Purpose
To compare the initial rate of anterolateral ligament (ALL) injury at the time of
anterior cruciate ligament (ACL) rupture in patients who subsequently experienced
ACL reconstruction graft failure versus patients who did not experience subsequent
ACL reconstruction graft failure.
Methods
Our institution's electronic medical record database was queried for patients who
underwent primary ACL reconstruction with subsequent ACL graft rupture. Exclusion
criteria included unavailable MRI scan, chronic ACL injury, multi-ligamentous injury,
previous ACL reconstruction, and age younger than 13 or older than 50 years. Each
patient was paired with an age-, gender-, and graft-matched control who underwent
ACL reconstruction without subsequent graft rupture. Each patient was diagnosed with
an intact, partially injured, or fully ruptured ALL on initial MRI. The location of
ALL injury was also noted. The incidence and location of ALL rupture were compared
using χ2 analysis.
Results
1,967 patients underwent primary ACL reconstruction. 128 patients experienced ACL
graft rupture, and 55 patients (43%) had MRI scans available for review. 39 of these
patients fulfilled inclusion criteria and were matched with a control patient. In
the revision group, the ALL was diagnosed as intact, partially torn, and completely
torn in 17, 14, and 8 patients, respectively, compared to 18, 13, and 8 patients,
respectively in the control group. No difference was found in frequency of ALL rupture
(Pearson χ2 = 0.066; P = .968) or rupture location (Pearson χ2 = 4.00, P = 0.135).
Conclusions
The incidence of initial ALL injury as documented on MRI was not different in patients
who experienced subsequent ACL graft rupture compared with patients who did not experience
ACL graft rupture after primary ACL reconstruction. The ALL was more commonly injured
on the tibial side in patients with ACL graft rupture and femoral-sided lesions were
more common in control patients.
Level of Evidence
Level III, prognostic case-control study.
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Article Info
Publication History
Published online: October 06, 2018
Accepted:
June 2,
2018
Received:
November 12,
2017
Footnotes
The authors report the following potential conflicts of interest or sources of funding: D.R.D. is an AOSSM board member and a consultant for DePuy Mitek, reports grants from Simmer Biomet and Aesculap, and reports royalties from Smith & Nephew. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Identification
Copyright
© 2018 Published by Elsevier on behalf of the Arthroscopy Association of North America
