Purpose
To compare patients undergoing anterior cruciate ligament (ACL) reconstruction with
hamstring grafts 7 mm or less in diameter combined with anterolateral ligament (ALL)
reconstruction versus isolated ACL reconstruction with grafts greater than 7 mm in
diameter.
Methods
We retrospectively evaluated the descriptive data and clinical outcomes of patients
who underwent primary ACL reconstruction with hamstring grafts from June 2013 to January
2020 and had a minimum follow-up period of 2 years. Patients with quadrupled or quintupled
semitendinosus and gracilis autograft 7 mm or less in diameter combined with single-strand
ALL reconstruction (ACL-ALL group) were matched in a 1:2 propensity ratio to patients
who underwent isolated single-bundle ACL reconstruction with hamstring grafts greater
than 7 mm (ACL group).
Results
We identified 30 patients in our database who met the criteria for the ACL-ALL group.
The patients in this group were matched to 60 patients comprising the ACL group. Both
groups were similar regarding all preoperative matched and unmatched variables. The
mean ACL graft diameter was 6.8 ± 0.4 mm in the ACL-ALL group and 8.6 ± 0.6 mm in
the ACL group (P < .001). The ACL-ALL group presented 1 failure (3.3%), and the ACL group presented
3 failures (5%) (P = .717). Postoperative KT-1000 measurements were similar between the groups (2.1
± 1.1 mm vs 1.9 ± 1.2 mm, P = .114), as were postoperative pivot-shift grades (P = .652). Subjective International Knee Documentation Committee scores and Lysholm
scores did not present any differences between the groups (P = .058 and P = .280, respectively).
Conclusions
Patients who undergo combined ACL-ALL reconstruction with an ACL graft diameter of
7 mm or less can achieve similar results to patients who undergo isolated ACL reconstruction
with a graft diameter greater than 7 mm. An associated ALL reconstruction can be performed
to increase knee stability in patients with small-diameter hamstring grafts.
Level of Evidence
Level III, retrospective, comparative therapeutic trial.
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Article info
Publication history
Published online: February 09, 2023
Accepted:
January 24,
2023
Received:
September 11,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
The authors report no conflicts of interest in the authorship and publication of this article. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Identification
Copyright
© 2023 by the Arthroscopy Association of North America
