Description
Introduction Rotational instability associated with anterior cruciate ligament (ACL) injuries is a key factor in knee stability. The rate of rotational instability persistence, measured by Pivot Shift, is a frequent cause of stress and is usually associated with surgery failure. Previous anatomical and biomechanical studies have shown the important role of anterolateral structures in rotational stability 2-3. Although anterolateral structures management techniques are indicated in rotational instability, there are few studies regarding this topic.
Purpose: To describe the results in a period of 6 years of the anterolateral augmentation (AAL) with Lemaire tenodesis in ACL reconstruction with a minimum follow-up of 2 years. In terms of functional results and return to play (RTP)
Study Design: Case series; Level of evidence, 4.
Material and Methods: 51 patients, from the Mutualidad de Futbolistas Españoles in a period of 6 years, were evaluated regarding functional performance and RTP. All patients underwent an arthroscopic ACL reconstruction, 25 using Bone - Patellar Tendon - Bone contralateral autograft and 26 Bone – Aquiles tendon for the AAL modified Lemaire technique. The primary outcome was the clinical assessment (Tegner – Lyshol Scale). The secondary outcome was the RTP (ACL-RSI) 7. Patients who did not complete follow-up or who underwent other lower extremity surgeries during this period were excluded.
Result: 50 of the 51 patients showed an excellent result on the Tegner – Lysholm functional scale, one patient presented a score compatible with a good result (89 points). This indicates the excellent functional mid-term results of this surgery. All patients were able to return to their pre-injury daily living and physical activities. No difference was found between both groups. Regarding RTP, the ACL RSI scale showed excellent results, greater than 90%, in most patients. However, when asked if they still played soccer, 18 of them no longer practiced that sport for reasons non-related to the injury.
Conclusions: ACL surgery with modified Lemaire tenodesis is a procedure that restores knee stability in a high percentage of the cases, with excellent functional results. The patients can return to professional and semi-professional soccer, without further objective functional deterioration.
Keywords: Modified Lemaire technique (AAL); Revision ACL; sports injury; soccer
