Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Orthopedic Surgery

Background: Rotational instability of the knee remains an issue after anterior cruciate ligament (ACL) reconstruction.Augmented ACL reconstruction with artificial ligament has been reported. Ligament advanced reinforcement system (LARSTM) artificial ligament may offer an alternative especially in case of undersized hamstring tendons.The anterolateral ligament (ALL) was recently found to be present in 97% of human cadaveric knees and it was found that it is important to control internal tibial rotation and prevent pivot shift. Hypothesis/Purpose: The purpose was to evaluate the subjective and objective outcomes of combined reconstruction of augmented anterior cruciate ligament with artificial ligament and anterolateral ligament of the knee.The hypothesis was that favorable outcomes can be achieved with this surgical procedure compared with isolated anatomic reconstruction of the ACL.Methods:Thirty patients with a unilateral ACL injury and high grade pivot shift were assigned to undergocombined ACL and ALL reconstruction. Preoperative and postoperativeevaluations of the patients were conducted by obtaining history details, recording physical examination findings and measuring kneelaxity using validated outcome scores for the knee.Results: At the end of follow-up for 1 year, 30 patients were available for analysis. Final IKDC score at the end of follow up in comparison to pre-operative score shows a statistically significant improvement in the total subjective and objective IKDC score among the study group. No serious complications were found among the study groupfferent demographic features

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