Modified Lemaire Anterolateral Corner Reconstruction Does Not Impact Forgotten Joint Score-12 at 2 Years in Hamstring Graft Anterior Cruciate Ligament Reconstructions in High-Risk Patients.

Abstract

To compare the Forgotten Joint Score-12 (FJS-12) at 2-year follow-up in patients younger than 25 years, with a preoperative Tegner score ≥7 and intent to return to competitive sports, undergoing either isolated single-bundle hamstring autograft anterior cruciate ligament reconstruction (ACLR) or hamstring autograft ACLR with modified Lemaire anterolateral corner (ALC) reconstruction. This single-center retrospective comparative cohort study included patients aged 16 to 25 years with a preoperative Tegner score ≥7 who underwent hamstring autograft ACLR, with or without a modified lateral extra-articular Lemaire tenodesis, between January 2019 and December 2022. Patients completed questionnaires preoperatively and at 6 weeks and 6, 12, and 24 months postoperatively. The primary outcome was FJS-12 at 24 months. Secondary outcomes included other patient-recorded outcome measures and rerupture rates at 24 months. Of 245 included patients, 122 (49.8%) underwent ACLR with a Lemaire ALC reconstruction. The 24-month follow-up rate was 88% (216/245). At 12 months, the FJS-12 was higher in the non-Lemaire group (88.0 ± 15.2 vs 75.0 ± 18.1, P = .003). At 24 months, FJS-12 scores were similar between groups (70.8 ± 21.7 vs 70.9 ± 20.6, P = .96). Within the non-Lemaire group, the FJS-12 declined significantly between 12 and 24 months (79.9 ± 17.9 vs 70.9 ± 20.6, P = .006). No significant differences were found in other patient-recorded outcome measures at 24 months. Reruptures occurred in 18 patients (14.6%) in the non-Lemaire group and 9 (7.4%) in the Lemaire group (P = .11). At 12 months, isolated ACLR resulted in higher FJS-12 scores compared with ACLR combined with modified Lemaire ALC reconstruction. However, this difference did not exceed the minimal clinically important difference and had disappeared by 24 months, suggesting no clinically meaningful difference associated with adding a Lemaire ALC reconstruction at 24-month follow-up. Level III, retrospective comparative study.