Mid-Term Results of Simultaneous Reconstruction of Anterior Cruciate and Anterolateral Ligaments in Athletes

Cover Page


Cite item

Abstract

Relevance. Today, there exist a large number of methods for arthroscopic reconstruction of the anterior cruciate ligament, however, the return to the competitive level among athletes remains quite low. It is believed that the functional state depends on the restoration of the rotational and anteroposterior stability of the knee. Such data facilitate the search of techniques for additional stabilization of the knee, one of which is the reconstruction of the anterolateral ligament of the knee. The goal of the study was to assess the medium-term results of combined one-stage arthroscopic reconstruction of the anterior cruciate and anterolateral ligaments of the knee in athletes and the probability of their return to the competitive level. Material and Methods. In the period from 2014 to 2015, 50 patients underwent surgery. They were divided into 2 groups. Group 1 (main) consisted of 20 patients, including 10 professional athletes, who underwent the arthroscopic reconstruction of the anterior cruciate ligament, supplemented by reconstruction of the anterolateral ligament. Group 2 (control) included 30 patients (of which 10 were the professional athletes) who underwent the arthroscopic reconstruction only of the anterior cruciate ligament. Results. Group 1. 2 years after surgical treatment, 100% of patients were able to return to the preoperative competitive levels of activity. The average Tegner Lysholm score before the operation was 72.60±6.45 points, after the operation — 97.40±1.18 points. The average value on the IKDC scale before surgery was 63.1±4.8%, after surgery — 96.3±1.8%. Group 2. Of 30 patients, 2 years after surgery, 20 patients returned to the preoperative and competitive levels (66.7%). Of the professional athletes, 5 out of 10 patients (50%) returned to the competitive level, among amateur athletes — 15 out of 20 patients (75%). The average Tegner Lysholm score before surgery was 69.6±3.5 points, after — 92.1±3.9 points. The average value on the IKDC scale before surgery was 73.4±3.2%, after — 90.3±3.7%. Conclusion. Medium-term results of the study showed that the onestage restoration of the anterior cruciate and anterolateral ligaments, compared with arthroscopic reconstruction of only the anterior cruciate ligament, increased the probability that the patients with high functional requirements and professional athletes would return to sports.

About the authors

E. N. Goncharov

Russian Medical Academy of Continuous Professional Education; Central Clinical Hospital of the Russian Academy of Sciences

Author for correspondence.
Email: goncharoven@gmail.com

Evgeny N. Goncharov — Cand. Sci. (Med.), Assistant Lecturer, Traumatology and Orthopedics Department, Russian Medical Academy of Continuous Professional Education; Orthopaedic Surgeon, Traumatology and Orthopedics Center, Central Clinical Hospital of the Russian Academy of Sciences

Moscow

Russian Federation

O. A. Koval

Central Clinical Hospital of the Russian Academy of Sciences

Email: fake@neicon.ru

Oleg A. Koval — Orthopaedic Surgeon, Traumatology and Orthopedics Center

Moscow

Russian Federation

V. E. Dubrov

Lomonosov Moscow State University

Email: fake@neicon.ru

Vadim E. Dubrov — Dr. Sci. (Med.), Head of General and Specific Surgery Department, Fundamental Medicine Faculty

Moscow

Russian Federation

E. N. Bezuglov

Sechenov First Moscow State Medical University

Email: fake@neicon.ru

Eduard N. Bezuglov — Assistant Lecturer, Department of Sport Medicine

Moscow

Russian Federation

A. A. Alekhin

Peoples’ Friendship University of Russia

Email: fake@neicon.ru

Anton A. Alekhin — Student

Moscow

Russian Federation

N. G. Goncharov

Russian Medical Academy of Continuous Professional Education; Central Clinical Hospital of the Russian Academy of Sciences

Email: fake@neicon.ru

Nikolay G. Goncharov — Dr. Sci. (Med.), Head of Department, Traumatology and Orthopedics Department, Russian Medical Academy of Continuous Professional Education; Head of Department, Traumatology and Orthopedics Center, Central Clinical Hospital of the Russian Academy of Sciences

Moscow

Russian Federation

References

  1. Sanders T.L., Maradit Kremers H., Bryan A.J., Larson D.R., Dahm D.L., Levy B.A. [et al.]. Incidence of Anterior Cruciate Ligament Tears and Reconstruction: A 21-Year Population-Based Study. Am J Sports Med. 2016;44(6):1502-1507. doi: 10.1177/0363546516629944.
  2. Лазишвили Г.Д., Кузьменко В.В., Гиршин В.Э. Артроскопическая реконструкция передней крестообразной связки коленного сустава. Вестник травматологии и ортопедии им. Н.Н. Приорова. 1997;(1):23-27.
  3. Федорук Г.В., Голева А.В., Бровкин С.С., Невзоров А.М. Современные технологии в эндопротезировании передней крестообразной связки коленного сустава. Земский врач. 2012;13(2):21-23.
  4. Davarinos N., O’Neill B.J., Curtin W. A Brief History of Anterior Cruciate Ligament Reconstruction. Adv Orthop Surg. 2014;2014:1-6. doi: 10.1155/2014/706042.
  5. Xie X., Liu X., Chen Z., Yu Y., Peng S., Li Q. A metaanalysis of bone-patellar tendon-bone autograft versus four-strand hamstring tendon autograft for anterior cruciate ligament reconstruction. Knee. 2015;22(2):100-110. doi: 10.1016/j.knee.2014.11.014.
  6. Gudas R., Jurkonis R., Smailys A. Comparison of Return to Pre-Injury Sport After 10 mm Size Bone-Patellar Tendon-Bone (BPTB) versus 8 mm Hamstring Anterior Cruciate Ligament Reconstruction: A Retrospective Study with a Two-Year Follow-Up. Med Sci Monit. 2018;24:987-996.
  7. Brophy R.H., Schmitz L., Wright R.W., Dunn W.R., Parker R.D., Andrish J.T. et al. Return to play and future ACL injury risk after ACL reconstruction in soccer athletes from the multicenter orthopaedic outcomes network (MOON) group. Am J Sports Med. 2012;40(11):25172522. doi: 10.1177/0363546512459476.
  8. Mascarenhas R., Tranovich M.J., Kropf E.J., Fu F.H., Harner C.D. Bone-patellar tendon-bone autograft versus hamstring autograft anterior cruciate ligament reconstruction in the young athlete: a retrospective matched analysis with 2-10 year follow-up. Knee Surg Sports Traumatol Arthrosc. 2012;20(8):1520-1527. doi: 10.1007/s00167-011-1735-2.
  9. Ardern C.L. Anterior Cruciate Ligament ReconstructionNot Exactly a One-Way Ticket Back to the Preinjury Level: A Review of Contextual Factors Affecting Return to Sport After Surgery. Sports Health. 2015;7(3):224-230. doi: 10.1177/1941738115578131.
  10. Chambat P., Guier C., Sonnery-Cottet B., Fayard J.M., Thaunat M. The evolution of ACL reconstruction over the last fifty years. Int Orthop. 2013;37(2):181-186. doi: 10.1007/s00264-012-1759-3.
  11. Nedeff D.D., Bach B.R. Jr. Arthroscopic anterior cruciate ligament reconstruction using patellar tendon autografts. Orthopedics. 2002;25(3):343-357; quiz 358-359.
  12. Kocher M.S., Steadman J.R., Briggs K.K., Sterett W.I., Hawkins R.J. Relationships between objective assessment of ligament stability and subjective assessment of symptoms and function after anterior cruciate ligament reconstruction. Am J Sports Med. 2004;32(3):629-634. doi: 10.1177/0363546503261722.
  13. Ayeni O.R., Chahal M., Tran M.N., Sprague S. Pivot shift as an outcome measure for ACL reconstruction: a systematic review. Knee Surg Sports Traumatol Arthrosc. 2012;20(4):767-777. doi: 10.1007/s00167-011-1860-y.
  14. Гончаров Е.Н., Коваль О.А., Краснов Г.О., Миронов А.Н., Гончаров Н.Г. Топографо-анатомическая характеристика антеролатеральной связки коленного сустава. Травматология и ортопедия России. 2018;24(2):88-95. doi: 10.21823/2311-2905-2018-24-1-88-95.
  15. Caterine S., Litchfield R., Johnson M., Chronik B., Getgood A. A cadaveric study of the anterolateral ligament: re-introducing the lateral capsular ligament. Knee Surg Sports Traumatol Arthrosc. 2015;23(11):31863195. doi: 10.1007/s00167-014-3117-z.
  16. Sonnery-Cottet B., Lutz C., Daggett M., Dalmay F., Freychet B., Niglis L., Imbert P. The involvement of the anterolateral ligament in rotational control of the knee. Am J Sports Med. 2016;44(5):1209-1214. doi: 10.1177/0363546515625282.
  17. Claes S., Luyckx T., Vereecke E., Bellemans J. The Segond fracture: a bony injury of the anterolateral ligament of the knee. Arthroscopy. 2014;30(11):1475-1482. doi: 10.1016/j.arthro.2014.05.039.
  18. Smith J.O., Yasen S.K., Lord B., Wilson A.J. Combined anterolateral ligament and anatomic anterior cruciate ligament reconstruction of the knee. Knee Surg Sports Traumatol Arthrosc. 2015;23(11):3151-3156. doi: 10.1007/s00167-015-3783-5.
  19. Wagih A.M., Elguindy A.M. Percutaneous Reconstruction of the Anterolateral Ligament of the Knee With a Polyester Tape. Arthrosc Tech. 2016;5(4):e691-e697. doi: 10.1016/j.eats.2016.02.028.
  20. Chahla J., Menge T.J., Mitchell J.J., Dean C.S., LaPrade R.F. Anterolateral Ligament Reconstruction Technique: An Anatomic-Based Approach. Arthrosc Tech. 2016;5(3):e453-e457. doi: 10.1016/j.eats.2016.01.032.
  21. Leiter J.R., Gourlay R., McRae S., de Korompay N., MacDonald P.B. Long-term follow-up of ACL reconstruction with hamstring autograft. Knee Surg Sports Traumatol Arthrosc. 2014;22(5):1061-1069. doi: 10.1007/s00167-013-2466-3.
  22. Ardern C.L., Webster K.E., Taylor N.F., Feller J.A. Return to sport following anterior cruciate ligament reconstruction surgery: a systematic review and meta-analysis of the state of play. Br J Sports Med. 2011;45(7):596-606. doi: 10.1136/bjsm.2010.076364.
  23. Kocher M.S., Steadman J.R., Briggs K., Zurakowski D., Sterett W.I., Hawkins R.J. Determinants of patient satisfaction with outcome after anterior cruciate ligament reconstruction. J Bone Joint Surg Am. 2002;84-A(9):15601572. doi: 10.2106/00004623-200209000-00008.
  24. Magnussen R.A., Lawrence J.T., West R.L., Toth A.P., Taylor D.C., Garrett W.E. Graft size and patient age are predictors of early revision after anterior cruciate ligament reconstruction with hamstring autograft. Arthroscopy. 2012;28(4):526-531. doi: 10.1016/j.arthro.2011.11.024.
  25. Mariscalco M.W., Flanigan D.C., Mitchell J., Pedroza A.D., Jones M.H., Andrish J.T. et al. The influence of hamstring autograft size on patient-reported outcomes and risk of revision after anterior cruciate ligament reconstruction: a Multicenter Orthopaedic Outcomes Network (MOON) Cohort Study. Arthroscopy. 2013;29(12):1948-1953. doi: 10.1016/j.arthro.2013.08.025.
  26. Van Eck C.F., Schkrohowsky J.G., Working Z.M., Irrgang J.J., Fu F.H. Prospective analysis of failure rate and predictors of failure after anatomic anterior cruciate ligament reconstruction with allograft. Am J Sports Med. 2012;40(4):800-807. doi: 10.1177/0363546511432545.
  27. Jonsson H., Riklund-Ahlström K., Lind J. Positive pivot shift after ACL reconstruction predicts later osteoarthrosis: 63 patients followed 5-9 years after surgery. Acta Orthop Scand. 2004;75(5):594-599. doi: 10.1080/00016470410001484.
  28. Monaco E., Maestri B., Conteduca F., Mazza D., Iorio C., Ferretti A. Extra-articular ACL Reconstruction and Pivot Shift: In Vivo Dynamic Evaluation With Navigation. Am J Sports Med. 2014;42(7):1669-1674. doi: 10.1177/0363546514532336.
  29. Helito C.P., Bonadio M.B., Gobbi R.G., da Mota E Albuquerque R.F., Pécora J.R., Camanho G.L., Demange M.K. Combined Intra- and Extra-articular Reconstruction of the Anterior Cruciate Ligament: The Reconstruction of the Knee Anterolateral Ligament. Arthrosc Tech. 2015;4(3):e239-244. doi: 10.1016/j.eats.2015.02.006.
  30. Sonnery-Cottet B., Thaunat M., Freychet B., Pupim B.H., Murphy C.G., Claes S. Outcome of a Combined Anterior Cruciate Ligament and Anterolateral Ligament Reconstruction Technique With a Minimum 2-Year Follow-up. Am J Sports Med. 2015;43(7):1598-1605. doi: 10.1177/0363546515571571.
  31. Ibrahim S.A., Shohdy E.M., Marwan Y., Ramadan S.A., Almisfer A.K., Mohammad M.W. et al. Anatomic Reconstruction of the Anterior Cruciate Ligament of the Knee With or Without Reconstruction of the Anterolateral Ligament: A Randomized Clinical Trial. Am J Sports Med. 2017;45(7):1558-1566. doi: 10.1177/0363546517691517.
  32. Mogos S., Sendrea B., Stoica I.C. Combined Anatomic Anterior Cruciate Ligament and Anterolateral Ligament Reconstruction. Maedica (Buchar). 2017;12(1):30-35.
  33. Sonnery-Cottet B., Saithna A., Cavalier M., Kajetanek C., Temponi E.F. Daggett M. et al. Anterolateral Ligament Reconstruction Is Associated with Significantly Reduced ACL Graft Rupture Rates at a Minimum Follow-up of 2 Years: A Prospective Comparative Study of 502 Patients From the SANTI Study Group. Am J Sports Med. 2017;45(7):1547-1557. doi: 10.1177/0363546516686057.
  34. Ardern C.L., Taylor N.F., Feller J.A., Webster K.E. A systematic review of the psychological factors associated with returning to sport following injury. Br J Sports Med. 2013;47(17):1120-1126. doi: 10.1136/bjsports-2012-091203.

Supplementary files

Supplementary Files
Action
1. JATS XML

Copyright (c)



СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС 77 - 82474 от 10.12.2021.


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies