Objective: Anterior cruciate ligament (ACL) reconstruction is a surgical procedure that aims to restore stability to the knee joint, improve its function, and ultimately enable the individual to resume participating in sports activities. The aim of this study was to identify the problems of rerupture and rotatory instability in patients who performed alone ACL surgery, and to examine the correlation between these problems and the Anterolateral ligament (ALL), as well as their impact on functional outcomes.

Materals and Methods: Retrospective analysis was conducted on a group of 48 patients between the years 2021 and 2023.

Results: A total of 9 (69.2%) patients with ACL and ALL injuries demonstrated lateral meniscal damage, while only 3 (8.6%) patients with ACL injury alone showed such damage (p<0.001). The lysholm knee scoring scale was 85.60±5.57 in the group consisting solely of ACL injuries and 63.54±5.04 in the group with both ACL and ALL injuries (p<0.001). The Tegner activity level was 8.14±1.03 in the group of individuals with just ACL injuries and 5.62±1.19 in the group of individuals with both ACL and ALL injuries (p<0.001).

Conclusion: The inadequacy of preoperative examination and lack of diagnosis of the ALL on MRI in all patients resulted in the oversight of this tear, which had a severe impact on the functional outcomes assessed using scales such as Tegner activity levels and Lysholm knee score post-surgery. Additionally, based on our present knowledge, this study is the first to show a high incidence of lateral meniscal tears in association with ALL lesions.