Anatomic Reconstruction of the Anterior Cruciate Ligament of the Knee With or Without Reconstruction of the Anterolateral Ligament: A Randomized Clinical Trial

Ibrahim, Samir Abdulrazik; Shohdy, Emad Mureed; Marwan, Yousef; Ramadan, Sami Abdulghaffar; Almisfer, Abdulrahman Khalid; Mohammad, Mohammad Wagdy; Abdulsattar, Wael Shoabe; Khirat, S

doi:10.1177/0363546517691517

Cited by 104 publications

(138 citation statements)

References 35 publications

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“…In this trial, the patients who received the combined procedure had the best IKDC (International Knee Documentation Committee) subjective scores and returned to sports sooner. In 2017, Ibrahim and colleagues 15 reported a trial in which 110 patients with high-grade pivot shifts were allocated by birthdates to receive semitendinosus ACLR with or without the addition of a gracilis ALL reconstruction. The authors found no obvious superiority for the combined procedure other than a mean 0.5-mm advantage in instrumented laxity testing and concluded that the adjunctive ALL reconstruction should not be performed routinely in patients undergoing ACLR.…”

mentioning

confidence: 99%

ACL or ACL+

Reider¹

2020

Am J Sports Med

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mentioning

confidence: 99%

ACL or ACL+

Reider¹

2020

Am J Sports Med

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“…There have been attempts to study clinical outcomes of ALL reconstructions; however, these studies had mixed outcomes and were not able to demonstrate the superiority of combined surgery over isolated ACL reconstruction. [24][25][26][27][28] Recently, Ibrahim et al 25 performed a randomized controlled trial in 110 patients with high-grade pivot shift either assigned to undergo combined ACL and ALL reconstruction or isolated ACL reconstruction, and found no significant difference between the two groups in terms of knee stability. However, the study was limited as there was no attempt to analyze the status of the ALL before determination for ALL reconstruction.…”

Section: Discussionmentioning

confidence: 99%

Magnetic Resonance Imaging-Based Prevalence of Anterolateral Ligament Abnormalities and Associated Injuries in Knees with Acute Anterior Cruciate Ligament Injury

et al. 2018

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The purpose of this study was to determine and compare the prevalence of anterolateral ligament abnormality and associated injuries among patients with complete and partial anterior cruciate ligament tears. In addition, the prevalence of associated injuries with anterolateral ligament abnormality was further analyzed. Of the 158 patients diagnosed with acute anterior cruciate ligament tear, 82 patients were diagnosed with acute complete anterior cruciate ligament confirmed by magnetic resonance imaging (MRI) and arthroscopic procedures (Group C), and 74 patients were diagnosed with acute partial anterior cruciate ligament tears confirmed by MRI (Group P). The status of the anterolateral ligament, collateral ligaments, menisci, and osseous lesions was assessed. There was a significantly higher prevalence of anterolateral ligament abnormalities in Group C than Group P (36.6 vs. 4.1%, < 0.001). Medial collateral ligament, lateral collateral ligament, Segond fracture, osseous lesion at the fibular head, lateral tibial plateau, lateral femoral condyle, and medial tibial plateau were significantly associated with anterolateral ligament abnormality. Furthermore, severity of osseous lesion at the lateral tibial plateau, lateral femoral condyle, and medial tibial plateau was significantly associated (with linear correlation) with anterolateral ligament abnormality. The prevalence of anterolateral ligament abnormality was significantly higher in patients with complete anterior cruciate ligament tear (36.6%) than those with partial anterior cruciate ligament tear (4.1%), but with noticeable prevalence of anterolateral ligament abnormality in the partial anterior cruciate ligament tear group. Associated lesions significant to anterolateral ligament abnormality were tears in both collateral ligaments, lateral-sided osseous lesions, and osseous lesion of the medial tibial plateau.

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“…However, long-term results of ALL reconstruction are not known and have not been suggested as a standard procedure with ACL reconstruction. Despite this, additional ALL reconstruction has been recommended in patients with grade III pivot shift or Segond fracture and athletes practicing of sports with pivot movements [32][33][34]. In addition ACL revision, subjective rotational looseness, and Telos value >10 mm are also considered as indicative of ALL reconstruction associated with ACL reconstruction [35].…”

Section: Surgical Indicationsmentioning

confidence: 99%

Decision-Making for ALL Reconstruction and Surgical Techniques

Gürpınar¹

2020

Knee Surgery - Reconstruction and Replacement

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The anterolateral ligament (ALL), which was first described in 1879, was reintroduced in 2013 by Claes et al. It originates near the lateral epicondyle of the distal femur, runs along the lateral outer aspect of the knee, and inserts on the proximal tibia between Gerdy's tubercle and fibular head. The ALL tightens when the knee is internally rotated (twisted inwards), and in doing so, it is proposed to be a stabilizer to internal tibial rotation. Biomechanical studies showed that the ALL restrains internal rotation of the tibia and thus affects the pivot-shift phenomenon in the anterior cruciate ligament (ACL)-injured knee. Therefore, it is proposed that the deficient ALL can be a reason for persistent rotatory instability after ACL reconstruction. Furthermore, ALL reconstruction techniques have evolved and indications extended. Commonly accepted indications for concomitant ACL and ALL reconstruction are ACL revisions, high-grade pivot-shift test, chronic ACL rupture, and young patients and patients doing pivoting activities. Most surgeons perform an anatomic reconstruction technique with gracilis autograft. However, only few studies published reporting the outcomes of ALL reconstruction and more studies with longer follow-up times are, therefore, needed to provide the compelling clinical evidence for the efficacy of concomitant ACL and ALL procedures.

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Anatomic Reconstruction of the Anterior Cruciate Ligament of the Knee With or Without Reconstruction of the Anterolateral Ligament: A Randomized Clinical Trial

Cited by 104 publications

References 35 publications

ACL or ACL+

ACL or ACL+

Magnetic Resonance Imaging-Based Prevalence of Anterolateral Ligament Abnormalities and Associated Injuries in Knees with Acute Anterior Cruciate Ligament Injury

Decision-Making for ALL Reconstruction and Surgical Techniques

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