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Clinical experience with combined reconstruction of the anterior cruciate and anterolateral ligaments of the knee in sportsmen

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Abstract

Background

Rupture of the anterior cruciate ligament (ACL) is one of the most common sports injuries of the knee joint. Today, we have a large number of approaches to arthroscopic reconstruction of the anterior cruciate ligament that lead to successful outcomes and allow the patients to return to a significant level of activity post-operatively. Nevertheless, the return to competitions rate stays relatively low. The functional state is thought to be dependent on rotational and anteroposterior stability of the knee. These data encourage search for methods of additional stabilization of the knee joint, one of them being extra-articular tenodesis, or reconstruction of anterolateral ligament of the knee.

The aim of the study

To evaluate medium-term results of combined simultaneous arthroscopic reconstruction of anterior cruciate ligament and anterolateral ligament of the knee joint in sportsmen and to access the probability of return to competitions.

Materials and methods

The surgeries were performed in 2014–2015 in 50 patients who fulfilled the entry criteria: 20 patients (including 10 professional sportsmen) underwent arthroscopic ACL reconstruction together with reconstruction of anterolateral ligament—group 1 (main group), and 30 patients (including 10 professional sportsmen) underwent arthroscopic ACL reconstruction—group 2 (control group).

Results

Group 1: All patients of group 1 were able to return to the pre-operative sports level in two years after the surgery. The mean Tegner Lysholm score was 72.6 ± 6.45 (hereinafter, SE—standard error) before the surgery and 97.4 ± 1.18 after the surgery. The mean IKDC score was 63.1 ± 4.8% before the surgery and 96.3 ± 1.8% after the surgery. Group 2: 20 of 30 patients (66.7%) returned to the pre-operative level of activity and returned to competitions (if they were professional sportsmen) in a year after the surgery. Five of ten patients (50%) (professional sportsmen) returned to competitions. Fifteen of 20 patients (75%) (amateur sportsmen) also returned to competitions. The mean pre-operative Tegner Lysholm score was 69.6 ± 3.5, and the mean post-operative score was 92.1 ± 3.9. The mean pre-operative IKDC score was 73.4 ± 3.2%, and the mean post-operative score was 90.3 ± 3.7%.

Conclusion

The results of the study show that more patients with higher functional demands and more professional sportsmen returned to sports. Despite the results of our and other foreign studies, a need remains for studies that will compare outcomes of ALL reconstruction with the same surgical technique in homogenous groups of patients.

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Authors and Affiliations

  1. Russian Medical Academy of Continuous Professional Education, Barrikadnaya st., 2/1, 123242, Moscow, Russia

    Evgeniy Nikolaevich Goncharov & Nikolay Gavriilovich Goncharov

  2. Traumatology and Orthopedics Center, Central Clinical Hospital of the Russian Academy of Sciences, Litovskiy blvd., 1a, 117593, Moscow, Russia

    Evgeniy Nikolaevich Goncharov, Oleg Aleksandrovich Koval, Anastasiya Mikhaylovna Filimonova & Nikolay Gavriilovich Goncharov

  3. Department of the Fundamental Medicine Faculty, Lomonosov Moscow State University, Leninskie gory, 1, 119991, Moscow, Russia

    Vadim Erikovich Dubrov

  4. Department of Sport Medicine, I.M. Sechenov First Moscow State Medical University, Trubetskaya st., 8c2, Moscow, Russia

    Eduard Nikolaevich Bezuglov

  5. Radiology Unit of Diagnostocal Center, Central Clinical Hospital of the Russian Academy of Sciences, Litovskiy blvd., 1a, 117593, Moscow, Russia

    Anastasiya Mikhaylovna Filimonova

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  1. Evgeniy Nikolaevich Goncharov
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Correspondence to Oleg Aleksandrovich Koval.

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Goncharov, E.N., Koval, O.A., Dubrov, V.E. et al. Clinical experience with combined reconstruction of the anterior cruciate and anterolateral ligaments of the knee in sportsmen. International Orthopaedics (SICOT) 43, 2781–2788 (2019). https://doi.org/10.1007/s00264-019-04409-8

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