Lateral Extra-Articular Tenodesis as an Adjunct to ACL Reconstruction

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomechanical Engineering

Background:

• Lateral extra-articular tenodesis (LET) is a supplementary surgical technique to anterior cruciate ligament reconstruction (ACLR).
• LET aims to improve internal rotational stability and reduce pivot shift, thereby decreasing ACLR failure risk.

Purpose of the Study:

• To evaluate the efficacy of LET as an adjunct to ACLR.
• To identify patient populations and indications for LET, including young athletes and those with specific knee laxity or previous graft failure.

Main Methods:

• The study describes the surgical technique for LET, involving iliotibial band graft harvesting and fixation using a knotless suture anchor.
• Patient selection criteria and surgical sequencing relative to ACLR are discussed.

Main Results:

• The STABILITY trial showed a significant reduction in clinical failure (40% to 25%) and graft rupture (11% to 4%) at 2 years with the addition of LET to ACLR.
• Meta-analysis of 6 studies confirmed reduced graft failure and anterolateral rotatory instability in patients undergoing ACLR with LET.

Conclusions:

• LET is an effective technique for reducing ACLR failure and improving anterolateral rotatory stability.
• The described knotless suture anchor technique provides a reliable method for LET augmentation.