{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T03:38:16Z","timestamp":1789961896726,"version":"4.0.1"},"reference-count":51,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2017,1,5]],"date-time":"2017-01-05T00:00:00Z","timestamp":1483574400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Sports Med"],"published-print":{"date-parts":[[2017,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The effect of an anterolateral ligament (ALL) reconstruction on rotational knee stability and corresponding anterior cruciate ligament (ACL) graft forces using multiple knee loading conditions including the pivot-shift phenomenon has not been determined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>First, to determine the rotational stability and ACL graft forces provided by an anatomic bone\u2013patellar tendon\u2013bone ACL reconstruction in the ACL-deficient knee alone and with an associated ALL\/iliotibial band (ITB) injury. Second, to determine the added rotational stabilizing effect and reduction in ACL graft forces provided by an ALL reconstruction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Controlled laboratory study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A 6 degrees of freedom robotic simulator was used to test 7 fresh-frozen cadaveric specimens during 5 testing conditions: intact, ACL-sectioned, ACL-reconstructed, ALL\/ITB-sectioned, and ALL-reconstructed. Lateral and medial tibiofemoral compartment translations and internal tibial rotations were measured under Lachman test conditions, 5-N\u00b7m internal rotation, and 2 pivot-shift simulations. Statistical equivalence within 2 mm and 2\u00b0 was defined as P &lt; .05.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Single-graft ACL reconstruction restored central tibial translation under Lachman testing and internal rotation under 5-N\u00b7m internal rotation torque ( P &lt; .05). A modest increase in internal rotation under 5-N\u00b7m internal rotation torque occurred after ALL\/ITB sectioning of 5.1\u00b0 (95% CI, 3.6\u00b0 to 6.7\u00b0) and 6.7\u00b0 (95% CI, 4.3\u00b0 to 9.1\u00b0) at 60\u00b0 and 90\u00b0 of flexion, respectively ( P = .99). Lateral compartment translation increases in the pivot-shift tests were &lt;2 mm. ALL reconstruction restored internal rotation within 0.5\u00b0 (95% CI, \u20131.9\u00b0 to 2.9\u00b0) and 0.7\u00b0 (95% CI, \u20132.0\u00b0 to 3.4\u00b0) of the ACL-reconstructed state at 60\u00b0 and 90\u00b0 of flexion, respectively ( P &lt; .05). The ALL procedure reduced ACL graft forces, at most, 75 N in the pivot-shift tests and 81 N in the internal rotation tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Although the ALL reconstruction corrected the small abnormal changes in the internal rotation limit at high flexion angles, the procedure had no effect in limiting tibiofemoral compartment translations in the pivot-shift test and produced only modest decreases in ACL graft forces. Accordingly, the recommendation to perform an ALL reconstruction to correct pivot-shift abnormalities is questioned.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance:<\/jats:title>\n                    <jats:p>The small changes in rotational stability after ALL\/ITB sectioning would not seem to warrant the routine addition of an ALL reconstruction in primary ACL injuries. Clinical exceptions may exist, as in grossly unstable grade 3 pivot-shift knees and revision knees. However, the concern exists of overconstraining normal tibial rotations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0363546516682233","type":"journal-article","created":{"date-parts":[[2017,1,7]],"date-time":"2017-01-07T09:53:42Z","timestamp":1483782822000},"page":"1018-1027","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":114,"title":["Is an Anterolateral Ligament Reconstruction Required in ACL-Reconstructed Knees With Associated Injury to the Anterolateral Structures? A Robotic Analysis of Rotational Knee Stability"],"prefix":"10.1177","volume":"45","author":[{"given":"Frank R.","family":"Noyes","sequence":"first","affiliation":[{"name":"Cincinnati Sports Medicine and Orthopaedic Center\u2013Mercy Health, Cincinnati, Ohio, USA"},{"name":"The Noyes Knee Institute, Cincinnati, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren E.","family":"Huser","sequence":"additional","affiliation":[{"name":"Cincinnati Sports Medicine and Orthopaedic Center\u2013Mercy Health, Cincinnati, Ohio, USA"},{"name":"The Noyes Knee Institute, Cincinnati, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darin","family":"Jurgensmeier","sequence":"additional","affiliation":[{"name":"Cincinnati Sports Medicine and Orthopaedic Center\u2013Mercy Health, Cincinnati, Ohio, USA"},{"name":"The Noyes Knee Institute, Cincinnati, Ohio, 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