Lateral Compartment Contact Pressures Do Not Increase After Lateral Extra-articular Tenodesis and Subsequent Subtotal...

Area of Science:

• Orthopedic surgery
• Biomechanics
• Sports medicine

Background:

• Modified Lemaire lateral extra-articular tenodesis (LET) is used for persistent anterolateral rotatory laxity after anterior cruciate ligament reconstruction (ACLR).
• Concerns exist regarding LET's potential to increase lateral compartment contact pressures.

Purpose of the Study:

• To evaluate tibiofemoral joint contact pressures after isolated ACLR and combined ACLR plus LET.
• To assess the impact of varying lateral meniscal injury states on these pressures.

Main Methods:

• Controlled laboratory study using eight cadaveric knee specimens.
• Pressure sensors measured lateral compartment contact pressures under varying flexion angles and surgical states (ACLR, ACLR + LET, meniscectomy, LETR).

Main Results:

• ACLR with LET did not significantly increase mean or peak lateral compartment pressures compared to isolated ACLR, even with lateral meniscectomy.
• Subtotal meniscectomy and LET release significantly reduced mean contact pressure from baseline.
• Center of pressure shifted anteriorly with meniscectomy and LET release.

Conclusions:

• LET, when combined with ACLR, does not alter lateral compartment contact pressures in knees with intact or deficient lateral menisci.
• Surgeons can be confident in performing LET with ACLR without negatively impacting lateral compartment pressures.