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Updated: Jun 25, 2025

Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach

Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach

Published on: January 24, 2018

Lateral Extra-Articular Tenodesis and Anterolateral Procedures.

Bertrand Sonnery-Cottet¹, Alessandro Carrozzo²

¹Orthopaedic Surgery, Centre Orthopédique Santy, FIFA Medical Centre of Excellence, Groupe Ramsay-Générale de Santé, Hôpital Privé Jean Mermoz, Lyon, France.

Clinics in Sports Medicine

|May 29, 2024

Summary

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Contralateral ACL Rupture as an Indicator of Intrinsic Risk for Graft Failure After ACL Reconstruction: A Cohort Study of 7718 Patients From the SANTI Study Group.

The American journal of sports medicine·2026

Lateral extra-articular procedures (LEAPs) combined with anterior cruciate ligament (ACL) reconstruction significantly improve knee stability and reduce graft failures, especially in high-risk patients. This approach enhances rotational control and return-to-play rates after ACL surgery.

Area of Science:

Orthopedic Surgery
Sports Medicine
Knee Biomechanics

Background:

Rotational instability is a persistent challenge in anterior cruciate ligament (ACL) reconstruction.
High-risk populations often experience poorer outcomes with standard ACL surgery alone.
Lateral extra-articular procedures (LEAPs) have gained attention for addressing these limitations.

Purpose of the Study:

To evaluate the efficacy of LEAPs when combined with ACL reconstruction.
To assess the impact of LEAPs on knee stability, graft failure, and patient outcomes.
To explore the role of LEAPs as lateral extra-articular tenodesis and anterolateral ligament reconstruction.

Main Methods:

Systematic review and meta-analysis of existing studies on LEAPs and ACL reconstruction.

Keywords:

ACL reconstruction ALL reconstruction Anterior cruciate ligament (ACL)Anterolateral ligament (ALL)Lateral extra-articular procedures Lateral extra-articular tenodesis

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Comparative analysis of outcomes between ACL reconstruction alone versus combined LEAPs and ACL reconstruction.

Evaluation of graft failure rates, rotational stability, and return-to-play metrics.

Main Results:

Combined LEAPs and ACL reconstruction demonstrate reduced graft failure rates.
Significant improvements in overall knee stability and rotational control are observed.
Higher rates of return to pre-injury activity levels are reported in patients undergoing combined procedures.

Conclusions:

LEAPs represent a valuable adjunct to ACL reconstruction, particularly for managing rotational instability.
The combination of LEAPs with ACL reconstruction improves functional outcomes and knee stability.
Further research into LEAPs as tenodesis and anterolateral ligament reconstruction is warranted to optimize ACL surgery outcomes.