Combined ACL, anterolateral ligament reconstruction yielded low graft rupture rates
NASHVILLE, Tenn. — Compared with patients who undergo isolated ACL reconstruction, patients who undergo ACL plus anterolateral ligament reconstruction experience better graft survivorship, lower reoperation rates and similar complications.
Adnan Saithna, MD, FACS, an orthopedic surgeon at AZBSC Orthopedics in Scottsdale, Arizona, presented findings on isolated ACL reconstruction (ACLR) vs. combined ACL plus anterolateral ligament reconstruction (ALLR) at the American Orthopaedic Society for Sports Medicine and Arthroscopy Association of North America Combined Meeting.
“The aim of this study is to address one of the major deficiencies in the literature, which is the lack of any long-term clinical outcomes,” he said.
Saithna and colleagues analyzed 86 1:1 propensity-matched pairs of patients who underwent ACLR combined with ALLR and patients who underwent isolated ACLR between January 2011 and March 2012.
After a mean postoperative follow-up of 104.33 months, researchers found patient-reported outcome (PRO) measures, such as Lysholm, IKDC and Tegner scores, as well as complications were similar between the two cohorts. However, isolated ACLR had an odds ratio for graft rupture of 5.549 and a reoperation rate of 32.6%, while ACLR combined with ALLR had an odds ratio for graft rupture of 0.0132 and 15.3% reoperation rate.
Despite similar PROs and complication rates between the cohorts, Saithna cited the five-fold increase in odds ratio for graft rupture in the isolated ACLR group as a cause for concern.
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Saithna A, et al. Isolated ACL reconstruction versus combined ACL and ALL reconstruction: A matched case series with mean follow-up of nine years. Presented at: American Orthopaedic Society for Sports Medicine and Arthroscopy Association of North America Combined Meeting; July 7-11, 2021; Nashville, Tennessee.
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