Abstract
Background: Persistent rotational instability and graft failure remain major challenges following anterior cruciate ligament reconstruction (ACLR). The addition of anterolateral ligament reconstruction (ALLR) and suture tape augmentation may enhance graft protection and early stability. This study aimed to assess the short-term clinical outcomes of combined ACLR and ALLR with suture tape augmentation, hypothesizing that this technique would yield favorable results in patients with ACL injury. Methods: Twenty-four patients (16 males, 8 females; mean age 30.8 years) with high grade pivot shift who underwent combined ACLR and ALLR with suture tape augmentation between 2022 and 2024 were retrospectively reviewed. Objective assessments included pivot-shift grading and anterior tibial translation (ATT) using a GNRB arthrometer. Patient-reported outcome measures (PROMs) comprised the International Knee Documentation Committee (IKDC), Marx activity score, and Single Assessment Numeric Evaluation (SANE) scores. Subgroup analysis compared graft diameters < 8 mm versus ≥8 mm. Results: The mean follow-up period was 23.4 months. Significant improvements were observed postoperatively in IKDC (45.9→83.7), Marx (4.4→9.9), SANE (49.2→85.2), and ATT (4.7→1.1 mm) (all p < 0.001). Full range of motion was regained at a mean of 3.2 months. Twenty-one patients presented no pivot shift and three with grade one postoperatively. No significant differences were found between the small (<8 mm) and large (≥8 mm) graft groups. MRI at one year showed intact grafts without adverse reactions. Conclusions: Combined ACL and anterolateral ligament reconstruction with suture tape augmentation demonstrated promising short-term stability and functional recovery without significant complications. This technique may enhance biomechanical reinforcement of both ACL and ALL grafts and represents a viable option for patients with smaller graft diameters.