Clinical outcomes of combined anterior cruciate ligament and anterolateral ligament reconstruction: a systematic review and meta-analysis View Full Text


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Article Info

DATE

2021-09-23

AUTHORS

Diego Ariel de Lima, Lana Lacerda de Lima, Nayara Gomes Reis de Souza, Rodrigo Amorim de Moraes Perez, Marcel Faraco Sobrado, Tales Mollica Guimarães, Camilo Partezani Helito

ABSTRACT

ObjectivesTo compare the clinical outcomes of isolated anterior cruciate ligament (ACL) reconstruction with combined reconstruction of the ACL and anterolateral ligament (ALL) of the knee.MethodsA search was conducted on the PubMed, Medline, Google Scholar, EMBASE, and Cochrane library databases, in line with the PRISMA protocol. The indexation terms used were “anterior cruciate ligament” OR “acl” AND “anterolateral ligament” AND “reconstruction.” Articles that compared patients submitted to combined ACL and ALL reconstruction with those submitted to isolated reconstruction of the ACL, with levels of evidence I, II, and III, were included. Studies with follow-up of less than 2 years and articles that did not use “anatomical” techniques for ALL reconstruction, such as extraarticular tenodesis, were excluded. A meta-analysis with R software was conducted, with a random effects model, presented as risk ratio (RR) or mean difference (MD), with a 95% confidence level (CI) and statistically significant at p < 0.05.ResultsTen articles were selected, with a total of 1495 patients, most of whom were men, of whom 674 submitted to ACL and ALL reconstruction and 821 to isolated ACL reconstruction. Combined ACL and ALL reconstruction exhibited a statistically significant advantage in residual pivot shift (RR 0.34, 95% CI 0.24–0.47, I2 = 0%, p < 0.01), rerupture rate (RR 0.34, 95% CI 0.19–0.62, I2 = 0%, p < 0.01), Lachman test (RR 0.59, 95% CI 0.40–0.86, I2 = 21%, p < 0.01), and postoperative Lysholm score (MD 2.28, CI 95% 0.75–3.81, I2 = 73%, p < 0.01).ConclusionsCombined ACL and ALL reconstruction obtained better postoperative clinical outcomes when compared with isolated ACL reconstruction, especially in reducing residual pivot shift and rerupture rate. More... »

PAGES

33

References to SciGraph publications

  • 2019-04-04. Anterolateral ligament of the knee: a step-by-step dissection in BMC MUSCULOSKELETAL DISORDERS
  • 2018-04-02. Combined reconstruction of the anterolateral ligament in chronic ACL injuries leads to better clinical outcomes than isolated ACL reconstruction in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • 2012-01-05. Pivot shift as an outcome measure for ACL reconstruction: a systematic review in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • 2019-09-11. Clinical experience with combined reconstruction of the anterior cruciate and anterolateral ligaments of the knee in sportsmen in INTERNATIONAL ORTHOPAEDICS
  • 2017-02-20. Anterolateral Ligament Expert Group consensus paper on the management of internal rotation and instability of the anterior cruciate ligament - deficient knee in JOURNAL OF ORTHOPAEDICS AND TRAUMATOLOGY
  • 2011-06-30. The anterolateral ligament of the human knee: an anatomic and histologic study in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • 2016-12-01. Causes of Failure of Anterior Cruciate Ligament Reconstruction and Revision Surgical Strategies in KNEE SURGERY & RELATED RESEARCH
  • 2020-07-02. Anterolateral ligament reconstruction improves the clinical and functional outcomes of anterior cruciate ligament reconstruction in athletes in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • 2020-04-22. Antero-lateral ligament reconstruction improves knee stability alongside anterior cruciate ligament reconstruction in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
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    http://scigraph.springernature.com/pub.10.1186/s43019-021-00115-1

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    http://dx.doi.org/10.1186/s43019-021-00115-1

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1141332677

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/34556187


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