Paper 26: Clinical Outcomes of Combined ACL and Anterolateral Ligament Reconstruction Versus Isolated ACL Reconstruction With Bone-Patellar Tendon-Bone Autograft As The Gold Standard: A Matched-Pair Analysis of 2018 Patients

Objectives: The aims of this study were to compare the clinical outcomes following “gold standard” ACL reconstruction (ACLR) with a Bone-Patellar Tendon-Bone (BPTB) autograft versus ACLR combined an anterolateral ligament (ALLR) using hamstring tendon autografts (HT), in large series propensity matched patients. hypothesis was that ACLR+ALLR would confer better graft rupture rates and lower non-graft related re-operation than isolated BPTB Methods: A retrospective analysis prospectively collected data performed. Patients undergoing HT between January 2003 December 2019 1:1 ratio patients BPTB. At end period any other re-operations or complications occurred index procedure identified by database interrogation, review medical records standardized telephone interview. Kaplan Meier survivorship analyses Cox-proportional hazards models used evaluate survivorship, free significance potentially important risk factors. Results: total 2018 (1009 pairs) included. mean duration follow-up 101.3 months. Analysis demonstrated significantly group when compared at every time point (Fig 1 Table 1). Cox model > 3-fold more likely experience failure (Hazard Ratio (HR) = 3.554 [1.744;7.243], p 0.0005). aged less 20 years particularly high (HR 5.65 [1.834;17.241], 0.0002) further subgroup also conferred 3 fold increased young ACLR+ALLR. Multivariate did not identify significant factors for rupture. Overall, there higher reoperation rate (BPTB 20.5%, 8.9%, < 0.0001). This finding accounted (9.9% vs 3.5%, <0.0001), cyclops syndrome (3.3% 1.5%, secondary meniscectomy (5% 2.9%, p=0.0196) group. Conclusions: who underwent experienced worse overall those autografts. [Table: see text]