The addition of lateral extra-articular augmentation procedures to bone-tendon-bone or quadriceps autograft anterior cruciate ligament reconstruction does not negatively affect physical or psychological readiness for return to sport at 6 and 9 months.
Christopher M LaPrade, E Grant Carey, Kennedy K Gachigi, Matthew Erbe, Chris Gabriel, Jonathan C Riboh
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引用次数: 0
Abstract
Purpose: The addition of lateral extra-articular augmentation procedures (LEAP) to anterior cruciate ligament reconstruction (ACLR) reduces graft failure rates in hamstring ACLR. However, their effects on return-to-sport (RTS) testing are not well understood in the setting of quadriceps (Quad) or bone-tendon-bone (BTB) autograft ACLR. The purpose was to evaluate the effects of adding LEAP to Quad or BTB autograft ACLR in young athletes, with respect to formal RTS testing outcomes. We hypothesized that the addition of LEAP to Quad or BTB ACLR would result in non-inferior outcomes as compared to isolated ACLR.
Methods: A retrospective case-control analysis was performed of prospectively collected data from 93 patients under the age of 25 undergoing Quad or BTB ACLR from a single surgeon between 2021 and 2023. A control group of isolated ACLR was compared to the study group of ACLR/LEAP (either anterolateral ligament reconstruction [ALLR] or lateral extra-articular tenodesis [LET]). All patients underwent standardized RTS testing at 6 and 9 months post-surgery. The study was powered based on a priori power analysis to assess non-inferiority of the ACL/LEAP group.
Results: There were 51 patients (54.8%) in the isolated ACLR group and 42 (45.2%) in the ACLR/LEAP group. The ACL/LEAP group was non-inferior to the isolated ACLR group for the limb symmetry index (LSI) and passing rates for each of the 6- and 9-month RTS tests, as well as psychological readiness, as measured by Anterior Cruciate Ligament-Return to Sport after Injury. There was no significant difference in overall pass rate between the control and ACL/LEAP groups (33% vs. 45.2%, respectively, p = 0.273) at 9 months. Subgroup analysis showed no differences in any outcome variables at 6 or 9 months between ACL/ALLR and ACL/LET.
Conclusions: This study confirmed our hypothesis that the addition of LEAP to Quad or BTB ACLR is non-inferior to isolated ACLR in terms of RTS testing and psychological readiness for sport at 6 and 9 months post-operatively.
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