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VOLUME 10 , ISSUE 1--4 ( January-December, 2024 ) > List of Articles

RESEARCH ARTICLE

The Functional Outcome of Lateral Extra-articular Tenodesis Combined with Anterior Cruciate Ligament Reconstruction in High-risk Patients: A Prospective Observational Study

Papa Rao Bezawada, Kishore Vemula, Sai Pramod Yadlapalli

Keywords : Anterior cruciate ligament graft failure, Arthroscopic anterior cruciate ligament reconstruction, Lateral extra-articular tenodesis, Lateral extra-articular tenodesis + anterior cruciate ligament reconstruction

DOI: 10.5005/jp-journals-10045-00318

License: CC BY-NC 4.0

Published Online: 15-12-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Abstract

Introduction: The estimated failure rate of anterior cruciate ligament reconstruction (ACLR) was 10–25% with retear rates of anterior cruciate ligament (ACL) grafts as high as 18% in young, high-demand populations. Besides the described causes of graft failure, there exists persistent rotational instability after ACLR in high-risk individuals, which might cause graft failure in the future. Lemaire introduced the concept of lateral extra-articular tenodesis (LEAT) as an adjuvant to routine ACLR, which can avoid rotatory stresses on the graft and prevent graft failures. This study aims to evaluate the efficacy of LEAT in preventing the failure of ACL reconstruction in high-risk patients. Materials and methods: Among 30 patients included in this study, 20 (66.6%) were males and 10 (33.3%) were females. The indications for LEAT were young, high-demand sports activity in 6 (20%) cases, hyperextension of the knee >10° in 12 (40%) cases, chronic ACL injuries (>3 months) in 8 (26.66%) cases, and revision ACLR in 4 (13.33%) patients. ACL tear-associated meniscal injuries were seen in 6 (20%) patients, for whom meniscal repair or balancing was done. Results: All the patients returned to their normal preinjury level, with a Tegner Lysholm knee function score of 94.73 ± 3.79 (excellent) at a mean follow-up of 3 ± 0.2 years. Three of them had reinjury to the same limb after 3 years of ACLR + LEAT. Arthroscopy performed in those cases revealed intact ACL grafts and minor meniscal injuries were repaired. Conclusion: LEAT combined with ACLR in high-risk patients can effectively reduce rotatory instability of the knee and avoid graft failures.


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