Description
Objectives:
Rotational instability of the knee remains an issue after anterior cruciate ligament (ACL) reconstruction. In fact, the association of antero-lateral ligament reconstruction seems to yield to better outcomes in patients with high grade pivot shift, however it remains a topic of discussion.
Our aim was to evaluate functional outcomes as well as residual laxity after isolated anatomic ACL reconstruction in amateur sportsmen with high grade pivot shift.
Methods:
Our retrospective study included 74 non-professional athletic patients participating in pivoting sports with at least grade II pivot shift who have had primary anatomic single-bundle reconstruction with hamstrings tendon graft for isolated acute ACL injury with minimum follow-up of two years.
Results:
The mean time between injury and surgery was 4 months. At the last follow-up ,5% of our patients still have anterior residual laxity at the Lachman Test and 8% still have positive pivot shift (4 patients Grade I and 2 patients Grade II).
Mean Tegner Lysholm score was 70.6 ± 5.2 before the surgery and 92.3 ± 4.7 after the surgery. The mean IKDC score was 61.2 ± 4.3 before the surgery and 95.3 ± 2.4 after the surgery. 72% of patients have returned to their athletic activity with mean time interval of 10 months. Only shorter time interval between trauma and surgery was statistically associated to a better functional result.
Conclusions:
Isolated anatomic ACL reconstruction was found to be effective in improving outcomes and allows a reliable control of anteroposterior as well as rotatory stability of the knee with satisfying functional results in amateur sportsmen with high pivot shift grade. Furthermore, additional reconstruction with anterolateral ligament maybe not mandatory however reduction of the time interval between trauma and surgery is recommended for a better result.
