The Role of Anterolateral Ligament Reconstruction or Lateral Extra-articular Tenodesis for Revision Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis of Comparative Clinical Studies

Boksh, Khalis; Sheikh, Nomaan; Chong, Han Hong; Ghosh, Arijit; Aujla, Randeep

doi:10.1177/03635465231157377

Cited by 16 publications

(6 citation statements)

References 62 publications

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“…There were no consistent differences between isolated procedures and combined procedures with regard to patientreported outcomes or return to sport. Boksh et al showed similar results with revision ACL reconstruction 26 . In a systematic review and meta-analysis with 10 studies and 793 patients, there were no differences in Lysholm and Tegner scores between either LET or ALL reconstruction and isolated revision ACL reconstruction.…”

Section: Acl Reconstructionmentioning

confidence: 73%

What’s New in Sports Medicine

Thompson,

Shelton,

Lee

2024

Journal of Bone and Joint Surgery

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Section: Acl Reconstructionmentioning

confidence: 73%

What’s New in Sports Medicine

Thompson,

Shelton,

Lee

2024

Journal of Bone and Joint Surgery

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“…The conclusion was that although ACL revision is often accompanied by a LET procedure, the results are conflicting, and there is a lack of high-level studies. Recently, Boksh et al [ 44 ] investigated the effect of an anterolateral supplemental procedure in revision ACL-R in a meta-analysis. They included 10 comparative studies with a total of 793 patients [ 26 , 31 , 42 , 45 – 51 ] and concluded that a lateral extra articular augmentation in ACL revision surgery could improve rotational stability, subjective IKDC scores, and reduce graft failure rate compared to isolated ACL revision.…”

Section: Discussionmentioning

confidence: 99%

Combined anterior cruciate ligament revision with reconstruction of the antero‐lateral ligament does not improve outcome at 2‐year follow‐up compared to isolated acl revision; a randomized controlled trial

Sørensen,

Faunø,

Konradsen

et al. 2023

Knee surg. sports traumatol. arthrosc.

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Purpose It is essential to obtain rotational stability of the knee after anterior cruciate ligament reconstruction (ACL-R) and it is suggested that a supplementary reconstruction of the antero-lateral ligament (ALL-R) may supports this. Theoretically, ALL-R may be particularly advantageous to support revision of failed ACL-Rs. It was hypothesized that ACL revision combined with ALL-R will result in superior outcome compared to isolated ACL revision. Methods The study was designed as a randomized controlled trial. Patients eligible for first time ACL revision were randomized to either isolated ACL revision (− ALL group) or ACL revision combined with a single-stranded allograft ALL-reconstruction (+ ALL group). Patient reported outcomes and function were evaluated at two-year follow-up by KNEES-ACL, KOOS, and Tegner activity scale. Objective knee laxity was evaluated at one-year follow-up using an instrumented Rolimeter test, the pivot shift test, and a manual Lachman test. Results A total of 103 patients were enrolled with 49 patients randomized to the + ALL group and 54 patients in the − ALL group. There were no differences at baseline between groups regarding age, gender, body mass index, preoperative patient reported outcome scores and concomitant meniscus or cartilage injury. The ACL revision was performed with an allograft in 10 patients (20%) in the + ALL group and 8 patients (15%) in the -ALL group. At follow-up there was no significant difference between the groups in patient reported outcome scores and clinical knee laxity. Conclusion Supplementary ALL-R does not improve subjective outcome of first time ACL revision at two-years and clinical knee stability at one-year follow-up compared to isolated ACL revision. Level of evidence Level I.

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“…Patients who underwent the associated ALL reconstruction presented lower failure rates of the meniscal repair. [1][2][3][4][5] In patients with chronic ACL tears, the combined ALL reconstructions lead to better functional outcomes and…”

Section: Video Transcriptmentioning

confidence: 99%

“…Patients who underwent the associated ALL reconstruction presented lower failure rates of the meniscal repair. 1-5…”

Section: Video Transcriptmentioning

confidence: 99%

Combined ACL and Anterolateral Ligament Reconstruction Using an Adjustable-Loop Fixation Device: Surgical Technique

Jaramillo Quiceno,

Sarmiento Riveros,

Helito

et al. 2024

Video Journal of Sports Medicine

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Background: There are several techniques for the combined reconstruction of the anterior cruciate ligament (ACL) and the anterolateral ligament (ALL), but none have shown superiority. This study aims to present a surgical technique that theoretically reduces some of the risks reported in these procedures. Indications: The main indications for the ALL reconstruction include chronic ACL injuries, revision ACL reconstruction, acute ACL injuries in patients with high-grade pivot-shift (grades 2 or 3), patients involved in pivoting sports, and generalized ligament hyperlaxity or knee hyperextension. Technique Description: Hamstring tendon autografts are used for the ACL and ALL reconstruction; a common femoral ACL and ALL tunnel is made outside-in, making a short socket. A continuous looped hamstring tendon autograft attached to one button is used. The ACL is fixed with an adjustable-loop button. Through small incisions, the tibial fixation of both grafts is performed with bioabsorbable screws. Results: We present a 19-year-old professional soccer player with an acute ACL tear, with no associated meniscal or chondral lesions. Owing to his young age and high-risk sports practice, a combined ACL and ALL reconstruction was performed. The combined ACL and ALL reconstruction with a single femoral tunnel using the hamstrings tendons graft is a well-established procedure for ACL augmentation, reducing failure rates for certain risk groups, with excellent outcomes reported. The use of an adjustable-loop button on the femur is a viable option for this kind of reconstruction with postoperative stability comparable to the interference screw, classically used for this kind of reconstruction. Discussion/Conclusion: This technique has some advantages, such as the use of a short outside-in femoral socket, thus theoretically improving healing. In addition, this lowers the risk of lateral collateral ligament injury, and since the ileotibial band graft is not used, the risk of injuring the lateral inferior genicular vessels and the peroneal nerve is theoretically reduced. Besides, using an adjustable-loop cortical button in the femur can theoretically reduce potential complications such as screw migration, soft-tissue impingement, femoral-site pain, and implant removal. Finally, the reconstruction is done with small incisions, improving the aesthetic result and postoperative pain. Considering all the aforementioned factors, this technique theoretically offers some benefits. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.

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The Role of Anterolateral Ligament Reconstruction or Lateral Extra-articular Tenodesis for Revision Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis of Comparative Clinical Studies

Cited by 16 publications

References 62 publications

What’s New in Sports Medicine

What’s New in Sports Medicine

Combined anterior cruciate ligament revision with reconstruction of the antero‐lateral ligament does not improve outcome at 2‐year follow‐up compared to isolated acl revision; a randomized controlled trial

Combined ACL and Anterolateral Ligament Reconstruction Using an Adjustable-Loop Fixation Device: Surgical Technique

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