Clinical Results of Combined ACL and Anterolateral Ligament Reconstruction: A Narrative Review from the SANTI Study Group

J Knee Surg DOI: 10.1055/s-0040-1701220Lateral extraarticular procedures (LEAPs) in the anterior cruciate ligament (ACL)-injured knee were widely abandoned in the 1990s but have seen a recent resurgence. The aim of this review was to demonstrate that anterolateral ligament reconstruction (ALLR) is associated with evidence of significant advantages and no evidence of historical concerns. A narrative review of the literature was performed. Combined ACL + ALLR is associated with improved outcomes when compared against isolated ACL reconstruction, including a significantly lower risk of ACL graft rupture (hazard ratio [HR]: 0.327, 95% CI: 0.130–0.758), a significantly lower risk of reoperation for secondary meniscectomy following medial meniscal repair at the time of ACL reconstruction (HR: 0.443, 95% CI: 0.218–0.866), significantly increased likelihood of return to the preinjury level of sport following primary (odds ratio [OR]: 1.938, 95% CI: 1.174–3.224) and revision ACL reconstruction (57.1 vs. 25.6%, respectively; p = 0.008), and in chronic ACL injuries, less residual pivot shift (9.1 vs. 35.3%, p = 0.011), and better IKDC (92.7 ± 5.9 vs. 87.1 ± 9.0, p = 0.0013) and Lysholm (95.4 ± 5.3 vs. 90.0 ± 7.1, p < 0.0001) scores, and no evidence of historical concerns. Combined ACLR + ALLR is associated with excellent clinical outcomes with no evidence of the adverse events that led to the historical widespread abandonment of other...
Source: Journal of Knee Surgery - Category: Orthopaedics Authors: Tags: Original Article Source Type: research