No difference found in the magnetic resonance imaging signal intensity of the anterior cruciate ligament reconstruction graft between single-bundle anterior cruciate ligament reconstruction with concomitant anterolateral ligament surgery and double-bundle anterior cruciate ligament reconstruction.

Abstract

The purpose is to investigate whether the graft of single-bundle anterior cruciate ligament reconstruction with concomitant anterolateral ligament surgery (SBACLR-ALLR) has a healing advantage over that of double-bundle ACLR (DBACLR). It is hypothesised that there is no difference in the signal-to-noise quotient (SNQ) of the ACLR graft between SBACLR-ALLR and DBACLR. A retrospective case-control study was conducted from 2010 to 2019, comparing patients who received SBACLR-ALLR and DBACLR. The primary outcome was the SNQ of the ACLR graft. The secondary outcomes were the clinical results assessed at 2 years postoperation. Forty-eight SBACLR-ALLRs and sixty DBACLRs with a mean follow-up of 53 months were identified. The SNQ of the ACLR graft in SBACLR-ALLR was comparable to that in DBACLR (6.9 ± 5.3 and 6.4 ± 5.0, respectively; <i>p</i> = 0.31). The graft rupture rates were 2.1% and 5%, respectively (<i>p</i> = 0.43). There was no statistically significant difference in the rate of return to previous sport at 2 years postoperation (SBACLR-ALLR = 79%, DBACLR = 60%; <i>p</i> = 0.05). The 2-year International Knee Documentation Committee (IKDC) subjective scores were 89.3 ± 9.2 and 87.6 ± 9.6, respectively (<i>p</i> = 0.21). Eighty-four per cent of SBACLR-ALLRs compared to 90% of DBACLRs achieved MCID in IKDC at 2-year follow-up (<i>p</i> = 0.33). There was no difference between the two groups in terms of the results of 2-year Lachman, anterior drawer and pivot shift tests. When comparing SBACLR-ALLR and DBACLR, no difference was found in the postoperative SNQ, the 2-year graft rupture rate, the rate of return to sport, the proportion of patients achieving MCID in IKDC at 2-year follow-up, and the 2-year clinical outcomes. These results suggest that adding an ALLR to SBACLR yields outcomes comparable to the more technically demanding DBACLR. Level III.