Comparison of the outcomes of isolated anterior cruciate ligament reconstruction and combined anterolateral ligament suture tape augmentation and anterior cruciate ligament reconstruction

Abstract

Objectives This study aims to compare the outcomes of isolated anterior cruciate ligament (ACL) reconstruction and combined anterolateral ligament (ALL) suture tape augmentation (STA) and ACL reconstruction after a minimum follow-up of two years. Patients and methods This retrospective study included 63 patients (36 males, 27 females; mean age 27.8±4.0; range, 19 to 35 years) who had unilateral ACL injury and participated in pivoting sports and were randomly assigned to undergo either isolated ACL reconstruction (Group 1, n=33) or combined ACL reconstruction and ALL STA (Group 2, n=30) between January 2015 and February 2018. The presence of an associated meniscal injury, chondral pathology, contralateral ACL rupture, and residual pivot shift; subjective and objective International Knee Documentation Committee scores; Cincinnati and Lysholm functional scores; KT-1000 measurements; and graft rupture rate were evaluated. Results Patients were followed for a minimum of two years. The groups did not differ with respect to age, sex, side, time from injury to surgery, postoperative follow-up time, ACL graft size, contralateral ACL rupture, graft size, partial meniscectomy, chondral pathology or preoperative physical examination results. A total of 9.1% of the patients in Group 1 and 0% of those in Group 2 presented postoperative positive pivot shift (p=0.357). The graft failure rate was 6.06% (n=2) in Group 1 and 0% in Group 2 (p=0.270). In the final evaluation, compared with Group 1, Group 2 showed better anteroposterior clinical stability, as evaluated by KT-1000 arthrometry (p=0.006). Although better results were observed in Group 2, the clinical evaluation results for postoperative function did not differ significantly between groups. Conclusion Combined ALL STA and ACL reconstruction was found to be effective in improving subjective and objective outcomes. Nevertheless, these findings were not significantly superior to those of isolated ACL reconstruction with hamstring grafts, except for the side-to-side differential anterior laxity testing results.

A Review of Current Concepts of the Anterolateral Complex of the Knee

“…30 The combination of ACLR and ALLR has shown remarkable improvement in clinical results compared with isolated ACLR. [66][67][68][69][70] Studies have shown that the most common femoral fixation sites were posterior and proximal to the lateral femoral epicondyle, and for the tibial fixation, the most common sites were between Gerdy's tubercle and the fibular head. 3,70 Regarding the graft's tension, Kunze et al, in a recent Systematic Review and Meta-Analysis of Randomized Controlled Trials, found that in 9 of 14 studies, the graft was tensioned at 30 o .…”

Is Lever Test Superior to Lachman, Pivot Shift, Drawer Tests in Diagnosing Anterior Cruciate Ligament Injuries?

“…The anterior cruciate ligament (ACL) is one of the primary ligaments of the tibio-femoral joint and has an important role in the motion and stabilization of the knee [1][2][3][4][5][6][7][8]. ACL injuries are one of the important health problems affecting the quality of life of individuals, and many reasons can lie in the etiology from injuries to wrong movements in sports activities.…”

Effects of Femoral Remnant Preservation During Anterior Cruciate Ligament Reconstruction on the Clinical and Functional Outcomes

“…Anterior cruciate ligament (ACL) tears are common sportsrelated injuries (1). Osteoarthritis may be a possible future outcome in patients with knee instability as a result of ACL tear.…”