Summary

In adolescents undergoing anterior cruciate ligament (ACL) reconstruction combined with an extra-articular lateral procedure, a 100% return-to-sport rate and a 2.6% graft failure rate were observed with an average follow-up of 18.6 months. High scores on the Tegner-Lysholm and IKDC subjective scales suggest favorable functional outcomes and a low re-intervention rate.

Abstract

Introduction. Anterior cruciate ligament (ACL) reconstruction in adolescents is associated with higher failure rates compared to the general population. Adding an extra-articular lateral procedure may help decrease these failure rates.
Objective. This study aimed to evaluate the functional outcomes and failure rates in adolescent patients who underwent ACL reconstruction combined with an anterolateral procedure, with a follow-up of at least one year.
Methodology. A prospective study was conducted at a single center. Data were collected from patients under 18 years old who underwent ACL reconstruction in conjunction with an extra-articular lateral procedure. Clinical and surgical details were gathered, and patients were followed for a minimum of one year. Evaluated variables included epidemiological data, Tegner-Lysholm and IKDC subjective scores, failure rates, re-interventions, and return-to-sport rates/times.
Results. The study included 38 patients with an average age of 15.6 years; 68.4% were male. All patients received hamstring autografts for ACL reconstruction. The extra-articular lateral procedure was performed using the modified LeMaire technique. The average follow-up duration was 18.6 months (range 12-27 months). The return-to-sport rate was 100%, although not all patients returned to their pre-injury level. The graft failure rate was 2.6%, and 7.8% of patients required re-intervention. At the end of follow-up, the average Tegner-Lysholm score was 89, and the average IKDC subjective score was 81.9.
Conclusions. Adolescents undergoing ACL reconstruction combined with an extra-articular lateral procedure showed favorable functional outcomes as measured by patient-reported scales. The rates of graft failure and re-intervention were low compared to typical outcomes for this age group. Combining an extra-articular lateral procedure with ACL reconstruction in adolescents appears to be a safe approach that may enhance functional outcomes and reduce failure rates.