Single-bundle anterior cruciate ligament reconstruction with and without concomitant anterolateral ligament reconstruction

Abstract

<p>INTRODUCTION<br>The anterolateral ligament (ALL) is an important secondary restraint against rotational instability of knee. The current study investigates whether concomitant ALLR and single-bundle anterior cruciate ligament reconstruction (SBACLR-ALLR) results in better clinical outcome, when compared with single-bundle anterior cruciate ligament reconstruction (SBACLR). The hypothesis is that there is no difference in clinical outcomes between patients receiving SBACLR-ALLR and SBACLR at the two-year follow-up. </p><p>METHOD<br>To test this hypothesis, a study was conducted on 466 patients who underwent primary SBACLR between 2007 and 2019. Patients with skeletal immaturity, inflammatory joint disease, multiple ligament reconstruction (other than ALLR), a graft rupture, or no post-operation MRI within the second year were excluded. Patients with SBACLR-ALLR and isolated SBACLR were matched one-to-one based on various factors. 40 matched pairs were identified. Clinical outcomes, including return to sport, International Knee Documentation Committee (IKDC) subjective score, and residual ACL laxity signs, were collected at the two-year assessment. </p><p>RESULT<br>Of the 40 matched pairs, 31 pairs attended the two-year follow-up. The average follow-up period was 41 months, with an 80% follow-up rate in the SBACLR-ALLR group and 98% in the isolated SBACLR group. Despite the demographics being comparable between the two groups, the SBACLR-ALLR group had a higher rate of return to sport (p=0.026), and a more normal or nearly-normal Lachman test (p=0.005) and pivot shift grading (p=0.004) at two-year follow-up. </p><p>CONCLUSION<br>The study concludes that patients receiving concomitant SBACLR-ALLR have superior clinical outcomes at two years compared to those receiving isolated SBACLR.​​​​​​​</p>