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Lateral Extra-articular Tenodesis: The Onlay Technique.

Trevor J Wait1, Jensen G Kolaczko1, Ognjen Stevanovic1

  • 1University of Colorado Health, Englewood, Colorado, USA.

Arthroscopy Techniques
|September 1, 2023
PubMed
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This study introduces an improved lateral extra-articular tenodesis (LET) technique for anterior cruciate ligament (ACL) tears. Using a suture anchor offers secure femoral fixation, reducing tunnel convergence and optimizing graft tension for better ACL reconstruction augmentation.

Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Biomechanical Engineering

Background:

  • Anterolateral rotary instability is a significant complication of anterior cruciate ligament (ACL) tears.
  • Current lateral extra-articular tenodesis (LET) techniques often face challenges with femoral fixation, using interference screws or staples.
  • These fixation methods can lead to issues like ACL tunnel-LET drilling convergence and suboptimal graft tensioning.

Purpose of the Study:

  • To present an improved technique for lateral extra-articular tenodesis (LET) graft fixation to the femur.
  • To demonstrate the use of a suture anchor as a superior alternative to traditional staples or interference screws.
  • To highlight the benefits of this novel technique in augmenting ACL reconstruction.

Main Methods:

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  • A modified lateral extra-articular tenodesis (LET) technique was developed utilizing a suture anchor for femoral fixation.
  • The technique was designed to minimize the footprint of fixation on the femur.
  • Emphasis was placed on achieving secure and adjustable graft tensioning.
  • Main Results:

    • The suture anchor technique provides secure fixation of the LET graft onto the femur.
    • This method effectively diminishes the risk of convergence between the ACL tunnel and the LET drilling site.
    • The technique allows for precise adjustment of graft tension, crucial for augmenting ACL reconstruction.

    Conclusions:

    • Suture anchor fixation represents an improved method for securing the LET graft during ACL reconstruction.
    • This technique offers advantages in reducing anatomical conflicts and enhancing graft tension control.
    • The improved LET fixation technique holds promise for better outcomes in managing anterolateral rotary instability associated with ACL tears.