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Contraindications to Lateral Extra-Articular Tenodesis: A Systematic Review.
Jakub Erdmann1, Jan Czerwiński1, Adam Kwapisz2
1Department of Orthopaedics and Traumatology, Faculty of Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-092 Bydgoszcz, Poland.
Journal of Clinical Medicine
|May 4, 2026
Summary
This study systematically reviewed contraindications for lateral extra-articular tenodesis (LET) during anterior cruciate ligament reconstruction (ACLR). Key contraindications identified include articular cartilage damage and concurrent injuries to other knee ligaments alongside the ACL tear.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Biomechanical Engineering
Background:
- Lateral extra-articular tenodesis (LET) is frequently used with anterior cruciate ligament reconstruction (ACLR).
- Definitive contraindications for LET in conjunction with ACLR are not well-established in existing literature.
- A scarcity of research necessitates a systematic review of reported contraindications for LET.
Purpose of the Study:
- To systematically review and consolidate reported contraindications for lateral extra-articular tenodesis (LET).
- To clarify contraindications for LET when performed concurrently with anterior cruciate ligament reconstruction (ACLR).
Main Methods:
- Systematic literature search across PubMed, ScienceDirect, Cochrane Central, Web of Science, and Embase databases.
- Inclusion criteria: clinical human studies, English language, levels of evidence I-III.
- Searched keywords included "extra-articular", "tenodesis", and "anterior cruciate ligament".
Main Results:
- Fourteen articles published between 2012 and 2024 were analyzed.
- The majority of studies (n=9) provided Level III evidence; the remainder (n=5) provided Level I evidence.
- Frequently cited contraindications include articular cartilage damage and concomitant injuries to other knee ligaments.
Conclusions:
- This study represents the first systematic compilation of contraindications for LET in ACLR.
- Contraindications for LET remain somewhat unclear.
- Articular cartilage damage and concurrent ligamentous knee injuries, in addition to ACL injury, are potential contraindications.
