Volume 29, Issue 155, January 2025

The importance of Anterolateral Ligament Repair in anterior cruciate ligament reconstruction – a review of the literature

Piotr Paluch¹, Karol Leśniewski¹, Kamil Gibczyński², Jakub Pudźwa¹, Martyna Orzechowska¹, Aleksandra Roztoczyńska¹, Aleksandra Jeńć-Magoń¹, Michał Orczyk¹, Karolina Jabłońska¹, Anita Król²

¹College of Medical Sciences, University of Rzeszów Tadeusza Rejtana 16c Ave, 35-310 Rzeszów, Poland
²Fryderyk Chopin University Clinical Hospital in Rzeszów, ul. Fryderyka Szopen 2, 35-055 Rzeszów, Poand

ABSTRACT

Rupture of the anterior cruciate ligament (ACL) is a common knee injury. While ACL reconstruction has historically been designed around isolated repair of the ACL, newer literature suggests that the role of anterolateral ligament (ALL) repair may have critical stability roles and improved surgical results. This study reviews the literature regarding anatomical and biomechanical contributions of the ALL and outcomes associated with concomitant ACL reconstruction and ALL repair. We performed a systematic review of 19 studies between 2013–2024 to provide insight into the role of the ALL and its use in reconstruction and surgery. The results demonstrate the presence of ALL lesions in 90% of ACL injuries, with concomitant ACL reconstruction and ALL repair improving knee rotational stability, decreasing graft failure rates, and improving patient-reported outcomes (PROs). Combined ACL reconstruction and ALL repair resulted in better functional outcomes, mainly presenting the majority of higher grades of rotational instability. In addition, this combined approach has a lower rate of rerupture than isolated ACL reconstruction. However, the addition of ALL reconstruction does not impact return-to-sport time significantly. Further studies are needed to ascertain the optimal surgical procedure and establish clear guidelines for patient selection.

Keywords: Anterolateral ligament, anterior cruciate ligament, surgery, reconstruction, repair, ACL, ALL

Medical Science, 2025, 29, e18ms3496

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DOI: https://doi.org/10.54905/disssi.v29i155.e18ms3496

Published: 27 January 2025