Combined anterior cruciate and anterolateral ligament reconstruction in the professional athlete: clinical outcomes from the SANTI Group in a series of seventy patients with a minimum follow up of two years

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Rosenstiel, N, Praz, C, Ouanezar, H, Saithna, A ORCID: https://orcid.org/0000-0002-2408-5307, Fournier, Y, Hager, J-P, Thaunat, M and Sonnery-Cottet, B, 2019. Combined anterior cruciate and anterolateral ligament reconstruction in the professional athlete: clinical outcomes from the SANTI Group in a series of seventy patients with a minimum follow up of two years. Arthroscopy: The Journal of Arthroscopic & Related Surgery, 35 (3), pp. 885-892. ISSN 0749-8063

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Official URL: http://doi.org/10.1016/j.arthro.2018.09.020

Abstract

Purpose: To evaluate clinical outcomes in professional athletes after combined anterior cruciate ligament (ACL) and anterolateral ligament (ALL) reconstruction, with a minimum follow-up of two years.

Methods: All professional athletes who underwent primary combined ACL and ALL reconstruction between January 2011 and March 2016 were included. A retrospective analysis of prospectively collected data from the SANTI Study Group database was performed. Patient assessment included physical examination, pre- and postoperative subjective and objective IKDC, Tegner activity scale (TAS) and Lysholm score.

Results: 72 professional athletes underwent primary ACL and ALL reconstruction, 70 (97%) were available with a mean follow-up of 3.9 years (range 2-7). The pre-operative side-to-side anteroposterior laxity difference was 7.1 ± 1.4mm and this decreased significantly after surgery to 0.40.9mm (p<0.0001). Pivot-shift grade evolved from 16 grade I (22.8%) and 54 grade II or III (77.2%) preoperatively, to 66 absent pivot shift (94.3%) and 4 grade I (5.7). By one-year post-operatively, sixty athletes (85.7%) returned to professional sport with a mean time interval of 7.9 months (range 5-12). At final follow up the mean subjective IKDC was 90.5 ± 7.6, Lysholm score 94.4 ± 7.5, Tegner 8.8 ± 1.5. 11 Patients (15,7%) underwent a subsequent ipsilateral re-operation including 4 (5.7%) revision ACL reconstructions. Subgroup analysis of early graft failures (within one year or 3 months of first match post-operatively) in professional soccer players demonstrated a significantly lower rate in the current series (0%) when compared against published rates (7%), chi2 8.457 p=0.0036.

Conclusions: Combined ACL and ALL reconstruction is associated with excellent outcomes in professional athletes with respect to graft rupture rates, return to sport, knee stability, and re-operation rates after injury. Subgroup analysis in professional soccer players demonstrates that combined ACL and ALL reconstruction is associated with significantly reduced graft rupture rates when compared to isolated ACL reconstruction.

Level of evidence: Level IV case series.

Item Type:	Journal article
Publication Title:	Arthroscopy: The Journal of Arthroscopic & Related Surgery
Creators:	Rosenstiel, N., Praz, C., Ouanezar, H., Saithna, A., Fournier, Y., Hager, J.-P., Thaunat, M. and Sonnery-Cottet, B.
Publisher:	WB Saunders
Date:	2019
Volume:	35
Number:	3
ISSN:	0749-8063
Identifiers:	Number Type 10.1016/j.arthro.2018.09.020 DOI S0749806318308302 Publisher Item Identifier
Rights:	© 2018 The Authors. Published by Elsevier on behalf of the Arthroscopy Association of North America. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Divisions:	Schools > School of Science and Technology
Record created by:	Linda Sullivan
Date Added:	24 Oct 2018 10:42
Last Modified:	17 Sep 2019 15:05
URI:	https://irep.ntu.ac.uk/id/eprint/34726