Lateral extra-articular tenodesis and anterior cruciate ligament reconstruction in young patients: clinical results and return to sport

Abstract

Lateral extra-articular tenodesis (L.E.T.) have been proposed to reduce the tibia’s anterior translation and internal rotation in concomitant to Anterior cruciate ligament (A.C.L.) reconstruction. Recent studies show that the addition of L.E.T. to A.C.L. reconstruction results in a statistically significant reduction in graft failure. The purpose of the present study was to evaluate the clinical outcomes, complications, and rate of return to preinjury sports level in pediatric patients who underwent combined A.C.L. reconstruction with L.E.T. at a minimum 2-year follow-up. The authors retrospectively evaluated 42 pediatric patients at high risk of graft failure who experienced ACLR connected to L.E.T. IKDC and Tegner-Lysholm Knee Scores Scale were used to assess clinical outcomes, and the Tegner Activity Scale to evaluate the return to sport. No graft failure or subsequent surgery related to A.C.L. reconstruction occurred. Furthermore, 88% of patients returned to the sport. Satisfactory clinical results were obtained on a short and medium-term follow-up. These findings help to consider this procedure for active adolescents at a high risk of graft failure to enhance A.C.L. reconstruction.

Approximately half of pediatric or adolescent patients undergoing revision anterior cruciate ligament reconstruction return to the same level of sport or higher: A systematic review

“…Although only used in 26 of 274 knees (9.5%) in this review, concomitant LET procedures are another area of interest in paediatric and adolescent patients undergoing r‐ACLR [47]. The aim of the LET is to reduce anterior translation and internal rotation of the tibia to provide added rotatory stability [48]. Indications for its use include r‐ACLR, high‐grade rotational laxity, and young patients returning to contact pivoting sports [47].…”

“…Indications for its use include r-ACLR, high-grade rotational laxity, and young patients returning to contact pivoting sports [47]. Previous studies have shown that performing concurrent LET with ACLR are associated with reduced re-rupture rates [48]. There is a significant positive linear relationship for the number of LETs performed in recent years in light of the growing body of evidence supporting its use in paediatric and adolescent populations [28,48,49].…”

“…Previous studies have shown that performing concurrent LET with ACLR are associated with reduced re-rupture rates [48]. There is a significant positive linear relationship for the number of LETs performed in recent years in light of the growing body of evidence supporting its use in paediatric and adolescent populations [28,48,49]. Failure of r-ACLR represents a significant issue in paediatric and adolescent patients.…”

Principles for optimizing anterior cruciate ligament reconstruction outcomes in elite athletes: a review of current techniques

“…Given the notable ability to stabilize and even overconstrain the knee, augmented procedures have gained popularity in at-risk patient populations ( 61 , 62 ). These high-risk populations have traditionally included; adolescent patients ( 63 ), revision ACLR ( 64 , 65 ), high grade pivot shift ( 66 ), increased posterior slope ( 67 ), soft tissue ACLR grafts ( 29 ), and knee hyperextension and generalized laxity ( 63 , 68 ). Another population which merits consideration is high-level athletes.…”

Concomitant Injuries Associated With ACL Rupture in Elite Professional Alpine Ski Racers and Soccer Players: A Comparative Study With Propensity Score Matching Analysis

“…8,12,19,23 Moreover, associated injuries, such as meniscal, cartilage, or collateral ligament lesions, may result in an increased risk of early osteoarthritis 2,7,20,26,28,30 and/or graft failure. 3,9,16,24,25,28,29 Because specific injury patterns are associated with certain sports, a better understanding of sport-specific injury mechanisms may lead to more personalized and effective ACL injury prevention programs. 31 To the best of our knowledge, only a few studies have described the effect of sport-specific injury mechanisms on concomitant injuries during ACL rupture.…”