Summary
There is a correlation between femoral malpositioning of ALL graft and ACL graft re-rupture
Abstract
Introduction
The femoral attachment of anterolateral ligament (ALL) reported by cadaveric studies is posterior and proximal to lateral femoral epicondyle (LFE). The aim was to estimate the correct femoral positioning of the ALL graft performing a percutaneous technique and then to evaluate the correlation between this positioning and the graft rupture rate, as well as clinical and functional outcomes.
Material And Methods
211 patients undergoing combined anterior cruciate ligament (ACL) and ALL reconstruction were included. Radiological measurements, Knee Injury and Osteoarthritis Outcome Score (KOOS), International Knee Documentation Committee (IKDC), and graft failure rate were collected at 24 months from surgery.
Results
A good anatomical positioning of femoral attachment of the ALL was reached in 79,1% (n=167). The mean proximal and posterior distances relative to LFE were 3,6 ± 2,8 and 5,2 ± 3,8 mm. The rate of outliers was 20,86% (n=44). The mean KOOS and IKDC were respectively 84 ± 10.9 and 80.1 ± 11.3. No statistically significant difference in KOOS and IKDC was observed between the group of patients with anatomical positioning and the group of outliers (p=0.1). The rate of ACL re-rupture of all patients was 3,79% (n=8). Of these, 87,5% (n=7) were outliers. The correlation between ALL femoral malpositioning and ACL re-rupture was statistically significant (p<0.001).
Conclusion
Independent ALLR performing a percutaneous technique enabled a correct positioning of the ALL graft in the most cases, with excellent clinical results and a low ACL re-rupture rate at a minimum follow-up of two years. There was a statistically significant correlation between femoral malpositioning of ALL graft and ACL graft re-rupture.