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Double-bundle ACL combined with ALL reconstruction for patients at high risk of ACL failure: clinical and radiological results.
- Source :
-
BMC musculoskeletal disorders [BMC Musculoskelet Disord] 2024 Jul 29; Vol. 25 (1), pp. 594. Date of Electronic Publication: 2024 Jul 29. - Publication Year :
- 2024
-
Abstract
- Background: We investigated whether double-bundle (DB) anterior cruciate ligament (ACL) reconstruction (ACLR) combined with anterolateral ligament reconstruction (ALLR) improved clinical and radiological outcomes in patients at high risk of ACL failure. The primary outcome was graft failure, and secondary outcomes included knee stability and patient-reported outcome measures (PROMs).<br />Patients and Methods: Fifty-two patients who underwent DB ACLR combined with ALLR were included in this retrospective cohort study. Preoperative risk factors, including femorotibial angle (FTA), lateral tibial slope (LTS), medial tibial slope (MTS), and meniscal tears, were assessed using X-ray and magnetic resonance imaging (MRI). The grade of post-operative pivot shift, Lysholm score, and Tegner activity score were used to assess clinical outcomes. The minimum follow up duration was 2 years.<br />Results: The cohort (mean age, 26.1 ± 9.4 years; 51.9% male) had a mean follow-up duration of 28.9 ± 3.4 months. Preoperatively, 57.8% had lateral meniscus (LM) tears, and 61.0% had a grade 2-3 pivot shift. Postoperatively, no graft failures or revision cases occurred during follow-up. Approximately 90.4% of the patients exhibited a negative pivot shift (p < 0.001), with Lysholm and Tegner activity scores of 92.5 ± 6.1 and 5.1 ± 2.0. The medial meniscus (MM) tear group had a significantly smaller FTA than the intact group (p = 0.043). No significant differences in PROMs were found between the LM tear and intact LM groups or between the high and low MTS or LTS groups (p = n.s.).<br />Conclusion: DB ACLR combined with ALLR had satisfactory clinical outcomes in patients at high risk of ACL failure, with no graft failures observed during a mean follow-up duration of 2.4 years. The technique effectively reduced the postoperative pivot shift, regardless of preoperative risk factors.<br />Study Design: Level IV, retrospective therapeutic case-series.<br />Trail Registration: ethical approval number, 202300134B0; ethical committee, the Institutional Review Board of Chang Gung Medical Foundation.<br /> (© 2024. The Author(s).)
- Subjects :
- Humans
Female
Male
Retrospective Studies
Adult
Young Adult
Adolescent
Risk Factors
Treatment Failure
Patient Reported Outcome Measures
Follow-Up Studies
Magnetic Resonance Imaging
Knee Joint surgery
Knee Joint diagnostic imaging
Knee Joint physiopathology
Joint Instability surgery
Joint Instability diagnostic imaging
Anterior Cruciate Ligament surgery
Anterior Cruciate Ligament diagnostic imaging
Anterior Cruciate Ligament Reconstruction methods
Anterior Cruciate Ligament Reconstruction adverse effects
Anterior Cruciate Ligament Injuries surgery
Anterior Cruciate Ligament Injuries diagnostic imaging
Subjects
Details
- Language :
- English
- ISSN :
- 1471-2474
- Volume :
- 25
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- BMC musculoskeletal disorders
- Publication Type :
- Academic Journal
- Accession number :
- 39069639
- Full Text :
- https://doi.org/10.1186/s12891-024-07703-8