Mid-Term Results of Simultaneous Reconstruction of Anterior Cruciate and Anterolateral Ligaments in Athletes
Relevance. Today, there exist a large number of methods for arthroscopic reconstruction of the anterior cruciate ligament, however, the return to the competitive level among athletes remains quite low. It is believed that the functional state depends on the restoration of the rotational and anteroposterior stability of the knee. Such data facilitate the search of techniques for additional stabilization of the knee, one of which is the reconstruction of the anterolateral ligament of the knee. The goal of the study was to assess the medium-term results of combined one-stage arthroscopic reconstruction of the anterior cruciate and anterolateral ligaments of the knee in athletes and the probability of their return to the competitive level. Material and Methods. In the period from 2014 to 2015, 50 patients underwent surgery. They were divided into 2 groups. Group 1 (main) consisted of 20 patients, including 10 professional athletes, who underwent the arthroscopic reconstruction of the anterior cruciate ligament, supplemented by reconstruction of the anterolateral ligament. Group 2 (control) included 30 patients (of which 10 were the professional athletes) who underwent the arthroscopic reconstruction only of the anterior cruciate ligament. Results. Group 1. 2 years after surgical treatment, 100% of patients were able to return to the preoperative competitive levels of activity. The average Tegner Lysholm score before the operation was 72.60 +/- 6.45 points, after the operation - 97.40 +/- 1.18 points. The average value on the IKDC scale before surgery was 63.1 +/- 4.8%, after surgery - 96.3 +/- 1.8%. Group 2. Of 30 patients, 2 years after surgery, 20 patients returned to the preoperative and competitive levels (66.7%). Of the professional athletes, 5 out of 10 patients (50%) returned to the competitive level, among amateur athletes - 15 out of 20 patients (75%). The average Tegner Lysholm score before surgery was 69.6 +/- 3.5 points, after - 92.1 +/- 3.9 points. The average value on the IKDC scale before surgery was 73.4 +/- 3.2%, after - 90.3 +/- 3.7%. Conclusion. Medium-term results of the study showed that the one-stage restoration of the anterior cruciate and anterolateral ligaments, compared with arthroscopic reconstruction of only the anterior cruciate ligament, increased the probability that the patients with high functional requirements and professional athletes would return to sports.