Combined Anterolateral and Anterior Cruciate Ligament Reconstruction Improves Pivot Shift and Anterior Tibial Translation with Similar Outcomes Compared with Isolated Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis of Randomized Controlled Trials.
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引用次数: 0
Abstract
Purpose: This study aimed to compare the subjective measurement indicators between isolated anterior cruciate ligament reconstruction (ACLR) and combined ACLR with anterolateral ligament reconstruction (ALLR) in patients with ACL injuries.
Methods: The Ovid MEDLINE and the Cochrane Central Registry of Controlled Trials were searched for Randomized Controlled Studies (RCTs) with a level of evidence (LOE) I-II published until September 2024 that evaluated subjective and safety outcomes between ACLR+ALLR and isolated ACLR. The Cochrane Risk of Bias 2.0 tool was used to evaluate publication bias.
Results: After literature reviews, 5 RCT studies were identified. The follow-up data were obtained for 377 patients; 184 underwent isolated ACLR, and 193 underwent ACLR+ALLR. The patients who achieved pivot shift test grade I or more after surgery were reported in all five studies, and it was significantly lower in the ACLR+ALLR group compared to the isolated ACLR group [(risk ratio (RR):0.47, 95% confidence interval (CI): 0.23-0.96, P=0.04, I2=20%). Moreover, the degree of anterior tibial translation after surgery was reported in four studies, and it was also significantly lower in the ACLR+ALLR group [mean difference (MD): -0.65, 95%CI: -1.26 - -0.04, P=0.04, I2=83%)]. The operative and follow-up outcomes were similar between the two groups.
Conclusions: Through a meta-analysis with LOE I-II and minimum 1-year follow-up data with similar outcomes, we proved that the combined ACLR+ALLR approach yielded superior residual laxity and pivot-shift test compared to isolated ACLR.
Level of evidence: Level II, meta-analysis of randomized controlled trials.
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