Combined Arthroscopic ACL Reconstruction with Anterolateral Ligament Reconstruction Versus Lateral Extra-articular Tenodesis in High Demanding Anterior Cruciate Ligament Deficient Knees. | ||||
| The Egyptian Orthopaedic Journal | ||||
| Volume 60, Issue 2, June 2025, Page 165-172 PDF (581.2 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/EOJ.2025.431798 | ||||
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| Authors | ||||
Ahmed Nady; Ahmed Mortada- Mahmoud; Khaled Omran 
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| Department of Orthopedic Surgery and Traumatology, Faculty of Medicine, Minia University, El-Minya, Egypt. | ||||
| Abstract | ||||
| Background To compare the functional outcomes and failure rate of two surgical procedures for treating anterior cruciate ligament (ACL) injuries in high-demand knees using simultaneous ACL reconstruction (ACLR) and lateral extraarticular augmentation techniques (LEA), which may be either anterolateral ligament reconstruction (ALLR) or lateral extra-articular tenodesis (LET). Study design Prospective single-center clinical study. Patients and Methods This prospective study included 88 patients at our hospital from August 2019 to October 2022, with a minimum follow-up of 2 years. Based on LEA procedures performed besides ACLR, patients were divided into two groups [ALLR (group A) and LET (group B)]. Indications for one-stage ACLR and LEA procedures were chronic ACL lesions of more than 18 months, associated Segond fracture, grade 3 pivot shift, high sporting activity, and pivoting sports. Patient selection in each group was exclusively based on surgeon indication regarding which associated anterolateral reconstruction was chosen. Pre- and postoperative evaluation was conducted for all patients using Lysholm scores, subjective international knee documentation committee (IKDC) scores, and a Tegner activity scale. Complications, including re-operation and graft failure, were also documented. Results The mean follow-up duration was 29.61±6.34 months. At the last visit, all patients in both groups had a complete range of mobility. The Lysholm, subjective IKDC, and Tegner activity scores were significantly improved (all P<0.001). Postoperatively, 73 patients had a negative pivot shift (grade 0), 13 patients were grade 1, and only two patients were grade 2 (P<0.001). No significant difference was reported between both groups regarding clinical, functional scores, and complications, except for the increased time of lateral pain in group B. Conclusions ACLR, in conjunction with LET or ALLR, is a safe and feasible technique, especially in subjects with high-risk factors for failed ACLR. No statistical significance differences were mentioned when comparing the two groups, other than the LET group, which experienced an increased postoperative period of lateral knee pain. | ||||
| Keywords | ||||
| Anterior cruciate ligament (ACL); Anterolateral ligament reconstruction (ALLR); Lateral extra-articular tenodesis (LET) | ||||
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