Influence of anterolateral ligament injuries on stability and second-look arthroscopic findings after allograft transtibial anterior cruciate ligament reconstruction.

Abstract

The purpose of this study was to evaluate the influence of anterolateral ligament (ALL) injuries on stability and second-look arthroscopic findings after anterior cruciate ligament (ACL) reconstruction. One-hundred and nineteen consecutive patients underwent a second-look arthroscopic surgery after ACL reconstruction and magnetic resonance imaging (MRI) examination of the ALL. The patients were divided into an ALL intact group (n = 39) and ALL injured group (n = 80). The ALL injuries were divided according to the three anatomical parts of the ALL (femoral, meniscal, and tibial) using MRI evaluation. Stability and clinical results were evaluated using the Lachman test, pivot-shift test, KT-2000 arthrometer, and Lysholm score. On second-look arthroscopy, graft tension and synovial coverage were evaluated. The clinical evaluation revealed no significant differences in ALL injury. Although the synovial coverages showed no significant difference (P = 0.113), the second-look arthroscopic findings indicated that tension was statistically significantly dependent on the ALL injury (P < 0.001). In addition, according to the location of the ALL injury, femoral, tibial, and combined ALL injuries showed significant differences in graft tension as compared with the ALL intact group; only the meniscal injuries had no effect on graft tension. Combined ACL and ALL injuries showed poor graft tension in the second-look arthroscopic findings after allograft transtibial ACL reconstruction, even though no significant differences in clinical outcomes and stability were observed.