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Article Abstract
In the past decade, increasing evidence supports knee lateral extra-articular tenodesis or anterolateral ligament reconstruction for anterolateral rotational instability in patients requiring anterior cruciate ligament (ACL) reconstruction. Extra-articular augmentation reduces the risk of ACL graft failure, particularly in high-risk populations. Recent research shows a 3-fold lower risk of failure and a lower rate of secondary meniscectomy. Indications include revision ACL reconstruction, pivoting sports participation, high-grade pivot shift, hyperlaxity or knee hyperextension, anterolateral complex injury on imaging evaluation, chronic ACL tear, meniscus repair, increased anterior translation (>7 mm), and posterior tibial slope >12°. We perform extra-articular procedures for every patient at high risk for rerupture, which currently accounts for more than 90% of our primary ACL reconstruction cases. Lateral extra-articular procedures may also be a viable option for treating patients who have undergone isolated ACL reconstruction and have symptomatic minor instabilities and an intact ACL graft.
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| http://dx.doi.org/10.1016/j.arthro.2025.04.018 | DOI Listing |
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