Clinical outcomes of percutaneous reconstruction of anterolateral ligament in anterior cruciate ligament-deficient knee in skeletally mature patients

M. Saleh
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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. The results of combined ACL and anterolateral ligament (ALL) reconstruction have shown a significant improvement in clinical outcome. Objectives To evaluate clinical outcomes of combined ACL and ALL reconstruction in ACL-deficient knee. Patients and methods This study included 20 patients aged from 21 to 45 years, who presented with ACL-deficient knee. Combined ACL and ALL reconstruction were performed to all cases. Patients were followed up for 24 months postoperatively. Patient assessment included preinjury, preoperative and postoperative subjective and objective International Knee Documentation Committee, Tegner activity scale, and Lysholm scores. Results Our study showed that the postoperative mean Lysholm knee score (94.20 ± 4.55) was significantly improved than preoperative (65.62 ± 3.42) (P<0.001) and there were 17 (85%) patients postoperatively with an excellent score. Also, postoperative mean Tegner activity score and International Knee Documentation Committee (8.22 ± 1.64 and 87.25 ± 8.71, respectively) were significantly improved than the preoperative (6.73 ± 1.21 and 52.71 ± 11.35, respectively) values (P=0.031 and P<0.001, respectively). The instrumented knee laxity test was performed using a KT-1000 arthrometer where the mean of postoperative translation (3.28 ± 0.74 mm) was significantly lower than the preoperative (11.15 ± 0.82 mm) (P<0.001) value. Conclusion Our technique of combined ACL and ALL reconstruction was found to be effective in improving subjective and objective outcomes. Also, no serious complications were noted with this operative procedure.
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经皮前交叉韧带缺损膝关节经皮前外侧韧带重建的临床效果
背景前交叉韧带(ACL)断裂是膝关节最常见的运动损伤之一。ACL联合前外侧韧带(ALL)重建的结果显示临床预后有显著改善。目的评价ACL与ALL联合重建治疗膝关节ACL缺损的临床效果。患者和方法本研究纳入了20例年龄在21 ~ 45岁之间的膝关节acl缺陷患者。所有病例均行ACL和ALL联合重建。术后随访24个月。患者评估包括损伤前、术前和术后主观和客观的国际膝关节文献委员会、Tegner活动量表和Lysholm评分。结果术后Lysholm膝关节平均评分(94.20±4.55)明显高于术前(65.62±3.42)(P<0.001), 17例(85%)患者术后评分为优等。术后平均Tegner活动评分和国际膝关节文献委员会评分(分别为8.22±1.64和87.25±8.71)较术前(分别为6.73±1.21和52.71±11.35)显著改善(P=0.031和P<0.001)。使用KT-1000关节计进行假体膝关节松弛试验,术后平移平均值(3.28±0.74 mm)显著低于术前平均值(11.15±0.82 mm) (P<0.001)。结论前交叉韧带与全韧带联合重建技术在主客观预后方面均有较好的效果。此外,手术过程中没有出现严重的并发症。
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