Learning curve for combined reconstruction of the anterolateral and anterior cruciate ligaments: a report of 108 cases with a single surgeon.

IF 2.3 3区医学 Q2 ORTHOPEDICS

Orthopaedics & Traumatology-Surgery & Research Pub Date : 2024-11-27 DOI:10.1016/j.otsr.2024.104077

Malo Buisson, Alexandre Zadem, Evrad Gancel, Charles Kajetanek

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引用次数: 0

Abstract

Background: Anterior cruciate ligament (ACL) rupture is a common lesion among young sports players, for whom isolated surgical repair remains the gold standard. However, there is a high risk of re-rupture after ACL reconstruction. Recent results of ACL reconstruction combined with reconstruction of the anterolateral ligament (ALL) have shown a significant decrease in this risk. However, as with all new techniques, this requires a learning curve.

Hypothesis: Combined reconstruction of the ACL and ALL would have a short learning curve, be reproducible and have no specific complications.

Patients and methods: This retrospective study included the first 108 patients who underwent combined ACL and ALL reconstruction by a single surgeon. The patients were divided into four similar sized chronological groups (groups 1-4). Tourniquet time and associated procedures were analysed. The results of the IKDC subjective knee evaluation, Lysholm, KOOS and SANE functional scores were collected postoperatively at 1-year through an online database. The position of the femoral tunnel was evaluated using the quadrant method of Bernard and Hertel.

Results: A significant improvement in the position of the femoral tunnel in the proximo-distal axis was observed between groups 1 and 4 (p < 0.01), as well as between groups 3 and 4 (p < 0.001). The Lysholm functional score was significantly higher in group 4 at 1-year (difference between groups 1 and 4 (+ 3.2 (1.4-5.1), p = 0.017)). The tourniquet time decreased significantly between the first group and groups 2, 3 and 4 (p < 0.002).

Discussion: Precise positioning of the femoral tunnel in the proximo-distal axis is important during combined reconstruction of the ACL and ALL. The combined technique had a rapid learning curve, was reproducible, and resulted in a rapid decrease in the tourniquet time.

Level of evidence: III; observational study.

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来源期刊

Orthopaedics & Traumatology-Surgery & Research 医学-外科

CiteScore

5.10

自引率

26.10%

发文量

329

审稿时长

12.5 weeks

期刊介绍： Orthopaedics & Traumatology: Surgery & Research (OTSR) publishes original scientific work in English related to all domains of orthopaedics. Original articles, Reviews, Technical notes and Concise follow-up of a former OTSR study are published in English in electronic form only and indexed in the main international databases.