Combined Anterior Cruciate and Anterolateral Ligament Reconstruction in the Professional Athlete: Clinical Outcomes From the Scientific Anterior Cruciate Ligament Network International Study Group in a Series of 70 Patients With a Minimum Follow-Up of 2 Years

Rosenstiel, Nikolaus, Ouanezar, Herve, Saithna, Adnan ORCID: 0000-0002-2408-5307, Fournier, Yann, Hager, Jean-Philippe, Thaunat, Mathieu and Sonnery-Cottet, Bertrand (2019) Combined Anterior Cruciate and Anterolateral Ligament Reconstruction in the Professional Athlete: Clinical Outcomes From the Scientific Anterior Cruciate Ligament Network International Study Group in a Series of 70 Patients With a Minimum Follow-Up of 2 Years. ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY, 35 (3). pp. 885-892.

Text 23 Saithna ACL Pro author version.docx - Author Accepted Manuscript Download (575kB)

Abstract

<h4>Purpose</h4>To evaluate clinical outcomes in professional athletes after combined anterior cruciate ligament (ACL) and anterolateral ligament (ALL) reconstruction at a minimum follow-up of 2 years.<h4>Methods</h4>A retrospective analysis of prospectively collected data from the Scientific Anterior Cruciate Ligament Network International (SANTI) Study Group database was performed. All professional athletes who underwent primary combined ACL and ALL reconstruction between January 2011 and March 2016 were included. Patient assessment included physical examination, pre- and postoperative subjective and objective International Knee Documentation Committee (IKDC), Tegner activity scale, and Lysholm scores.<h4>Results</h4>Seventy-two professional athletes underwent primary ACL and ALL reconstruction; 70 (97%) were available, with a mean follow-up of 3.9 years (range, 2-7). The preoperative side-to-side anteroposterior laxity difference was 7.1 ± 1.4 mm, and this decreased significantly after surgery to 0.4 ± 0.9 mm (P < .0001). Pivot-shift grade evolved from 16 grade I (22.8%) and 54 grade II or III (77.2%) preoperatively, to 66 absent pivot shift (94.3%) and 4 grade I (5.7; P < .001). By 1-year postoperatively, 60 athletes (85.7%) returned to professional sport, with a mean time interval of 7.9 months (range, 5-12). Preoperatively, the mean subjective IKDC was 56.1 ± 12.3, the Lysholm score was 48.4 ± 12.5, and the Tegner score was 9.3 ± 1. At final follow-up, the mean subjective IKDC was 90.5 ± 7.6 (P < .0001), the Lysholm score was 94.4 ± 7.5 (P < .0001), and the Tegner score was 8.8 ± 1.5 (P < .004). The objective IKDC evolved from 39 grade C (55.7%) and 31 grade D (44.3%) preoperatively to 65 grade A (92.9%) and 5 grade B (7.1%) (P < .0001). Eleven Patients (15,7%) underwent a subsequent ipsilateral reoperation including 4 (5.7%) revision ACL reconstructions. The risk of graft rupture was significantly higher in female patients (13.6% vs 2.1% in male patients; P = .048).<h4>Conclusions</h4>Combined ACL and ALL reconstruction is associated with excellent outcomes in professional athletes with respect to graft rupture rates, return to sport, knee stability, and reoperation rates after injury.<h4>Level of evidence</h4>Level IV, case series.

Item Type:	Article
Uncontrolled Keywords:	Anterior Cruciate Ligament, Knee Joint, Humans, Athletic Injuries, Knee Injuries, Rupture, Reoperation, Retrospective Studies, Follow-Up Studies, Adult, Female, Male, Young Adult, Anterior Cruciate Ligament Reconstruction, Lysholm Knee Score, Anterior Cruciate Ligament Injuries
Depositing User:	Symplectic Admin
Date Deposited:	11 Feb 2019 09:15
Last Modified:	03 Feb 2024 09:22
DOI:	10.1016/j.arthro.2018.09.020
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3032604