Lateral Extra-articular Tenodesis Utilizing Modified Ellison Technique With Knotless Anchor Fixation

Lateral extra-articular tenodesis (LET) to augment anterior cruciate ligament reconstruction significantly reduces graft failure rates. Although there are many techniques for lateral extra-articular tenodesis, the modified Ellison technique provides numerous advantages as a distally fixed construct, including dynamic rotational stability, reducing the risk of lateral compartment overload, and eliminating femoral tunnel convergence. The addition of knotless anchor fixation provides a reproducible and efficient method for providing extra-articular stability to anterior cruciate ligament reconstruction without the need to alter postoperative rehabilitation protocols. We describe our preferred lateral extra-articular tenodesis technique utilizing the modified Ellison approach with both an all-suture knotless anchor and a hardbody knotless anchor to provide stable fixation while minimizing additional operative time during anterior cruciate ligament reconstruction.