Combined anterior cruciate ligament and anterolateral ligament reconstruction leads to better postural control than isolated anterior cruciate ligament reconstruction in the early postoperative phase.

Background

Recent studies suggest that the anterolateral ligament (ALL) contributes to knee rotational stability by acting synergistically with the anterior cruciate ligament (ACL). Although combined ACL and ALL reconstruction has shown benefits in physical examination, subjective physical scales, and return-to-sport or re-rupture rates, few studies have compared postural control. This study aimed to compare postural control between isolated ACL reconstruction and combined ACL and ALL reconstruction.

Methods

Between June 2016 and July 2022, patients who underwent isolated ACL reconstruction (n = 37) or combined ACL and ALL reconstruction (n = 30) were included. Static and dynamic postural control were assessed using the Biodex Balance System and the Y-balance test (YBT) preoperatively and at three and six months postoperatively.

Findings

A total of 67 patients were enrolled, including 49 men and 18 women, with a mean age of 30.2 ± 8.1 years and a mean body mass index of 25.98 ± 3.6 kg/m2. In the YBT, which assesses dynamic postural control as the contralateral limb moves away from the center of gravity, significant main effects of time and group were observed, except in the anterior direction. The YBT-posteromedial (p = 0.009) and YBT-posterolateral (p = 0.049) directions, which reflect knee rotational stability, was significantly better in the combined ACL and ALL reconstruction group than in the isolated ACL reconstruction group.

Interpretation

At three months postoperatively, combined ACL and ALL reconstruction showed better dynamic postural control than isolated ACL reconstruction, particularly during tasks requiring multidirectional postural adjustments.