Anterolateral tenodesis fixation combined with single-bundle reconstruction for treatment of anterior cruciate ligament injury with high-grade pivot-shift
Objective To investigate the efficacy of modified Lemaire anterolateral tenodesis fixation combined with single-bundle reconstruction on the anterior cruciate ligament(ACL)injury with high-grade pivot-shift.Methods The 79 cases who suffered from ACL injuries with high-grade pivot-shift were divided into combined reconstruction group(40 cases were performed with modified Lemaire anterolateral tenodesis fixation combined with single-bundle re-construction)and the simple reconstruction group(39 cases were adopted with single-bundle reconstruction alone).Lachman test,anterior drawer test in neutral position,and pivot-shift test were used to assess the stability status of knee joints.Results All patients were followed up for 12～24 months.Postoperative Lachman test,anterior drawer test in neutral position of two groups were all negative.At the last follow-up,the results of the pivot-shift test of two groups were improved than the preoperation(P＜0.05),and there was statistical difference between two groups(P＜0.05).The Lysholm score and IKDC score of the two groups had statistical differences,compared with those before surgery(P＜0.01),but there were no statistical differences between the two groups(P＞0.05).In the simple ACL re-construction group,there were 2 cases of graft re-rupture,1 case of contralateral ACL rupture,and 3 caess of meniscal re-tears;and no related complications occurred in the combined reconstruction group.Conclusions ACL injury with high-grade pivot-shift is treated with modified Lemaire anterolateral tenodesis fixation combined with single-bundle ACL reconstruction,which can improve the rotational stability of the knee,reduce the incidence rate of residual pivot-shift instability and the overall re-operation rate,and prevent the intraarticular ACL graft from re-tearing due to high tension during ligamination by distributing stress.
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