Combined Anterolateral and Anterior Cruciate Ligament Reconstruction Improves Pivot Shift Compared With Isolated Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Kunze, Kyle N.; Manzi, Joseph E.; Richardson, Michelle; White, Alexander E.; Coladonato, Carlo; DePhillipo, Nicholas N.; LaPrade, Robert F.; Chahla, Jorge

doi:10.1016/j.arthro.2021.03.058

Cited by 39 publications

(39 citation statements)

References 70 publications

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“…As demonstrated in a recent systematic review, the femoral tunnel of the ALL is generally created proximal and posterior to the LFE, following the descriptions in current anatomical studies [21,24]. To create the femoral tunnel, the LFE is palpated and identified.…”

Section: Anterolateral Ligament Reconstructionmentioning

confidence: 99%

“…Like LET, RCTs and prospective cohort studies in ALLR also demonstrated improved stability, lower graft tear rate, and better clinical scores than isolated ACLRs [21,56,58]. Sonnery-Cottet et al, compared combined ALLRs and ACLRs performed in 221 patients with isolated ACLRs in 176 patients and reported a significantly lower graft tear rate in the combined ALLR and ACLR group at 4% compared to 11% in the isolated ACLR group [58].…”

Section: Clinical Outcomes Of Anterolateral Proceduresmentioning

confidence: 99%

“…Another RCT showed that residual laxity in term of the normalization of pivot-shift is lower in combined ALLRs and ACLRs than isolated ACLRs [56]. A recent systematic review demonstrated that the graft tear rate in combined ACLRs and ALLRs ranged between 2.7% and 11.1% and combined ACLRs and ALLRs had advantages over isolated ACLRs in terms of restoration of pivot shift [21].…”

Section: Clinical Outcomes Of Anterolateral Proceduresmentioning

confidence: 99%

“…Recently, the clinical advantages of ALLR combined with ACLR compared to isolated ACLR have been demonstrated in multiple studies: reduced re-tear rate, a lower reoperation rate for secondary meniscectomy, and a higher rate of return to sports [21][22][23]. However, the proper indications and optimal surgical techniques are still controversial, owing to conflicting indications and surgical techniques across studies.…”

Section: Introductionmentioning

confidence: 99%

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Anatomy, Biomechanics, and Reconstruction of the Anterolateral Ligament of the Knee Joint

et al. 2022

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Despite remarkable advances in the clinical outcomes after anterior cruciate ligament reconstructions (ACLRs), residual rotational instability of the knee joint remains a major concern. Since the anterolateral ligament (ALL) on the knee joint has been “rediscovered”, the role of anterolateral structures, including ALL and deep iliotibial band, as secondary stabilizers of anterolateral rotatory instability has gained interest. This interest has led to the resurgence of anterolateral procedures combined with ACLRs to restore rotational stability in patients with anterior cruciate ligament (ACL) deficiencies. However, the difference in concepts between anterolateral ligament reconstructions (ALLRs) as anatomical reconstruction and lateral extra-articular tenodesis (LETs) as non-anatomical reinforcement has been conflicting in present literature. This study aimed to review the anatomy and biomechanics of anterolateral structures, surgical techniques, and the clinical outcomes of anterolateral procedures, including LET and ALLR, in patients with ACL deficiencies.

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Section: Anterolateral Ligament Reconstructionmentioning

confidence: 99%

Section: Clinical Outcomes Of Anterolateral Proceduresmentioning

confidence: 99%

Section: Clinical Outcomes Of Anterolateral Proceduresmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Anatomy, Biomechanics, and Reconstruction of the Anterolateral Ligament of the Knee Joint

et al. 2022

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“…However, in certain cases this may not be enough, and augmentations of an ACL reconstruction with lateral stabilization technique may offer a solution. 6 More importantly, not all ACL reconstructions are the same. There are so many different steps and techniques that it is irrational to consider that there are fixed rules that apply to all ACL reconstructions, particularly when there is such variability among our patients.…”

Section: See Related Article On Page 1969mentioning

confidence: 99%

Editorial Commentary: Major Technical Advances in Knee Anterior Cruciate Ligament Reconstruction Address Anatomy, Biomechanics, and Healing

Paschos¹

2022

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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High incidence of RAMP lesions and a nonnegligible incidence of anterolateral ligament and posterior oblique ligament rupture in acute ACL injury

D'Ambrosi,

Sconfienza,

Albano

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeThe purpose of this study was to assess the frequency of medial collateral ligament (MCL), posterior oblique ligament (POL) and anterolateral ligament (ALL) tears and different types of RAMP lesions of patients with verified acute anterior cruciate ligament (ACL) tears by magnetic resonance imaging (MRI).MethodsMRI was performed on patients with a clinical diagnosis of acute ACL injury. Patients were eligible for inclusion if they had an initially clinically noted ACL tear confirmed on MRI within 30 days of trauma.ResultsA total of 146 patients were included in the study, 42 (28.8%) females and 104 (71.2%) males. The mean age at MRI was 27.2 ± 9.4 years, and the mean time from injury to MRI was 15.7 ± 7.8 days. Thirty‐four (23.3%) patients had a complete MCL lesion, 32 (21.9%) had a complete POL lesion and 28 (19.2%) had a complete ALL lesion. One hundred and fourteen patients (78.1%) presented with RAMP lesions, while 20 (13.7%) patients reported other meniscal lesions. The mean medial and lateral tibial slopes were 4.0° ± 2.7° and 4.0° ± 3.1°, respectively. Only 10 (6.8%) patients reported no lesions associated with ACL rupture. The most common injuries were isolated RAMP type 3 (18–12.3%) and isolated RAMP type 1 (17–11.6%). Thirteen (8.9%) patients had a combination of MCL, POL and ALL rupture.ConclusionsIsolated lesions of the ACL are extremely rare. In most cases, a single RAMP lesion should be investigated. In the presence of MCL injury, POL injury should always be suspected as well, while nearly 20% of patients present a rupture of the ALL. About one in 10 patients had three lesions (MCL, ALL and POL), and most of them had a combined RAMP lesion.Level of EvidenceLevel IV.

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Combined Anterolateral and Anterior Cruciate Ligament Reconstruction Improves Pivot Shift Compared With Isolated Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Cited by 39 publications

References 70 publications

Anatomy, Biomechanics, and Reconstruction of the Anterolateral Ligament of the Knee Joint

Anatomy, Biomechanics, and Reconstruction of the Anterolateral Ligament of the Knee Joint

Editorial Commentary: Major Technical Advances in Knee Anterior Cruciate Ligament Reconstruction Address Anatomy, Biomechanics, and Healing

High incidence of RAMP lesions and a nonnegligible incidence of anterolateral ligament and posterior oblique ligament rupture in acute ACL injury

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