Does an extra-articular procedure improve clinical outcome in ACL reconstruction with hamstrings in female football players?

A positive mini-pivot shift test is a common finding after Anterior Cruciate Ligament (ACL) reconstructions, especially in women. The aim of the study was to prospectively evaluate the role of Cocker-Arnold’s extra-articular procedure in reducing the incidence of a residual post-operative rotator knee laxity. Sixty patients affected by an ACL injury with a +2 or +3 pivot-shift test entered this prospective study: they were randomly assigned to group A (control group, hamstrings) or group B (study group, hamstrings plus Cocker-Arnold). Thirty-two patients entered group A and twenty-eight group B. At follow-up, patients underwent clinical evaluation, KT-1000 arthrometer and Lysholm, Tegner, VAS and subjective and objective IKdC form. Introduction Methods At a mean follow-up of 44.6 months, the same expert surgeon reviewed 55 patients (28 group A and 27 group B). The comparison of the results of the evaluation scales used and of the KT-1000 arthrometer did not show statistically significant differences (p>0.05). Lachman test was negative in all the patients of both groups (100%). A residual positive pivot-shift was found in 16 patients (57.1%) of group A and in 5 patients (18.6%) of group B (p<0.05). Results The extra-articular MacIntosh procedure modified by Cocker-Arnold associated with ACL reconstruction might be effective in reducing the rotational instability of the knee.