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Fulltext Association of ACL Laxity Tests with Arthroscopic Findings in Chronic ACL and PCL Deficient Knees

Sazali S, Rusdi A, Siti HT

Surg J (N Y), 2018 Jan;4(1):e43-e45.
PMID: 29588914 DOI: 10.1055/s-0038-1637008

An anterior cruciate ligament (ACL) injury may be diagnosed by clinical examination and radiological investigation using magnetic resonance imaging or by arthroscopy.1,2Based on our experience, the ACL tear in concomitant chronic ACL and posterior cruciate ligament (PCL) deficient knees may produce knee laxity, which is more difficult to assess on clinical examination, which in turn may affect the management algorithm of the patient. Our hypothesis is that, in a concomitant chronic ACL and PCL injury, posterior capsular contracture and abnormal reattachment of torn ACL will result in less clinical and subjective laxity, preoperatively. The aim of this study is to review a cohort of patients who had undergone PCL reconstructive surgery and compare the preoperative clinical assessments with and without anesthesia with arthroscopic finding of ACL. This is to assess the accuracy and reliability of clinical ACL laxity tests in detecting ACL tear in chronic ACL and PCL injury.
Short-term functional outcomes of a delayed single-stage reconstruction of chronic posterior cruciate ligament and posterolateral corner deficiency

Rusdi A, Shahrulazua A, Siti HT, Nizlan NM

Clin Ter, 2014;165(1):e28-34.
PMID: 24589957 DOI: 10.7471/CT.2014.1668

AIMS: To evaluate the functional outcomes of a delayed (>6 months post-injury) and combined reconstruction of grade III posterior cruciate ligament (PCL) and grade III posterolateral corner (PLC) deficiencies.
PATIENTS AND METHODS: Between March 2006 and October 2009, a delayed surgery consisting of arthroscopically-assisted PCL reconstruction and open reconstruction of the PLC was performed on 19 men and 2 women (average age, 29 years). The mean time-to-surgery was 18 months (range, 7-51 months) and duration of follow-up was 22 months (range, 12-48 months). Postoperatively, patients were evaluated using Lysholm score, Tegner activity score, and International Knee Documentation Committee (IKDC) subjective and objective scores.
RESULTS: At the final follow-up, majority of the knees (61.9%) achieved either normal or nearly normal rating objective IKDC score. The means of IKDC subjective score, Lysholm score and Tegner activity level were 62.09, 74.35 and 5.14 respectively. One patient was able to participate in competitive sport, 5 patients were able to be involved in recreational sports for at least 5 times per week, 10 patients were able to perform heavy labour and recreational sports for at least twice weekly, 4 patients were able to engage in moderately heavy labour work and one patient was only able to perform light labour work. There was no significant statistical association found between the time-to-surgery and the final patients' outcomes.
CONCLUSIONS: A delayed simultaneous reconstruction of chronic grade III PCL and PLC deficiencies can restore sufficient function for standard daily and recreational sports activities to the patients.
Fulltext Acromion Morphology of Patients with Rotator Cuff Disease in Standard AP Shoulder Radiograph in Hospital Sultanah Bahiyah and Hospital Kuala Lumpur

Leong YC, Yeoh CW, Azman MI, Juhari MS, Siti HT

Malays Orthop J, 2022 Nov;16(3):50-54.
PMID: 36589379 DOI: 10.5704/MOJ.2211.009

INTRODUCTION: Rotator cuff pathology is commonly attributed to acromion morphology that is demonstrable in standard AP shoulder radiographs by measuring the critical shoulder angle (CSA), the lateral acromial angle (LAA), and the acromial index (AI). However, these parameters vary among races and countries. Therefore, our study aimed to get the local data on acromion morphology in patients with rotator cuff disease.
MATERIALS AND METHODS: MRI shoulder reports between January 2012 and June 2018 were reviewed. The study group consisted of 47 patients with rotator cuff injury with a partial or complete tear, and a control group of 37 patients with tendinitis or osteoarthritis and intact rotator cuffs. The CSA, LAA, and AI of both groups were measured on the anteroposterior shoulder radiograph. The risk factors for both groups and the acromion morphology were recorded.
RESULTS: The CSA for the rotator cuff tear and the control group was 39.08° and 38.28°, LAA was 72.57 ° and 73.51°, and AI was 0.79 and 0.75. The acromion morphology differed in terms of gender, and only LAA was different among the different ethnic groups. There was a negative correlation between age and CSA, age and AI, LAA and CSA, LAA and AI, but a positive correlation between AI and CSA.
CONCLUSION: The CSA for rotator cuff tear patients in our population was 39.08°, LAA was 72.57°, and AI was 0.79. The acromion morphology was significantly influenced by age and gender.

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