Related Experiment Video
Updated: Feb 15, 2026

Author Spotlight: Implementing the Enhanced Recovery After Surgery Concept in Rehabilitation Following Anterior Cruciate Ligament Reconstruction
Published on: March 1, 2024
The Augmentation of Revision Anterior Cruciate Ligament Reconstruction With Modified Iliotibial Band Tenodesis to
Mark D Porter1, Bruce Shadbolt2, Samantha Pomroy1
1Canberra Orthopaedics and Sports Medicine, Calvary Clinic, Bruce, Australia.
Background:
Iliotibial band (ITB) tenodesis improves stability and functional outcomes when added to anterior cruciate ligament (ACL) reconstruction. Its precise indications are unknown. Persistence of the pivot shift after revision ACL reconstruction may be one indication.
Hypothesis:
The addition of ITB tenodesis for a persistent pivot shift after revision ACL reconstruction will improve stability and activity levels.
Study Design:
Cohort study; Level of evidence, 2.
Methods:
Adults with recurrent ACL ruptures underwent revision ACL reconstruction, followed by a pivot-shift test before the surgery ended. If the pivot shift was grade 0 or 1, no further surgery was performed (group 1). If it was grade 2 or 3, ITB tenodesis was performed (group 2). The pivot-shift test was performed, graded, and measured using computer navigation before revision ACL reconstruction and after revision ACL reconstruction with and without ITB tenodesis. Tegner activity scores were obtained 2 years after surgery. Groups were compared with regard to anterior translation and internal rotation during the pivot shift as well as Tegner activity scores ( P < .05).
Results:
There were 20 patients in group 1 and 18 in group 2. The mean anterior translation improved in group 1, from 17.7 ± 3.5 mm to 6.6 ± 1.9 mm, and group 2, from 18.5 ± 3.3 mm to 6.1 ± 1.2 mm, after revision ACL reconstruction ( P < .001), with no difference between the groups ( P = .15). After ITB tenodesis, the reduction in anterior translation in group 2 (5.3 ± 1.5 mm) became greater than that in group 1 (6.6 ± 1.9 mm) ( P = .03). In both groups after revision ACL reconstruction, there was a reduction in internal rotation (group 1: 24.2° ± 4.0° to 10.3° ± 1.1°; group 2: 25.4° ± 3.7° to 14.6° ± 2.8°; P < .001), but this change was less in group 2 ( P = .02). After ITB tenodesis, internal rotation in group 2 (8.3° ± 2.6°) became less than that in group 1 (10.3° ± 1.1°) ( P = .02). The mean Tegner activity scores in group 1 were 8.1 ± 1.1 before surgery and 7.4 ± 0.9 after surgery, while in group 2 they were 7.0 ± 1.3 and 7.2 ± 0.4, respectively, and not significantly different ( P = .29).
Conclusion:
ITB tenodesis improved laxity, although it did not affect activity levels, when there was a persistent pivot shift after revision ACL reconstruction.
Clinical Relevance:
An indication to perform ITB tenodesis is the persistence of a grade ≥2 pivot shift after revision ACL reconstruction.
More Related Videos
10:32Athymic Rat Model for Evaluation of Engineered Anterior Cruciate Ligament Grafts
Published on: March 26, 2015
06:28Anterior Cruciate Ligament Transection and Synovial Fluid Lavage in a Rodent Model to Study Joint Inflammation and Posttraumatic Osteoarthritis
Published on: September 2, 2025
Related Concept Videos
Band Theory
The energy difference between these bands is known as the band gap.
Conductor, Semiconductor,...
Pivot Bearings
A pivot bearing is a specialized type of bearing designed to support axial loads on a rotating shaft. The bearing surface, or the pivot, is positioned at the end of a shaft to support the axial thrust. The pivot may...
Distance Corrections
Power Factor Correction
Energy Bands in Solids
Band Formation:
When atoms are brought close together, as in a solid, these discrete energy levels begin to split due to the overlap of electron orbitals from adjacent atoms. This split occurs because of the Pauli exclusion principle, which states...
Muscles of the Anterior Neck