Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Feb 14;59(2):366.
doi: 10.3390/medicina59020366.

Outcomes of Combined Anterior Cruciate Ligament and Anterolateral Ligament Reconstruction According to GNRB Arthrometer Measurement

You-Hung Cheng  1   2 , Chih-Hao Chiu  2   3 , Alvin Chao-Yu Chen  2   3 , Yi-Sheng Chan  2   3 , Kuo-Yao Hsu  1   2   3
Affiliations

Outcomes of Combined Anterior Cruciate Ligament and Anterolateral Ligament Reconstruction According to GNRB Arthrometer Measurement

You-Hung Cheng et al. Medicina (Kaunas). .

Abstract

Background and Objectives: To investigate the prognosis of combined anterior cruciate ligament (ACL) and anterolateral ligament (ALL) reconstruction, we used a GNRB (Genourob, Laval, France) arthrometer to measure surgical outcomes. Materials and Methods: This retrospective study reviewed patients who underwent combined ACL and ALL reconstruction and had a minimum follow-up of 2 years. Subjective outcomes, namely the International Knee Documentation Committee (IKDC) evaluation form scale scores and Lysholm scores, were evaluated preoperatively and postoperatively. We used a GNRB arthrometer to test the side-to-side laxity under pressures of 134 and 200 N, and we calculated the differential of the slope of the curves. We also recorded complications. Results: Our study examined 18 patients (mean age: 30.56 ± 8.9 years, range: 19-53) with a mean follow-up of 27.37 ± 3.4 months (range: 24-36). Both Lysholm and IKDC scores were significantly improved following the operation. The GNRB arthrometer measured mean anteroposterior laxity side-to-side as 0.76 ± 0.78 mm and 0.82 ± 0.8 mm under pressures of 134 and 200 N, respectively. The mean side-to-side differential slope under 200 N was 3.52 ± 2.17 μm/N. These values indicated that patients displayed no graft tear or low functional knee instability. All patients had a grade 3 pivot shift preoperatively; only two patients had a grade 1 pivot shift postoperatively, with the rest having a negative pivot shift. Conclusions: Our study revealed that combined ACL and ALL reconstruction has an excellent prognosis. GNRB measurement demonstrated excellent stability, and most patients had no residual pivot shift.

Keywords: ACL; ALL; GNRB arthrometer.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
GNRB (Genourob, Laval, France) arthrometer used in our institute.
Figure 2
Figure 2
Image of combined ACL and ALL reconstruction. (Red arrow: gracilis was used as an autograft for ALL reconstruction. Asterisk: the anatomic femoral tunnel of the ALL.)
Figure 3
Figure 3
One patient with follow-up computed tomography imaging who received surgery using our technique of combined ACL and ALL reconstruction. The side-to-side laxity under 134 N with the GNRB arthrometer was 0.1 mm for this patient. (Asterisk: the anatomic femoral tunnel of ALL located at the lateral epicondyle posteriorly and proximally. Star: the anatomic tibial tunnel of ALL located between the Gerdy’s tubercle and the fibular head.)
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Ibrahim S.A., Shohdy E.M., Marwan Y., Ramadan S.A., Almisfer A.K., Mohammad M.W., Abdulsattar W.S., Khirat S. Anatomic Reconstruction of the Anterior Cruciate Ligament of the Knee With or Without Reconstruction of the Anterolateral Ligament: A Randomized Clinical Trial. Am. J. Sports Med. 2017;45:1558–1566. doi: 10.1177/0363546517691517. - DOI - PubMed
    1. Jacquet C., Pioger C., Seil R., Khakha R., Parratte S., Steltzlen C., Argenson J.N., Pujol N., Ollivier M. Incidence and Risk Factors for Residual High-Grade Pivot Shift After ACL Reconstruction With or Without a Lateral Extra-articular Tenodesis. Orthop. J. Sports Med. 2021;9:23259671211003590. doi: 10.1177/23259671211003590. - DOI - PMC - PubMed
    1. Magnussen R.A., Reinke E.K., Huston L.J., MOON Knee Group. Hewett T.E., Spindler K.P., Amendola A., Andrish J.T., Brophy R.H., Dunn W.R., et al. Effect of High-Grade Preoperative Knee Laxity on 6-Year Anterior Cruciate Ligament Reconstruction Outcomes. Am. J. Sports Med. 2018;46:2865–2872. doi: 10.1177/0363546518793881. - DOI - PMC - PubMed
    1. Claes S., Vereecke E., Maes M., Victor J., Verdonk P., Bellemans J. Anatomy of the anterolateral ligament of the knee. J. Anat. 2013;223:321–328. doi: 10.1111/joa.12087. - DOI - PMC - PubMed
    1. Daggett M., Busch K., Sonnery-Cottet B. Surgical Dissection of the Anterolateral Ligament. Arthrosc. Tech. 2016;5:e185–e188. doi: 10.1016/j.eats.2015.10.019. - DOI - PMC - PubMed

LinkOut - more resources