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. 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.

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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

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