NCT06147427

Brief Summary

Anterior cruciate ligament (ACL) tears are associated with concomitant lesions of the anterolateral ligament (ALL), which increase rotatory instability of the knee. If untreated, ALL insufficiency can compromise the results of ACL reconstruction, with higher risk of iterative ACL tear or additional meniscal lesion. Several surgical techniques have been described to reconstruct the ALL. Indications are increasingly frequent and actually, consensus being young patients, patients practising pivot sports, significant rotational laxity on clinical examination with a positive pivot shift test, or in cases of iterative surgery. To date, the two most popular techniques are the Lemaire technique (use of a fascia lata strip) and LAL reconstruction plasty (use of part of an accessory hamstring tendon). The older Lemaire procedure, popularized in the 1980s has proved its efficiency in terms of biomechanics, safety and reproducibility. More recently, following a new, precise anatomical description, anterolateral ligament plasty (ALL) has been developed, which is intended to be more anatomical than Lemaire's technique, but whose clinical superiority has not yet been demonstrated. Both techniques are currently used in our department, with the choice of technique left to the surgeon's discretion. To date, no randomized prospective study has demonstrated the clinical superiority of one technique over the other with a long term follow up. The aim of this study was to compare graft survival of ALL reconstruction versus modified Lemaire LET in combination with ACL reconstruction with a minimum follow up of 2 years. Secondary aim was to compare functional outcomes between both groups.

Trial Health

77
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
248

participants targeted

Target at P75+ for not_applicable

Timeline
32mo left

Started Jan 2024

Longer than P75 for not_applicable

Geographic Reach
1 country

1 active site

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

Study Progress48%
Jan 2024Jan 2029

First Submitted

Initial submission to the registry

November 17, 2023

Completed
10 days until next milestone

First Posted

Study publicly available on registry

November 27, 2023

Completed
2 months until next milestone

Study Start

First participant enrolled

January 16, 2024

Completed
5 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

January 16, 2029

Expected
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

January 16, 2029

Last Updated

January 18, 2024

Status Verified

January 1, 2024

Enrollment Period

5 years

First QC Date

November 17, 2023

Last Update Submit

January 16, 2024

Conditions

Keywords

ACL reconstructionlateral extra-articular tenodesismodified Lemaire tenodesisanterolateral ligament

Outcome Measures

Primary Outcomes (1)

  • Graft rupture rate

    Graft rupture rate (percentage)

    At 24 months post-operative

Secondary Outcomes (2)

  • International Knee Documentation Committee (IKDC) score

    Pre-operatively and at 6, 12 and 24 months post-operatively

  • Complications

    Pre-operatively and at Day 0, Day 21, Day 45, 6 months, 12 months and 24 months post-operatively

Study Arms (2)

ACL reconstruction with hamstrings combined with ALL plasty

EXPERIMENTAL

Patient treated by ACL reconstruction with hamstrings combined anterolateral plasty using the ALL reconstruction technique (Gracilis throught the femur tunnel of the ACL graft and fixed to the tibia by an anchor on its point of isometry on the tibia).

Procedure: ACL reconstruction with hamstrings combined with ALL plasty

ACL reconstruction with hamstrings combined with modified Lemaire's LET

EXPERIMENTAL

Patient treated by ACL reconstruction with hamstrings combined with modified Lemaire's lateral extra-articular tenodesis technique (Fascia lata strip pedicled to the Gerdy and fixed to the femur throught the tunnel of the ACL graft).

Procedure: ACL reconstruction with hamstrings combined with modified Lemaire's LET

Interventions

ACL reconstruction with hamstrings combined anterolateral plasty using the ALL reconstruction technique (Gracilis throught the femur tunnel of the ACL graft and fixed to the tibia by an anchor on its point of isometry on the tibia).

ACL reconstruction with hamstrings combined with ALL plasty

ACL reconstruction with hamstrings combined with modified Lemaire's lateral extra-articular tenodesis technique (Fascia lata strip pedicled to the Gerdy and fixed to the femur throught the tunnel of the ACL graft).

ACL reconstruction with hamstrings combined with modified Lemaire's LET

Eligibility Criteria

Age18 Years - 50 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64)

You may qualify if:

  • Man or woman with age between 18 and 50 years old
  • disabling anterior chronic laxity
  • criteria of anterolateral plasty indication : pivot sport, rotatory instability with positive pivot shift test
  • Patient who signed the informed consent form.

You may not qualify if:

  • any associated procedure (excluding meniscal resection or repair) like osteotomy or meniscus graft
  • pregnant patient
  • Persons deprived of their liberty by judicial or administrative decision, persons under psychiatric care
  • Adults under legal protection

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Service de chirurgie orthopédique et de médecine du sport

Lyon, 69004, France

RECRUITING

MeSH Terms

Conditions

Anterior Cruciate Ligament Injuries

Condition Hierarchy (Ancestors)

Knee InjuriesLeg InjuriesWounds and Injuries

Study Officials

  • Elvire SERVIEN, MD

    Service de chirurgie orthopédique et de médecine du sport

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

November 17, 2023

First Posted

November 27, 2023

Study Start

January 16, 2024

Primary Completion (Estimated)

January 16, 2029

Study Completion (Estimated)

January 16, 2029

Last Updated

January 18, 2024

Record last verified: 2024-01

Data Sharing

IPD Sharing
Will not share

Locations