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Comparison of ACL and Anterolateral Ligament Reconstruction With Isolated ACL Reconstruction Using Hamstring Autograft: Outcomes in Young Female Patients With High-Grade Pivot Shift.
- Source :
- Orthopaedic Journal of Sports Medicine; Sep2023, Vol. 11 Issue 9, p1-11, 11p
- Publication Year :
- 2023
-
Abstract
- Background: Inferior return to sports (RTS) and functional outcomes have been reported in women after anterior cruciate ligament reconstruction (ACLR). Purpose/Hypothesis: The purpose was to evaluate the results of combined ACLR and anterolateral ligament reconstruction (ALLR) in young women with a high-grade pivot shift (grade ≥2). It was hypothesized that combined ACLR and ALLR would result in better RTS and rotational stability than isolated ACLR. Study Design: Cohort study; Level of evidence, 3. Methods: Two groups were retrospectively evaluated and compared. Group I (n = 39; mean age, 31.1 ± 5.7 years) underwent isolated ACLR using hamstring autografts; group C (n = 39; mean age, 30.4 ± 6.1 years) underwent combined ACLR and ALLR. Subjective outcome measures included the International Knee Documentation Committee subjective form, Lysholm, Tegner, and ACL–Return to Sport after Injury (ACL-RSI). Objective tests included a KT-2000 arthrometer stress test, a pivot-shift test, an isokinetic strength test, a Y-balance test, and a single-leg hop test. A postoperative questionnaire was administered to determine the rates and types of RTS, quality of sports performance, and reinjury and satisfaction rates. Subjective scores and clinical tests were performed at 2 years. Magnetic resonance imaging and second-look arthroscopy were conducted during the 1- and 2-year follow-ups, respectively. Results: The mean follow-up for groups I and C were 30.4 ± 3.9 and 29.3 ± 3.5 months, respectively (P =.194). Patients in group C had better anteroposterior (P =.001) and rotational (P =.005) stability and higher ACL-RSI scores (P =.025) than those in group I. Group C had higher composite and posteromedial reach scores on the Y-balance test than group I (P =.014 and P =.010, respectively). A total of 26 (66.7%) patients in group C and 17 (43.6%) in group I returned to their prior level of sports (P =.040). Rerupture of the ACL graft and contralateral ACL rupture occurred in 2 (5.1%) and 2 (5.1%) patients in group I, respectively, compared with no rerupture or contralateral ACL rupture in group C. Conclusion: Combined ACLR and ALLR in young women with a high-grade pivot shift was associated with better knee stability parameters, dynamic postural stability, and psychological readiness to RTS than isolated ACLR. [ABSTRACT FROM AUTHOR]
- Subjects :
- SPORTS participation
CONFIDENCE intervals
JOINT instability
ARTICULAR ligaments
ARTHROSCOPY
MULTIVARIATE analysis
MAGNETIC resonance imaging
RETROSPECTIVE studies
ACQUISITION of data
MANN Whitney U Test
FISHER exact test
SURGICAL complications
AUTOGRAFTS
TREATMENT effectiveness
COMPARATIVE studies
T-test (Statistics)
ANTERIOR cruciate ligament injuries
HAMSTRING muscle
QUESTIONNAIRES
DESCRIPTIVE statistics
MEDICAL records
CHI-squared test
ANTERIOR cruciate ligament surgery
COMBINED modality therapy
DATA analysis software
LOGISTIC regression analysis
ODDS ratio
WOMEN'S health
LONGITUDINAL method
EVALUATION
ADULTS
Subjects
Details
- Language :
- English
- ISSN :
- 23259671
- Volume :
- 11
- Issue :
- 9
- Database :
- Complementary Index
- Journal :
- Orthopaedic Journal of Sports Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 172447001
- Full Text :
- https://doi.org/10.1177/23259671231178048