Repair of antero lateral ligament injuries in acute anterior cruciate ligament tears. an in vivo study using navigation

Background. To evaluate the effect of antero-lateral ligament (ALL) repair on the anterior- tibial translation (ATT) and the axial-tibial rotation (ATR) during the pivot-shift test with a navigation system in patient undergoing acute anterior cruciate ligament (ACL) reconstruction of acute injuries of anterolateral compartment in cases of acute ACL tears. Methods. Ten consecutive patients operated for an acute ACL reconstruction were enrolled in this prospective study. The pivot-shift test was repeated after all three steps of the procedure with navigation system: preoperatively, after repair of the ALL and after ACL reconstruction. This system provided a real-time calculation of ATT and ATR during the pivot shift test. Results. The mean ATT during the dynamic pivot-shift test was 15mm +/- 3mm before ACL reconstruction and ALL repair, 11mm +/- 2mm after ALL repair and 6mm +/- 3mm after ALL repair and ACL reconstruction. The mean ATR during the dynamic pivot-shift test was 22 degrees +/- 12 degrees before ACL reconstruction and ALL repair, 16 degrees +/- 3 degrees after ALL repair and 10 degrees +/- 4 degrees after ALL repair and ACL reconstruction. Conclusion. The repair of the antero-lateral compartment had a statistically significant effect on ATR, with no effect on ATT. The addition of the ACL reconstruction produced a significant effect on ATT, but no effect on ATR.