged, such as the all-inside repair technique or the utilization of scaffolds to enhance local biology, in an attempt to achieve better outcomes. The possibility of functional instead of surgical repair, graft choice, fixation of the graft, concomitant injuries and their management, and complications following reconstruction are some of the issues that orthopaedic surgeons have to face in everyday clinical practice when addressing ACL tears. Lastly, a relatively early but mainly safe return to sports, along with a high rate of patient satisfaction, constitutes a primary objective of ACL reconstruction.

The goal of this Special Issue is to provide a comprehensive review of these challenges by collecting papers from an expert panel of authors, with a particular focus on clinical advances and prognosis after ACL reconstruction.

Dr. Georgios Komnos
Prof. Dr. Michael Hantes
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • anterior cruciate ligament
  • ACL reconstruction
  • ACL grafts
  • ACL biology
  • challenges

Published Papers (3 papers)

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Research

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14 pages, 993 KiB  
Article
Impact of Surgical Timing on Functional Outcomes after Anterior Cruciate Ligament Reconstruction
by Tatsuhiro Kawashima, Hirotaka Mutsuzaki, Arata Watanabe, Kotaro Ikeda, Yuki Yamanashi and Tomonori Kinugasa
J. Clin. Med. 2024, 13(10), 2994; https://doi.org/10.3390/jcm13102994 - 20 May 2024
Viewed by 390
Abstract
Objectives: Although acute anterior cruciate ligament reconstruction (ACLR) is often avoided because of postoperative joint stiffness, delayed ACLR can lead to a longer recovery time and can have a negative impact on physical function due to detraining. This study aimed to determine [...] Read more.
Objectives: Although acute anterior cruciate ligament reconstruction (ACLR) is often avoided because of postoperative joint stiffness, delayed ACLR can lead to a longer recovery time and can have a negative impact on physical function due to detraining. This study aimed to determine the effects of acute ACLR on postoperative outcomes, including muscle strength, performance, and return to sports. Methods: A total of 110 patients who underwent anatomical ACLR using hamstring autografts were included in this study and were divided into three groups: acute (ACLR performed within 2 weeks after ACL injury), 2–6 weeks (ACLR performed between 2 and 6 weeks after injury), and 6–12 weeks (ACLR performed between 6 and 12 weeks after injury). Several parameters were evaluated, including range of motion, knee joint stability, isokinetic knee strength, performance, and return to sports. Results: No significant differences were found in the range of motion or knee joint stability between the groups. The acute group exhibited significantly greater quadriceps strength at 3 months postoperatively than the other groups (p < 0.05). The single-leg hop test showed that 66.7%, 38.7%, and 33.3% of the patients in the acute, 2–6 weeks, and 6–12 weeks groups, respectively, recovered to an LSI of 90% or greater (p = 0.09, Cramer’s V = 0.27). All patients in the acute group were able to return to sports (p = 0.14; Cramer’s V = 0.28). Conclusions: Acute ACLR is advantageous for the early recovery of strength and performance without adverse events. Acute ACLR may shorten the time spent away from sports activities. Full article
(This article belongs to the Special Issue Anterior Cruciate Ligament Reconstruction: Clinical Advances and Prognosis)
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10 pages, 843 KiB  
Article
Influence of a Concomitant Medial Meniscus Injury on Knee Joint Function and Osteoarthritis Presence after Anterior Cruciate Ligament Reconstruction
by Darian Bayerl, Lukas B. Moser, Markus Neubauer, Johannes Neugebauer, Dietmar Dammerer, Markus Winnisch and Rudolf Schabus
J. Clin. Med. 2024, 13(8), 2433; https://doi.org/10.3390/jcm13082433 - 22 Apr 2024
Viewed by 605
Abstract
(1) Background: The aim of this study was to investigate how a medial meniscus injury accompanying an anterior cruciate ligament rupture affects the clinical outcome 10 years after ACL reconstruction. (2) Methods: A total of 37 patients who received anterior cruciate ligament reconstruction [...] Read more.
(1) Background: The aim of this study was to investigate how a medial meniscus injury accompanying an anterior cruciate ligament rupture affects the clinical outcome 10 years after ACL reconstruction. (2) Methods: A total of 37 patients who received anterior cruciate ligament reconstruction (ACLR) were included in this retrospective study. Two groups were analyzed at a single follow-up of 10 years: (i) “isolated (ACLR)” (n = 20) and (ii) “ACLR with medial meniscal injury” (n = 17). The following clinical scores were recorded: International Knee Documentation Committee (IKDC), the Knee Injury and Osteoarthritis Outcome Score (KOOS), Lysholm Score and Tegner Activity Score. To determine the degree of osteoarthritis the Kellgren–Lawrence score was used. (3) Results: The “isolated ACLR” study group scored significantly higher (p < 0.05) on the IKDC subjective questionnaire (mean: 88.4) than the “ACLR with medial meniscus injury” group (mean: 81). The KOOS category “activities of daily living” showed significantly better results in the isolated ACLR group (p < 0.05). The “ACLR with medial meniscus injury” group had significantly higher degree of osteoarthritis (p < 0.05). No significant differences were found in all the other clinical scores. (4) Conclusions: The results of this study further indicate that patients with a concomitant medial meniscus injury have slightly more discomfort in everyday life and increased risk of developing osteoarthritis 10 years after surgery. Full article
(This article belongs to the Special Issue Anterior Cruciate Ligament Reconstruction: Clinical Advances and Prognosis)
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Review

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13 pages, 343 KiB  
Review
Management of Medial Femorotibial Knee Osteoarthritis in Conjunction with Anterior Cruciate Ligament Deficiency: Technical Note and Literature Review
by Claudio Legnani, Alberto Ventura, Laura Mangiavini, Nicola Maffulli and Giuseppe M. Peretti
J. Clin. Med. 2024, 13(11), 3143; https://doi.org/10.3390/jcm13113143 - 27 May 2024
Viewed by 142
Abstract
In recent years, there has been increased interest in the management of medial femorotibial knee osteoarthritis (OA) in conjunction with anterior cruciate ligament (ACL) deficiency. Traditional treatment modalities included conservative therapy, high tibial osteotomy with or without ACL reconstruction, and total knee replacement. [...] Read more.
In recent years, there has been increased interest in the management of medial femorotibial knee osteoarthritis (OA) in conjunction with anterior cruciate ligament (ACL) deficiency. Traditional treatment modalities included conservative therapy, high tibial osteotomy with or without ACL reconstruction, and total knee replacement. Since younger patients with higher physical demands are more likely to suffer from this pathological condition, reduced invasiveness, faster recovery time, and improved knee kinematics are preferred to allow for satisfying clinical and functional outcomes. Thus, a new surgical strategy combining medial unicompartmental knee replacement (UKR) and ACL reconstruction has been proposed to allow bone stock preservation, to reduce surgical morbidity and recovery time, and ultimately to improve joint kinematics and clinical outcomes. Based on the data present in the literature, in the setting of unicompartmental OA in association with ACL deficiency, UKR combined with ACL reconstruction provided encouraging early results. Studies evaluating the outcomes of combined ACL reconstruction and UKR demonstrate promising results in select patient populations. Improved knee stability, pain relief, functional recovery, and patient satisfaction improved after surgery. Moreover, the combined approach offered advantages such as reduced surgical trauma, faster rehabilitation, and preservation of native knee anatomy compared with traditional treatment strategies. However, still, high-level studies on this topic are lacking; therefore, more comparative studies reporting long-term outcomes are needed to support the potential of this combined procedure to become mainstream. In this paper, we discuss the relevant features and rationale behind the indications and technique of this combined surgical procedure, to help surgeons choose the correct therapeutic approach for a patient with concomitant medial OA and ACL insufficiency. Continued advancements in surgical techniques, patient selection criteria, and rehabilitation strategies will further enhance the success of this combined approach, offering hope to individuals with concomitant ACL injuries and unicompartmental knee OA. Full article
(This article belongs to the Special Issue Anterior Cruciate Ligament Reconstruction: Clinical Advances and Prognosis)
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