PDF herunterladen
J Knee Surg 2021; 34(09): 962-970
DOI: 10.1055/s-0040-1701220
Original Article

Clinical Results of Combined ACL and Anterolateral Ligament Reconstruction: A Narrative Review from the SANTI Study Group

Adnan Saithna 
1   Kansas City University of Medicine and Biosciences, Kansas City, Missouri
2   Sano Orthopedics, Overland Park, Kansas
3   School of Science and Technology, Nottingham Trent University, Clifton Campus, Nottingham, United Kingdom
,
Matt Daggett
1   Kansas City University of Medicine and Biosciences, Kansas City, Missouri
2   Sano Orthopedics, Overland Park, Kansas
,
Camilo Partezani Helito
4   Department of Orthopedic Surgery, Grupo de Joelho, Instituto de Ortopedia e Traumatologia, Hospital das Clinicas HCFMUSP, Universidade de São Paulo, São Paulo, Brazil
5   Department of Orthopedic Surgery, Hospital Sírio Libanês, São Paulo, Brazil
,
Edoardo Monaco
6   Department of Orthopedic Surgery, Sant'Andrea Hospital, La Sapienza University of Rome, Rome, Italy
,
Florent Franck
7   Department of Orthopedic Surgery, Centre Orthopedique Santy, FIFA Medical Centre of Excellence, Lyon, France
,
Thais Dutra Vieira 
7   Department of Orthopedic Surgery, Centre Orthopedique Santy, FIFA Medical Centre of Excellence, Lyon, France
8   Department of Orthopedic Surgery, Groupe Ramsay-Generale de Sante, Hôpital Privé Jean Mermoz, Lyon, France
,
Charles Pioger
7   Department of Orthopedic Surgery, Centre Orthopedique Santy, FIFA Medical Centre of Excellence, Lyon, France
,
Jin Goo Kim
9   Department of Orthopedic Surgery, Konkuk University Medical Center, Seoul, South Korea
,
Bertrand Sonnery-Cottet
7   Department of Orthopedic Surgery, Centre Orthopedique Santy, FIFA Medical Centre of Excellence, Lyon, France
8   Department of Orthopedic Surgery, Groupe Ramsay-Generale de Sante, Hôpital Privé Jean Mermoz, Lyon, France
› Institutsangaben Funding None.
› Weitere Informationen
    Lizenzen und Reprints

Abstract

Lateral extraarticular procedures (LEAPs) in the anterior cruciate ligament (ACL)-injured knee were widely abandoned in the 1990s but have seen a recent resurgence. The aim of this review was to demonstrate that anterolateral ligament reconstruction (ALLR) is associated with evidence of significant advantages and no evidence of historical concerns. A narrative review of the literature was performed. Combined ACL + ALLR is associated with improved outcomes when compared against isolated ACL reconstruction, including a significantly lower risk of ACL graft rupture (hazard ratio [HR]: 0.327, 95% CI: 0.130–0.758), a significantly lower risk of reoperation for secondary meniscectomy following medial meniscal repair at the time of ACL reconstruction (HR: 0.443, 95% CI: 0.218–0.866), significantly increased likelihood of return to the preinjury level of sport following primary (odds ratio [OR]: 1.938, 95% CI: 1.174–3.224) and revision ACL reconstruction (57.1 vs. 25.6%, respectively; p = 0.008), and in chronic ACL injuries, less residual pivot shift (9.1 vs. 35.3%, p = 0.011), and better IKDC (92.7 ± 5.9 vs. 87.1 ± 9.0, p = 0.0013) and Lysholm (95.4 ± 5.3 vs. 90.0 ± 7.1, p < 0.0001) scores, and no evidence of historical concerns. Combined ACLR + ALLR is associated with excellent clinical outcomes with no evidence of the adverse events that led to the historical widespread abandonment of other types of LEAP. Specifically, comparative series have demonstrated significant advantages of ALLR when compared against isolated ACLR with respect to reduced rates of ACL graft rupture, secondary meniscectomy, persistent instability, and significantly improved functional outcomes and improved return to sport metrics.

Keywords

anterior cruciate ligament reconstruction - anterolateral ligament reconstruction - lateral extraarticular procedures


Publikationsverlauf

Eingereicht: 09. September 2019

Angenommen: 27. November 2019

Artikel online veröffentlicht:
05. Februar 2020

© 2020. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Claes S, Vereecke E, Maes M, Victor J, Verdonk P, Bellemans J. Anatomy of the anterolateral ligament of the knee. J Anat 2013; 223 (04) 321-328
    CrossrefPubMedGoogle Scholar
  • 2 Ferretti A. Extra-articular reconstruction in the anterior cruciate ligament deficient knee: a commentary. Joints 2014; 2 (01) 41-47
    PubMedGoogle Scholar
  • 3 Pearl A, Bergfeld J. Extra-articular reconstruction in the anterior cruciate ligament deficient knee: a commentary. Vol. III. Champaign, IL: Human Kinetics Publishers; 1992
  • 4 Tramer JS, Fidai MS, Kadri O. et al. Anterolateral ligament reconstruction practice patterns across the United States. Orthop J Sports Med 2018; 6 (12) 2325967118811063
    Google Scholar
  • 5 Sonnery-Cottet B, Thaunat M, Freychet B, Pupim BHB, Murphy CG, 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 (07) 1598-1605
    CrossrefPubMedGoogle Scholar
  • 6 Delaloye J-R, Murar J, Vieira TD. et al. Combined anterior cruciate ligament repair and anterolateral ligament reconstruction. Arthrosc Tech 2018; 8 (01) e23-e29
    CrossrefPubMedGoogle Scholar
  • 7 Saithna A, Thaunat M, Delaloye JR, Ouanezar H, Fayard JM, Sonnery-Cottet B. Combined ACL and anterolateral ligament reconstruction. JBJS Essential Surg Tech 2018; 8 (01) e2
    CrossrefPubMedGoogle Scholar
  • 8 Roessler PP, Schüttler KF, Heyse TJ, Wirtz DC, Efe T. The anterolateral ligament (ALL) and its role in rotational extra-articular stability of the knee joint: a review of anatomy and surgical concepts. Arch Orthop Trauma Surg 2016; 136 (03) 305-313
    CrossrefPubMedGoogle Scholar
  • 9 Webster KE, Feller JA. Exploring the high reinjury rate in younger patients undergoing anterior cruciate ligament reconstruction. Am J Sports Med 2016; 44 (11) 2827-2832
    CrossrefPubMedGoogle Scholar
  • 10 Kamath GV, Murphy T, Creighton RA, Viradia N, Taft TN, Spang JT. Anterior cruciate ligament injury, return to play, and reinjury in the elite collegiate athlete: analysis of an NCAA Division I Cohort. Am J Sports Med 2014; 42 (07) 1638-1643
    CrossrefPubMedGoogle Scholar
  • 11 Sonnery-Cottet B, Saithna A, Cavalier 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 (07) 1547-1557
    CrossrefPubMedGoogle Scholar
  • 12 Sonnery-Cottet B, Vieira TD, Ouanezar H. Anterolateral ligament of the knee: diagnosis, indications, technique, outcomes. Arthroscopy 2019; 35 (02) 302-303
    CrossrefPubMedGoogle Scholar
  • 13 Magnussen RA, Reinke EK, Huston LJ, Hewett TE, Spindler KP. ; MOON Group. Factors associated with high-grade lachman, pivot shift, and anterior drawer at the time of anterior cruciate ligament reconstruction. Arthroscopy 2016; 32 (06) 1080-1085
    CrossrefPubMedGoogle Scholar
  • 14 Isberg J, Faxén E, Laxdal G, Eriksson BI, Kärrholm J, Karlsson J. Will early reconstruction prevent abnormal kinematics after ACL injury? Two-year follow-up using dynamic radiostereometry in 14 patients operated with hamstring autografts. Knee Surg Sports Traumatol Arthrosc 2011; 19 (10) 1634-1642
    CrossrefPubMedGoogle Scholar
  • 15 Logan M, Dunstan E, Robinson J, Williams A, Gedroyc W, Freeman M. Tibiofemoral kinematics of the anterior cruciate ligament (ACL)-deficient weightbearing, living knee employing vertical access open “interventional” multiple resonance imaging. Am J Sports Med 2004; 32 (03) 720-726
    CrossrefPubMedGoogle Scholar
  • 16 Inderhaug E, Stephen JM, Williams A, Amis AA. Anterolateral tenodesis or anterolateral ligament complex reconstruction: effect of flexion angle at graft fixation when combined with ACL reconstruction. Am J Sports Med 2017; 45 (13) 3089-3097
    CrossrefPubMedGoogle Scholar
  • 17 Hewison CE, Tran MN, Kaniki N, Remtulla A, Bryant D, Getgood AM. Lateral Extra-articular tenodesis reduces rotational laxity when combined with anterior cruciate ligament reconstruction: a systematic review of the literature. Arthroscopy 2015; 31 (10) 2022-2034
    CrossrefPubMedGoogle Scholar
  • 18 Helito CP, Camargo DB, Sobrado MF. et al. Combined reconstruction of the anterolateral ligament in chronic ACL injuries leads to better clinical outcomes than isolated ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 2018; 26 (12) 3652-3659
    CrossrefPubMedGoogle Scholar
  • 19 Kim S-J, Choi CH, Kim S-H. et al. Bone-patellar tendon-bone autograft could be recommended as a superior graft to hamstring autograft for ACL reconstruction in patients with generalized joint laxity: 2- and 5-year follow-up study. Knee Surg Sports Traumatol Arthrosc 2018; 26 (09) 2568-2579
    CrossrefPubMedGoogle Scholar
  • 20 Larson CM, Bedi A, Dietrich ME. et al. Generalized hypermobility, knee hyperextension, and outcomes after anterior cruciate ligament reconstruction: prospective, case-control study with mean 6 years follow-up. Arthroscopy 2017; 33 (10) 1852-1858
    CrossrefPubMedGoogle Scholar
  • 21 Helito CP, Sobrado M, Bonadio M, Pecora J, Camanho G, Demange M. Combined reconstruction of the anterolateral ligament in patients with ACL injury and ligamentous hyperlaxity leads to better clinical stability and a lower failure rate than isolated ACL reconstruction. Arthroscopy 2019; 35 (09) 2648-2654
    CrossrefPubMedGoogle Scholar
  • 22 Monaco E, Helito CP, Redler A. et al. Correlation between magnetic resonance imaging and surgical exploration of the anterolateral structures of the acute anterior cruciate ligament-injured knee. Am J Sports Med 2019; 47 (05) 1186-1193
    CrossrefPubMedGoogle Scholar
  • 23 Lee DW, Kim JG, Cho SI, Kim DH. Clinical outcomes of isolated revision anterior cruciate ligament reconstruction or in combination with anatomic anterolateral ligament reconstruction. Am J Sports Med 2019; 47 (02) 324-333
    CrossrefPubMedGoogle Scholar
  • 24 Sonnery-Cottet B, Saithna A, Blakeney WG. et al. Anterolateral ligament reconstruction protects the repaired medial meniscus: a comparative study of 383 anterior cruciate ligament reconstructions from the SANTI study group with a minimum follow-up of 2 years. Am J Sports Med 2018; 46 (08) 1819-1826
    CrossrefPubMedGoogle Scholar
  • 25 Sonnery-Cottet B, Lutz C, Daggett M. et al. The Involvement of the anterolateral ligament in rotational control of the knee. Am J Sports Med 2016; 44 (05) 1209-1214
    CrossrefPubMedGoogle Scholar
  • 26 Ferretti A, Monaco E, Fabbri M, Maestri B, De Carli A. Prevalence and classification of injuries of anterolateral complex in acute anterior cruciate ligament tears. Arthroscopy 2017; 33 (01) 147-154
    CrossrefPubMedGoogle Scholar
  • 27 Muramatsu K, Saithna A, Watanabe H. et al. Three-dimensional magnetic resonance imaging of the anterolateral ligament of the knee: an evaluation of intact and anterior cruciate ligament-deficient knees from the scientific anterior cruciate ligament network international (SANTI) study group. Arthroscopy 2018; 34 (07) 2207-2217
    CrossrefPubMedGoogle Scholar
  • 28 Sonnery-Cottet B, Praz C, Rosenstiel N. et al. Epidemiological evaluation of meniscal ramp lesions in 3214 anterior cruciate ligament-injured knees from the santi study group database: a risk factor analysis and study of secondary meniscectomy rates following 769 ramp repairs. Am J Sports Med 2018; 46 (13) 3189-3197
    CrossrefPubMedGoogle Scholar
  • 29 Ardern CL, Taylor NF, Feller JA, Webster KE. Fifty-five per cent return to competitive sport following anterior cruciate ligament reconstruction surgery: an updated systematic review and meta-analysis including aspects of physical functioning and contextual factors. Br J Sports Med 2014; 48 (21) 1543-1552
    CrossrefPubMedGoogle Scholar
  • 30 Rosenstiel N, Praz C, Ouanezar H. et al. Combined anterior cruciate and anterolateral ligament reconstruction in the professional athlete: clinical outcomes from the scientific anterior cruciate ligament network international study group in a series of 70 patients with a minimum follow-up of 2 years. Arthroscopy 2019; 35 (03) 885-892
    CrossrefPubMedGoogle Scholar
  • 31 Strum GM, Fox JM, Ferkel RD. et al. Intraarticular versus intraarticular and extraarticular reconstruction for chronic anterior cruciate ligament instability. Clin Orthop Relat Res 1989; (245) 188-198
    PubMedGoogle Scholar
  • 32 Dodds AL, Gupte CM, Neyret P, Williams AM, Amis AA. Extra-articular techniques in anterior cruciate ligament reconstruction: a literature review. J Bone Joint Surg Br 2011; 93 (11) 1440-1448
    CrossrefPubMedGoogle Scholar
  • 33 Thaunat M, Clowez G, Saithna A. et al. Reoperation rates after combined anterior cruciate ligament and anterolateral ligament reconstruction: a series of 548 patients from the santi study group with a minimum follow-up of 2 years. Am J Sports Med 2017; 45 (11) 2569-2577
    CrossrefPubMedGoogle Scholar
  • 34 Kraeutler MJ, Bravman JT, McCarty EC. Bone-patellar tendon-bone autograft versus allograft in outcomes of anterior cruciate ligament reconstruction: a meta-analysis of 5182 patients. Am J Sports Med 2013; 41 (10) 2439-2448
    CrossrefPubMedGoogle Scholar
  • 35 Li X, Xu CP, Song JQ, Jiang N, Yu B. Single-bundle versus double-bundle anterior cruciate ligament reconstruction: an up-to-date meta-analysis. Int Orthop 2013; 37 (02) 213-226
    CrossrefPubMedGoogle Scholar
  • 36 Buda R, Ruffilli A, Parma A. et al. Partial ACL tears: anatomic reconstruction versus nonanatomic augmentation surgery. Orthopedics 2013; 36 (09) e1108-e1113
    CrossrefPubMedGoogle Scholar
  • 37 Helito CP, Saithna A, Bonadio MB. et al. Anterolateral ligament reconstruction: a possible option in the therapeutic arsenal for persistent rotatory instability after ACL reconstruction. Orthop J Sports Med 2018; 6 (01) 2325967117751348
    Google Scholar
  • 38 Praz C, Kandhari VK, Saithna A, Sonnery-Cottet B. ACL rupture in the immediate build-up to the Olympic Games: return to elite alpine ski competition 5 months after injury and ACL repair. BMJ Case Rep 2019; 12 (03) e227735
    CrossrefPubMedGoogle Scholar
  • 39 Ferretti A, Monaco E, Ponzo A. et al. Combined Intra-articular and Extra-articular Reconstruction in Anterior Cruciate Ligament-Deficient Knee: 25 Years Later. Arthroscopy 2016; 32 (10) 2039-2047
    CrossrefPubMedGoogle Scholar
  • 40 Redler A, Iorio R, Monaco E. et al. Revision anterior cruciate ligament reconstruction with hamstrings and extra-articular tenodesis: a mid- to long-term clinical and radiological study. Arthroscopy 2018; 34 (12) 3204-3213
    CrossrefPubMedGoogle Scholar
  • 41 Musahl V, Rahnemai-Azar AA, van Eck CF, Guenther D, Fu FH. Anterolateral ligament of the knee, fact or fiction?. Knee Surg Sports Traumatol Arthrosc 2016; 24 (01) 2-3
    CrossrefPubMedGoogle Scholar
  • 42 Sonnery-Cottet B, Claes S, Blakeney WG. et al; Scientific Anterior Cruciate Ligament Network International (SANTI) Study Group. Anterolateral ligament: let's stick to the facts!. Arthroscopy 2018; 34 (08) 2259-2262
    CrossrefPubMedGoogle Scholar
  • 43 Sonnery-Cottet B, Saithna A, Helito C, Daggett M, Thaunat M. Regarding “anterolateral ligament of the knee, fact or fiction?”. Arthroscopy 2016; 32 (09) 1740-1741
    CrossrefPubMedGoogle Scholar
  • 44 Lubowitz JH, Provencher MT, Rossi MJ, Brand JC. News you can use: the knee anterolateral ligament and the ISAKOS journal. Arthroscopy 2016; 32 (05) 727-728
    CrossrefPubMedGoogle Scholar
  • 45 Sonnery-Cottet B, Daggett M, Fayard J-M. et al. Anterolateral ligament expert group consensus paper on the management of internal rotation and instability of the anterior cruciate ligament - deficient knee. J Orthop Traumatol 2017; 18 (02) 91-106
    CrossrefPubMedGoogle Scholar
  • 46 Sonnery-Cottet B, Thaunat M, Fayard JM. et al. ClinicalTrials.gov [Internet]. Bethesda (MD): National Library of Medicine (US). 2000 Feb 29 -. Identifier NCT03740022, a randomized controlled trial of ACL reconstruction with or without anterolateral ligament reconstruction: preliminary results from the SANTI study. Group 2016
    Google Scholar