Foișor Orthopaedics Hospital Bucharest, Romania.
University of Medicine and Pharmacy Carol Davila Bucharest, Bucuresti, Romania.
Phys Sportsmed. 2023 Aug;51(4):371-378. doi: 10.1080/00913847.2022.2112914. Epub 2022 Aug 18.
The purpose of the current prospective randomized clinical trial (RCT) was to compare the clinical outcomes of combined anterior cruciate ligament (ACL) and anterolateral ligament (ALL) reconstruction with those of isolated ACL reconstruction and evaluate the re-rupture rate between the two study groups.
This prospective RCT included 58 patients (43 men and 15 women) who underwent ACL reconstruction, either isolated (Group I: 26 patients) or combined with the ALL reconstruction (Group II: 32 patients). Preoperatively, the two groups differed in age and rate of medial meniscal injuries. The patients were evaluated preoperatively and postoperatively during the time points corresponding to 6 (T) weeks, 12 (T) weeks, 6 (T) months, 12 (T) months, and 24 (T) months. The evaluation included the clinical examination (comprising Lachman test, Pivot Shift test, Range of Motion, and Rolimeter differential anterior laxity), the objective clinical score (Objective IKDC [The International Knee Documentation Committee] score), and the subjective clinical scores (comprising Subjective IKDC score, Lysholm score, and Tegner activity score). The postoperative complications of all the patients were recorded.
Both the groups reported a significant improvement in clinical scores during the final follow-up as compared to the preoperative value (p < 0.05). The only differences between the two groups were observed with respect to the pivot shift test during each follow-up, wherein more patients from group I reported a pivot shift test grade I as compared to group II (p < 0.05). Three patients from group I reported a re-rupture of the operated knee, whereas no patients from group II reported new ruptures (p = 0.041).
Combined ACL and ALL reconstruction has proven to be more effective in obtaining a high grade of rotational knee stability during mid-term follow-up as compared to isolated ACL reconstruction along with a significantly lower rate of re-ruptures.
Level I: Randomized Clinical Trial.
researchregistry5873: www.researchregistry.com.
本前瞻性随机临床试验（RCT）的目的是比较前交叉韧带（ACL）和前外侧韧带（ALL）重建联合与单纯 ACL 重建的临床结果，并评估两组之间的再断裂率。
本前瞻性 RCT 纳入了 58 例患者（男 43 例，女 15 例），均接受 ACL 重建，包括单纯 ACL 重建（I 组：26 例）或联合 ALL 重建（II 组：32 例）。术前，两组在年龄和内侧半月板损伤率方面存在差异。患者在术前和术后分别于 6（T）周、12（T）周、6（T）个月、12（T）个月和 24（T）个月时进行评估。评估内容包括临床检查（包括 Lachman 试验、前抽屉试验、关节活动度和 Rolimeter 差异前侧松弛度）、客观临床评分（客观 IKDC[国际膝关节文献委员会]评分）和主观临床评分（包括主观 IKDC 评分、Lysholm 评分和 Tegner 活动评分）。记录所有患者的术后并发症。
与术前相比，两组患者在最终随访时的临床评分均显著提高（p<0.05）。两组之间仅在各随访时的前抽屉试验中存在差异，I 组中更多患者报告前抽屉试验 I 级（p<0.05）。I 组有 3 例患者报告手术膝关节再次断裂，而 II 组无患者报告新的断裂（p=0.041）。
与单纯 ACL 重建相比，ACL 和 ALL 重建联合在中期随访中更有效地获得高等级的膝关节旋转稳定性，且再断裂率显著降低。
I 级：随机临床试验。
researchregistry5873：www.researchregistry.com。
