No difference found in the magnetic resonance imaging signal intensity of the anterior cruciate ligament reconstruction graft between single‐bundle anterior cruciate ligament reconstruction with concomitant anterolateral ligament surgery and double‐bundle anterior cruciate ligament reconstruction

Abstract

<p>Purpose: The purpose is to investigate whether the graft of single‐bundle anterior cruciate ligament reconstruction with concomitant anterolateral ligament surgery (SBACLR‐ALLR) has a healing advantage over that of double‐bundle ACLR (DBACLR). It is hypothesised that there is no difference in the signal‐to‐noise quotient (SNQ) of the ACLR graft between SBACLR‐ALLR and DBACLR.</p><p>Methods: A retrospective case‐control study was conducted from 2010 to 2019, comparing patients who received SBACLR‐ALLR and DBACLR. The primary outcome was the SNQ of the ACLR graft. The secondary outcomes were the clinical results assessed at 2 years postoperation.</p><p>Results: Forty‐eight SBACLR‐ALLRs and sixty DBACLRs with a mean follow‐up of 53 months were identified. The SNQ of the ACLR graft in SBACLR‐ALLR was comparable to that in DBACLR (6.9 ± 5.3 and 6.4 ± 5.0, respectively; p = 0.31). The graft rupture rates were 2.1% and 5%, respectively (p = 0.43). There was no statistically significant difference in the rate of return to previous sport at 2 years postoperation (SBACLR‐ALLR = 79%, DBACLR = 60%; p = 0.05). The 2‐year International Knee Documentation Committee (IKDC) subjective scores were 89.3 ± 9.2 and 87.6 ± 9.6, respectively (p = 0.21). Eighty‐four per cent of SBACLR‐ALLRs compared to 90% of DBACLRs achieved MCID in IKDC at 2‐year follow‐up (p = 0.33). There was no difference between the two groups in terms of the results of 2‐year Lachman, anterior drawer and pivot shift tests.</p><p>Conclusion: When comparing SBACLR-ALLR and DBACLR, no difference was found in the postoperative SNQ, the 2-year graft rupture rate, the rate of return to sport, the proportion of patients achieving MCID in IKDC at 2-year follow-up, and the 2-year clinical outcomes. These results suggest that adding an ALLR to SBACLR yields outcomes comparable to the more technically demanding DBACLR.</p><p>Level of Evidence: Level III.</p>