| Abstract ID |
| 20260111 |
| Category |
| Knee: ACL |
| Preferable Presentation |
| Oral Presentation |
| Title |
| CLINICAL EFFICACY OF COMBINED INTERNAL AND EXTERNAL RECONSTRUCTION TECHNIQUES IN TREATING ANTERIOR CRUCIATE LIGAMENT INJURIES IN ELITE FOOTBALL PLAYERS |
| Author |
|
| Presenter |
| xiaohan Zhang |
| Abstract |
| Background: In recent years, combined ACLR and anterolateral structure reconstruction (ACLR+LET) has emerged as an effective strategy to enhance lateral knee stability, yet its clinical outcomes and rehabilitation efficacy warrant further investigation. Objective: This study aims to compare the clinical outcomes of AI-ACLR and ACLR+LET in elite football players with ACL injuries when combined with preoperative and postoperative rehabilitation. Study design: A randomized controlled clinical trial was conducted, enrolling 53 elite football players who met the inclusion and exclusion criteria for ACL injury. Participants were assigned to either the AI-ACLR or ACLR+LET group based on their surgical procedure. Postoperative follow-up assessments included IKDC, Lysholm, Tegner, Marx, and ACL-RSI scores, pivot shift test (PST), KT-2000 anterior displacement measurement, isokinetic strength testing, passive proprioception testing, hop tests, Y-balance test, lower limb circumference measurement, and graft maturation evaluation. Results: At 6-month and 12-month follow-ups, the ACLR+LET group demonstrated superior knee joint rotational stability, muscle strength recovery, and sports performance compared to the AI-ACLR group (P < 0.05). The positive rate of PST was significantly lower in the ACLR+LET group. At 6 months postoperatively, IKDC, Lysholm, Tegner, and Marx scores were significantly higher in the ACLR+LET group compared to the AI-ACLR group (P < 0.05); however, the differences were not significant at 12 months postoperatively (P > 0.05). Regarding psychological evaluation, the ACLR+LET group exhibited significantly higher ACL-RSI scores at both time points (P < 0.05), indicating greater confidence in returning to sport (RTS) and return to play (RTP). Isokinetic strength testing revealed that at both follow-up points, quadriceps and hamstring muscle strength recovery in the ACLR+LET group was significantly better (P < 0.05), with the limb symmetry index approaching 90%, outperforming the AI-ACLR group (P < 0.05). Similar trends were observed in passive proprioception and lower limb circumference changes (P < 0.05). During rehabilitation, athletes in the ACLR+LET group exhibited faster progress in dynamic stability, agility, and sport-specific training. They achieved earlier completion of hop and Y-balance tests, with significantly better performance compared to the AI-ACLR group. Moreover, both RTS and RTP occurred earlier in the ACLR+LET group. MRI evaluation at 12 months postoperatively showed significantly better graft maturation in the ACLR+LET group than in the AI-ACLR group (P < 0.05). Conclusion: At 6 months postoperatively, the ACLR+LET group demonstrated superior knee joint stability, dynamic balance, rotational control, and graft maturation compared to the AI-ACLR group. This suggests that reinforcing the anterolateral structure facilitates earlier restoration of rotational stability and knee function. At 12 months postoperatively, the advantages of the ACLR+LET group were less pronounced but still evident. The earlier RTS and RTP timelines in the ACLR+LET group suggest a lower risk of reinjury and a higher quality of athletic recovery. |