Anterolateral Ligament Reconstruction in ACL Insufficient Knee with High-grade Pivot Shift——Surgical Technique and Early Follow-up Results / 中国运动医学杂志

ABSTRACT

Objective To evaluate the effectiveness of anterior cruciate ligament (ACL) reconstruction combined with anterolateral ligament(ALL)reconstruction in ACL injury patients with high-grade pivot shift.Methods From May 2015 to April 2016,156 patients underwent ACL reconstruction by the same surgeon,and 22 of them with grade 2/3 pivot shift were included in this study.Anteroposterior knee stability was evaluated using KT1000 measurement,and the rotatory stability was assessed using the pivot-shift test.The Lysholm score was used to monitor the clinical function.Results There were 14 male subjects and 8 females,with an average age of 29.3 years.The mean follow-up period was 8.6 months.The mean side-to-side difference of anteroposterior knee laxity was 2.1 ± 0.6 mm,significantly improved compared with the preoperative 8.9 ± 3.1 mm.The preoperative pivot-shift indicated 2+ in 20 patients and 3+ in 2 patients,while at the final follow-up,21 patients had negative pivot shift with 1 of 1+ pivot shift.The difference was significant.The average Lysholm score improved significantly from 60.5 ± 12.3 preoperatively to 79.2 ± 7.8 at the final follow-up.Conclusion The rotatory instability can be effectively restored through the ACL reconstruction combined with ALL reconstruction in patients with high-grade pivot shift.The early-stage knee stability and functional outcomes indicate significant improvement postoperatively.