Clinical outcomes and biomechanical analysis of posterolateral bundle augmentation in patients with partial anterior cruciate ligament tears.

Abstract

To examine the clinical and biomechanical results of posterolateral (PL) augmentation to reconstruct damaged PL bundle while preserving the less-damaged anteromedial bundle for partial anterior cruciate ligament (ACL) tears in comparison with double-bundle ACL reconstruction. Sixteen patients who underwent PL augmentation for partial ACL tears (Group P) and 37 patients who underwent double-bundle ACL reconstructions for complete ACL tears were examined (Group D). Anterior tibial translation (ATT) was evaluated using the KT-1000 arthrometer. ATT during the Lachman test and acceleration of posterior tibial translation (APT) during the pivot shift test were evaluated using an electromagnetic measurement system (EMS). Clinical outcomes were evaluated using the Lysholm score. Second-look arthroscopy was performed 1year after surgery. The mean postoperative Lysholm scores were 91.7±12.2 and 94.6±7.2 in Groups P and D, respectively, and there was no statistically significant difference between the two groups. The mean side-to-side difference of ATT on the KT-1000 was significantly improved in both Groups P and D. In the EMS analysis, the mean side-to-side difference of ATT and the mean APT were significantly improved in both Groups P and D. There was no significant difference in the second-look evaluation between the two groups. The clinical and biomechanical outcomes of PL augmentation were satisfactorily comparable to those of double-bundle ACL reconstruction. PL augmentation could be a useful treatment option for patients with partial ACL tears. IV.