ISAKOS Congress 2021

2021 ISAKOS Biennial Congress ePoster

 

Supplemental Antero-Lateral Ligament Reconstruction to ACL Revision does not improve Subjective Outcome and Knee Stability at One-Year Follow-Up compared to isolated ACL Revision; A Randomized Controlled Trial.

Ole Gade Sørensen, MD, PhD, Aarhus DENMARK
Peter Faunoe, MD, Risskov DENMARK
Lars Konradsen, MD, Hillerod DENMARK
Bjarne Mygind-Klavsen, MD, Aarhus V DENMARK
Susanne Olesen Schaarup, MD DENMARK
Torsten Grønbech Nielsen, PhD., Aarhus N DENMARK
Michael Rindom Krogsgaard, MD, PhD DENMARK
Martin Lind, MD, PhD, Prof., Aarhus N DENMARK

University Hospital of Aarhus, Aarhus, Middle region, DENMARK

FDA Status Not Applicable

Summary

This randomized controlled study investigates the effect of supplemental antero-lateral ligament reconstruction in anterior cruciate ligament revision. Preliminary results at 1-year follow-up suggest no subjective outcome and knee stability improvement with combined antero-lateral ligament reconstruction and anterior cruciate ligament revision compared to isolated anterior cruciate ligament revisi

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Abstract

Background

Rotational stability of the knee after anterior cruciate ligament reconstruction (ACL-R) is important for outcome and graft protection. Recently, supplemental reconstruction of the antero-lateral ligament (ALL-R) in combination with ACL-R demonstrated reduced failure rates. The outcome after ACL revision in combination with ALL-R remains unclear.

Purpose

To investigate the effect of ALL-R in ACL revision surgery on subjective outcome and knee stability.

Methods

Patients eligible for first time ACL revision were randomized to either isolated ACL revision (-ALL group) or ACL revision combined with a single-strand allograft ALL-reconstruction (+ALL group). Patient reported outcomes were evaluated using KNEES, KOOS, and Tegner Activity score. Objective knee laxity was evaluated using instrumented Rolimeter test, the pivot shift test, and manual Lachman’s test.

Results

A total of 103 patients were enrolled with 49 patients in the +ALL group and 54 patients in the -ALL group. No baseline differences between groups were seen regarding age, gender, and body mass index. Meniscal injury and cartilage lesions were seen in 27% and 45% in the +ALL and in 20% and 41% in the -ALL group, respectively. Allograft for ACL revision was used in 20% of the patients in the +ALL group compared to 15% in the -ALL group. There were no significant differences in subjective knee stability sensation and knee function based on KNEES, KOOS, and Tegner scores. Also, no significant differences between groups were seen at one-year follow-up regarding objective laxity measured with Rolimeter test, Lachman’s test, and the pivot shift test.

Conclusion

Supplemental ALL reconstruction in ACL revision does not improve subjective outcome and knee stability at one-year follow-up compared to isolated ACL revision.