ABSTRACT:

OBJECTIVE Lateral extra-articular tenodesis (LET) has been proposed to resolve rotatory instability following anterior cruciate ligament reconstruction (ACLR). The present meta-analysis aimed to compare the clinical outcomes of ACLR and ACLR with LET using the modified Lemaire technique.
MATERIALS AND METHODS We performed a meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) staement. The literature search was performed on the PubMed, EBSCOHost, Scopus, ScienceDirect, and WileyOnline databases. The data extracted from the studies included were the study characteristics, the failure rate (graft or clinical failure) as the primary outcome, and the functional score as the secondary outcome. Comparisons were made between the patients who underwent isolated ACLR (ACLR group) and those submitted to ACLR and LET through the modified Lemaire technique (ACLR + LET group).
RESULTS A total of 5 studies including 797 patients were evaluated. The ACLR + LET group presented a lower risk of failure and lower rate of rerupture than the ACLR group (risk ratio [RR] = 0.44; 95% confidence interval [95%CI]: 0.26 to 0.75; I2 = 9%; p = 0.003). The ACLR + LET group presented higher scores on the Knee Injury and Osteoarthritis Outcome Score (KOOS) regarding the following outcomes: pain, activities of daily living (ADL), sports, and quality of life (QOL), with mean differences of 0.20 (95%CI: 0.10 to 0.30; I2 = 0%; p < 0.0001), -0.20 (95%CI: -0.26 to -0.13; I2 = 0%; p <0.00001), 0.20 (95%CI: 0.02 to 0.38; I2 = 0%; p = 0.03), and 0.50 (95%CI: 0.29 to 0.71; I2 = 0%; p < 0.00001) respectively when compared with the ACLR group.
CONCLUSION Adding LET through the modified Lemaire technique to ACLR may improve knee stability because of the lower rate of graft rerupture and the superiority in terms of clinical outcomes.Level of Evidence I.

Keywords: anterior cruciate ligament reconstruction; joint instability; knee joint; tenodesis; treatment outcome.

RESUMO:

OBJETIVO A tenodese extra-articular lateral (TEL) foi proposta para resolver a instabilidade rotatória após a reconstrução do ligamento cruzado anterior (RLCA). Esta metanálise teve como objetivo comparar os resultados clínicos da RLCA e da RLCA com TEL por meio da técnica de Lemaire modificada.
MATERIAIS E MÉTODOS Esta metanálise foi feita de acordo com a declaração dos Itens Principais para Relatar Revisões Sistemáticas e Metanálises (Preferred Reporting Items for Systematic Reviews and Meta-Analysis, PRISMA, em inglês). A pesquisa bibliográfica foi realizada nos bancos de dados PubMed, EBSCOHost, Scopus, ScienceDirect e WileyOnline. Dos estudos incluídos foram extraídas informações sobre as características do estudo, a taxa de falha (falha clínica ou do enxerto) como resultado primário, e o escore funcional como resultado secundário. Foram feitas comparações entre os pacientes submetidos apenas à RLCA (grupo RLCA) e à RLCA e TEL pela técnica de Lemaire modificada (grupo RLCA + TEL).
RESULTADOS Foram avaliados 5 estudos que incluíam 797 pacientes. O grupo RLCA + TEL apresentou um risco menor de falha e menor taxa de rerruptura do que o grupo RLCA (razão de risco [RR] = 0,44; intervalo de confiança de 95% [IC95%] 0,26 a 0,75; I2 = 9%; p = 0,003). O grupo RLCA + TEL obteve pontuações maiores no Escore de Desfechos de Osteoartrite e Lesão no Joelho (Knee Injury and Osteoarthritis Outcome Score, KOOS, em inglês) com relação aos seguintes desfechos: dor, atividades cotidianas (AC), esportes, e qualidade de vida (QV), com diferenças médias de 0,20 (IC95%: 0,10 a 0,30; I2 = 0%; p < 0,0001), -0.20 (IC95%: -0,26 a-0,13; I2 = 0%; p < 0,00001), 0,20 (IC95%: 0,02 a 0,38; I2 = 0%; p = 0,03) e 0,50 (IC95%: 0,29 a 0,71; I2 = 0%; p < 0,00001), respectivamente, quando comparado com o grupo RLCA.
CONCLUSÃO O acréscimo de TEL pela técnica de Lemaire modificada à RLCA pode melhorar a estabilidade do joelho devido à menor taxa de rerruptura do enxerto e à superioridade dos resultados clínicos.Nível de evidência I.

Palavras-chave: reconstrução do ligamento cruzado anterior; instabilidade articular; articulação do joelho; tenodese; resultado do tratamento.

FIGURES

Citation: Damayanthi ED, Kholinne E, Singjie LC, Sakti M, Anesstesia IJ. Combined Anterior Cruciate Ligament Reconstruction (ACLR) and Lateral Extraarticular Tenodesis through the Modified Lemaire Technique versus Isolated ACLR: A Meta-analysis of Clinical Outcomes. 59(2):e180. doi:10.1055/s-0044-1785492
Financial Support: The authors declare that they did not receive funding from agencies in the public, private, or not-for-profit sectors for the conduction of the present study.

Conflict of Interests: The authors have no conflict of interests to declare.

Work developed at the Department of Orthopedic Surgery, St. Carolus Hospital, Faculty of Medicine, Trisakti University, Jakarta, Indonesia.

Received: March 27 2023; Accepted: August 25 2023
 

INTRODUCTION

Anterior cruciate ligament (ACL) ruptures are among the most commonly studied injuries in orthopedic research, and their incidence is estimated to range from 30 to 78 cases per 100 thousand people a year.1 After ACL reconstruction (ACLR), 61% to 89% of athletes successfully return to sports, typically between 8 and 18 months after the reconstruction, depending on the level of play.1 Under certain conditions, a rerupture can occur, which may be devastating. The reported rate of ACL rerupture ranges from 1% to 11%, and they may be caused by traumatic reinjuries, biological graft failure, or technical surgical errors.1,2

The management of ACL injury in patients at a higher risk of rerupture remains controversial. It has been shown that the risk factors for graft rupture include younger patients (< 20 years of age), those with generalized hypermobility and physiologic knee hyperextension, and those returning to high-risk (pivoting) sports.3 Further, Saita et al.4 showed that knee hyperextension and a small lateral condyle are associated with greater antero-lateral rotatory instability, which is difficult to manage in patients who continue to show a positive pivot shift after isolated ACLR. In the literature,3,5,6,7 the MacIntosh, Lemaire, and anterolateral ligament (ALL) reconstruction techniques have been shown to resolve anterolateral rotatory instability. Reconstruction of the ALL was found to reduce the graft failure rate in large series of patients at 2 years of follow-up.8 The modified Lemaire technique has been shown to present a low complication rate and to cause a reduction in pivot-shift instability.6

One of the reasons to favor lateral extra-articular tenodesis (LET) rather than ALL reconstruction is because of the evidence indicating that ALL reconstruction could overconstrain the lateral joint while not being as mechanically advantageous in resisting rotation.9,10 The aim of LET is to decrease the rerupture rate by providing more stability to the knee joint. A cohort study by Cavaignac et al.11 reported that ACLR with LET showed better graft maturity on magnetic resianace imaging (MRI) scans after one year of the procedures. Mayr et al.12 focused on the modified Lemaire technique, which has recently been used to perform LET, and they showed that it may decrease the strain on the graft as well as residual rotational laxity, thus improving the clinical outcomes. There-fore, we conducted a meta-analysis to determine the impact of ACLR and LET through the modified Lemaire technique compared with ACLR on patients with ACL rupture in terms of the rerupture rate and clinical outcome. The objective of the present study was to determine the surgical outcome of ACLR with modified Lemaire LET for ACL rupture, which is be represented by the rerupture rate and clinical outcomes.

 

MATERIALS AND METHODS

Search Strategy

We conducted a systematic review and meta-analysis based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement.13 The study protocol was registered in the Open Science Framework. The literature search was conducted in June 2022 on several databases, including PubMed, EBSCOHost, Scopus, ScienceDirect, and WileyOnline, focusing on the Population, Intervention, Control, and Outcome (PICO) strategy. The population consisted of patients with ACL tears, the intervention was ACLR and LET through the modified Lemaire technique, and isolated ACLR was the comparator. The outcomes assessed were the rerupture rate as the primary outcome, and the patient-reported outcome measures (PROMs) and functional scores as secondary outcomes.

Study Selection

The exclusion criteria were animal studies, revision cases of ACLR, concomitant posterior cruciate ligament (PCL) or meniscus reconstruction, underlying congenital condition or neoplasm, ACLR with ALL reconstruction, patients treated with pharmacologic treatment, nutrition treatment, physical therapy or isolated rehabilitation, and ACLR with LET not through the modified Lemaire technique. Only studies published in English within the last twenty years were included.

Quality Appraisal and Risk of Bias Assessment

Two authors (ED and LC) performed the identification and selectionof studies, as well as data extraction. The quality assessment was performed by two other authors (MS, IJA). Differences in opinion between the two reviewers were resolved by reassessment and discussion with another author (EK). The selected studies were assessed using the Joanna Briggs Institute’s tools for critical appraisal.14

Data Extraction and Analysis

The data extracted from the included studies were characteristics such as author and year of publication, location, design, sample characteristics (age, gender, injury type), failure (graft or clinical failure), and outcome (Knee Injury and Osteoarthritis Outcome Score [KOOS], functional outcome, and clinical outcome). The studies were assessed qualitatively and quantitatively using the Review Manager (RevMan, The Cochrane Collaboration, London, United Kingdom) software, version 5.4. The random-effects model was used to calculate pooled ratio from each study based on the heterogeneity. The Cochrane I-squared (I2) test was conducted to determine the heterogeneity. The results of the studies are presented in a forest plot with the pooled risk ratio (RR).

 

RESULTS

In the initial screening, 163 studies were retrieved (►Fig. 1). Among the ten remaining studies, two did not have a primary outcome (success rate),12,15 one included skeletally-immature patients,16 and one did not have adequate control.17 In the end, we found five studies18,19,20,21,22 eligible for qualitative and quantitative analysis after the searching strategies were applied. Two studies were randomized controlled trials (RCTs)18,19 and three were cohort studies.20,21,22

Fig. 1. PRISMA flowchart.

The appraisal of the studies using the Joanna Briggs Institute’s critical appraisal tools showed that all of them were considered good in terms of methodological quality and lack of the possibility of bias in their design, conduct and analysis (►Table 1). ►Table 2 shows the characteristics of the studies. including the intraoperative details. ►Table 3 shows the outcome parameters measured for each study.

Table 1. Critical appraisal the results of the selected studies
Study Items on the Joanna -Briggs Institute's tools for critical appraisal
1 2 3 4 5 6 7 8 9 10 11 12 13
Castoldi et al.18 (2020) Y Y Y NA NA Y Y Y Y Y Y Y Y
Getgood et al.19 (2020) Y Y Y NA NA Y Y Y Y Y Y Y Y
Eggeling et al.21 (2022) Y Y Y NA NA Y Y Y Y Y Y Y Y
Rowan et al.22 (2019) Y Y Y Y Y Y Y Y Y Y Y
Dejour et al.20 (2013) Y Y Y NA NA Y Y Y Y Y Y

Abbreviations: NA, not available; Y, yes.

Table 1. Critical appraisal the results of the selected studies
Table 2. Characteristics of the included studies
Study Type Level of evidence No. of patients Mean Age (years) Mean/ minimum follow-up (years) Mean Time from Injury to Surgery (months) Graft Tensioning method LET fixation ACL fixation
LET Non-LET LET Non-LET LET Non-LET ACL LET
M F T M F T
Castoldi et al.18 (2020) RCT 2 47 13 60 43 18 61 26.2 25.9 19.4 NR NR BPTB G 30 degrees of knee flexion Suture fixation Femoral/tibial side: absorbable interference screw
Getgood et al.19 (2020) RCT 2 151 155 306 151 161 312 19.1 18.8 2 9.3 8.1 H ITB 60-70 degrees of knee flexion Barbed Richards fixation staple Femoral side: femoral cortical suspensory fixation; tibial side: tibial interference screw
Eggeling et al.21 (2022) C 3 13 10 23 35 20 55 33.3 31.9 2.4 NR NR BPTB, H, Q ITB 45 degrees of knee flexion Suture fixation Femoral/tibial sides: interference screw
Rowan et al.22 (2019) C 3 34 21 55 120 98 218 26 33 2 NR NR ST + G ITB 30 degrees of knee flexion Fixation staple with spike Femoral/tibial sides: absorbable interference screw
Dejour et al.20 (2012) C 3 20 5 25 17 8 25 21.4 27.5 2 10.78 12.96 BPTB G Full extension Suture fixation Femoral/tibial sides: interference screw

Abbreviations: ACL, anterior cruciate ligament; BPTB, bone-patellar tendon-bone; C, cohort; F, female; G, gracilis; H, hamstring; ITB, iliotibial band; LET, lateral extra-articular tenodesis; M, male; NR, not reported; Q, quadriceps; RCT, randomized controlled trial; ST, semitendinosus; T, total.

Table 2. Characteristics of the included studies
Table 3. Outcomes of the included atudies
Study Failure (%LET vs. %control) Outcome
KOOS pain score KOOS symptom score KOOS ADL score KOOS sports score KOOS QoL score Tegner score International Knee Documentation Committee score Lysholm score Marx score
Castoldi et al.18 (2020) Craft failure: 5/38 (13%) vs. 12/42 (29%) - - - - - - 82.4 ± 11.2 vs. 81.1 ± 14.38 - -
Getgood et al.19 (2020) Clinical failure: 72/291 (25%) vs. 120/298 (40%) (RR: 0.38; 95%CI: 0.21-0.52; p = 0.0001) 92.1 ± 0.6 vs. 91.9 ± 0.6 84.7 ± 0.8 vs. 84.6 ± 0.8 97 ± 0.4 vs. 97.2 ± 0.4 85.3 ± 1.1 vs. 85.1 ± 1.1 63.8 ± 18.9 vs. 58.4 ± 19.7 - 87.3 ± 0.8 vs. 86.8 ± 0.8 - 12.1 ± 5.5 vs. 12.7 ± 4.7
Graft ailure: 11/291 (4%) vs. 34/298 (11%) (RR: 0.67; 95%CI, 0.36-0.83; p = 0.001) - - - -
Eggeling et al.21 (2022) Clinical failure: 3/23 (13%) vs. 6/55 (10.9%) 87.9 ± 14.6 vs. 87.9 ± 14.1 87.6 ± 15.4 vs. 87.3 ± 14.8 95.2 ± 8.2 vs. 93 ± 10 72.6 ± 25.9 vs. 76 ± 22.7 75.4 ± 1.3 vs. 74.9 ± 1.3 5.7 ± 1.3 vs. 5.9 ± 1.5 80.1 ± 14.9 vs. 77.5 ± 16.2 81.9 ± 14.2 vs. 83.8 ± 14.5 -
Rowan et al.22 (2019) Clinical failure: 0/46(0%) vs. 13/125 (10.4%) - - - - - 8.04 ± 1.35 vs. 75.4 ± 1.35 - 98 ± 11.2 vs. 90 ± 16.2 -
Dejour et al.20 (2012) Clinical failure: 0/25 (0%) vs. 2/25 (8%) - - - - - - - - -

Abbreviations: 95%CI, 95% confidence interval; ADL, activities of daily living; KOOS, Knee Injury and Osteoarthritis Outcome Score; LET, lateral extra-articular tenodesis; QoL, quality of life; RR, risk ratio; vs., versus.

Table 3. Outcomes of the included atudies

In the present study, we found that the RR for failure was lower in the ACLR + LET group with the modified Lemaire rechnique than in the ACLR group, with low heterogeneity among the studies (RR = 0.44; 95% confidence interval [95% CI]: 0.26 to 0.75; I2 = 9%; p = 0.003) (►Fig. 2).

Fig. 2. Risk ratio for failure in the group of ACLR + LET through the modified Lemaire technique and the ACLR group.

The meta-analysis showed a superiority of the ACLR + LET group with the modified Lemaire Technique regarding of the following outcomes on the KOOS: pain, activities of daily living (ADL), sports, and quality of life (QoL), with mean differences of 0.20 (95%CI: 0.10 to 0.30; p < 0.0001), -0.20 (95%CI: -0.26 to -0.13; p < 0.00001), 0.20 (95%CI: 0.02 to 0.38; p = 0.03) and 0.50 (95%CI: 0.29 to 0.71; p < 0.00001) respectively. However, there was no significant difference between the groups in the symptom scores on the KOOS, with a mean difference of 0.10 (95%CI: -0.03 to 0.2; p = 0.13). Neither were there were differences between the groups regarding the scores on the Tegner Activity Scale (TAS) and Lysholm Knee Scoring Scale (LKSS), with mean differences of 0.19 (95%CI: -0.49 to 0.87; p = 0.58) and 3.45 (95%CI: -6.22 to 13.22; p = 0.48) respectively. However, there was a significant difference regarding the scores on the International Knee Documentation Committee (IKDC) Subjective Knee Form, with a mean difference of 0.70 (95%CI: 0.57 to 0.83; p < 0.00001). Low heterogeneity was found in the scores on the KOOS and IKDC Subjective Knee Form , but high heterogeneity was found in TAS and LKSS scores. (►Fig. 3).

Fig. 3. Forest Plot of the secondary outcome of the included studies.
 

DISCUSSION

The most important findings of the current research were that, when compared with the ACLR group, the ACLR + LET with modified Lemaire presented a lower failure rate and significant superiority regarding the functional outcome based on the mean differences in pain, ADL, sports, and QoL domains.

When compared with the ACLR group, the ACLR + LET with modified Lemaire group was found to present a lower failure rate (RR = 0.44; I2 = 9%; p = 0.003). The ACLR + LET with modified Lemaire group showed a significant superiority regarding the functional outcome based on the mean differences in the scores on the KOOS domains of pain, ADL, sports, and QoL (p < 0.00001; p < 0.03; p < 0.00001; and p < 0.00001 respectively) and the scores on the IKDC Subjective Knee Form (p < 00001).

Rotational stability was not recovered with isolated ACLR in a certain population.23 Therefore, both intra- and extra-articular procedures were necessary to improve ACL stability, thus improving the ability to perform sports in this population. It is known that LET is one of the extra-articular procedures that preserves knee stability. Na et al.23 compared isolated ACLR to ACLR combined with anterolateral extra-articular procedures, and they noticed that both techniques improved pivot-shift grades and graft failure rates. However, in the ACLR + LET group, there was an increased risk of knee stiffness and adverse events.23 These findings explain the significantly better KOOS and IKDC scores in the group submitted to ACLR + LET with the modified Lemaire technique.

Various LET procedures, namely Lemaire, MacIntosh, and ALL reconstruction, are the choices to manage rotatory instability. However, a in a kinematic study published by Inderhaug et al.10 in 2017, the authors found that ALL reconstruction is underconstrained procedure. Compared with ALL reconstruction, the modified Lemaire technique has been shown to present a low complication rate and to cause a reduction in pivot-shift instability. The modified Lemaire technique also showed good graft survival and PROMs in a high-risk population.1 This may suggest that LET is an effective technique to restore joint stability to a knee with additional features of laxity.2,10

In a meta-analysis, Onggo et al.24 compared ACLR and ACLR + LET through any method, and the inclusion of studies with a minimum of two years of follow-up. They found improved stability (RR = 0.59; 95%CI: 0.39 to 0.88) and improved clinical outcomes in the ACLR + LET group, shown by mean differences in the IKDC and Lysholm scores of 2.31 (95%CI: 0.54 to 4.09) and 2.71 (95%CI 0.68 to 4.75) respectively. In addition, there was less likelihood of graft rerupture in the ACLR + LET group, with an RR of 0.31 (95%CI: 0.17 to 0.58).24 In a single-armed systematic review involving 851 patients who underwent ACLR + LET, Grassi et al.25 showed favorable results in terms of KOOS scores, with 74% of the patients returning to their previous sports activities, as well as complication and failure rates of 8.0% and 3.6% respectively.

The combination of ACLR and LET has also been considered safe for the patients. Feller et al.26 reported that, at the 12-month follow-up, a contact-related graft rupture occurred in one patient, accounting for 4% of the total. Two additional ACL injuries in the opposite knee were observed, making up 9% of the cases, with 1 of them being an ACL graft rupture at 11 months postoperatively and another occurring at 22 months. Furthermore, a separate incident of contralateral ACL graft rupture took place at the 26-month follow-up.26 Concerns were raised about the potential for excessive restriction of the lateral compartment of the knee and the subsequent development of lateral compartment osteoarthritis in relation to LET. However, a meta-analysis by Devitt et al.27 provided strong evidence that the addition of LET reduces the movement of the lateral compartment. Biomechanical studies support these clinical findings, showing that both anatomic ALL reconstruction and LET procedures can overly restrict the lateral compartment. On the contrary, a recent systematic review indicated that adding LET to ACLR does not increase long-term osteoarthritis rates. While there is insufficient evidence to determine whether adding LET to primary ACLR improves various outcomes, there is strong evidence that LET effectively reduces laxity in the lateral compartment, as demonstrated by stress radiography.28,29

In the biomechanics study, there is still a controversy regarding ACLR + LET with the modified Lemaire technique. A laboratory study10 with a fresh frozen cadaver found that this technique might have overconstrained knee kinematics. However, a pilot study by Di Benedetto et al.30 on 16 patients aged 21 to 37 years who underwent ACLR + LET revealed reacquisition of sagittal knee stability and gait dynamics to the preoperative level. These findings are also supported by a meta-analysis by Feng et al.,31 who reported that, in 1,745 patients, ACLR + LET provided reduced pivot-shif,t with an odds ratio of 0.48 (95% CI: 0.31 to 0.74), and better graft failure rate, with an odds ratio of 0.34 (95%CI: 0.20 to 0.55).

As a limitation of the present study, there is still a lack of raw data to make a more comprehensive functional outcome analysis. Therefore, future studies with large samples might be needed to find better evidence regarding the effectiveness of ACLR combined with LET through the modified Lemaire technique.

 

CONCLUSION

The combination of LET through the modified Lemaire technique and ACLR showed a reliable result to minimize the rate of graft rerupture, as well as superiority in terms of clinical outcomes compared with isolated ACLR due to its role in improving knee stability.

 

REFERENCES

1
Gans I, Retzky JS, Jones LC, Tanaka MJ. Epidemiology of Recurrent anterior cruciate ligament injuries in National Collegiate Athletic Association Sports: The injury surveillance program, 2004–2014. Orthop J Sports Med 2018;6(06):2325967118777823
2
Mahmoud A, Torbey S, Honeywill C, Myers P. Lateral Extra-articular tenodesis combined with anterior cruciate ligament reconstruction is effective in knees with additional features of lateral, hyperextension, or increased rotational laxity: A matched cohort study. Arthroscopy 2022;38(01):119–124
3
Nitri M, Rasmussen MT, Williams BT, et al. An in vitro robotic assessment of the anterolateral ligament, Part 2: Anterolateral ligament reconstruction combined with anterior cruciate ligament reconstruction. Am J Sports Med 2016;44(03):593–601
4
Saita Y, Schoenhuber H, Thiébat G, et al. Knee hyperextension and a small lateral condyle are associated with greater quantified antero-lateral rotatory instability in the patients with a complete anterior cruciate ligament (ACL) rupture. Knee Surg Sports Traumatol Arthrosc 2019;27(03):868–874
5
Herbst E, Arilla FV, Guenther D, et al. Lateral extra-articular tenodesis has no effect in knees with isolated anterior cruciate ligament injury. Arthroscopy 2018;34(01):251–260
6
Williams A, Ball S, Stephen J, White N, Jones M, Amis A. The scientific rationale for lateral tenodesis augmentation of intra-articular ACL reconstruction using a modified ’Lemaire’ procedure. Knee Surg Sports Traumatol Arthrosc 2017;25(04): 1339–1344
7
Zaffagnini S, Marcheggiani Muccioli GM, Grassi A, et al. Over-the-top ACL reconstruction plus extra-articular lateral tenodesis with hamstring tendon grafts: Prospective evaluation with 20-year minimum follow-up. Am J Sports Med 2017;45(14):3233–3242
8
Sonnery-Cottet B, Saithna A, Cavalier M, et al. Anterolateral ligament reconstruction is associated with significantly reduced ACL graft rupture rates at a minimum follow-up of 2 years: A prospective comparative study of 502 patients from the SANTI study group. Am J Sports Med 2017;45(07):1547–1557
9
Schon JM, Moatshe G, Brady AW, et al. Anatomic anterolateral ligament reconstruction of the knee leads to overconstraint at any fixation angle. Am J Sports Med 2016;44(10):2546–2556
10
Inderhaug E, Stephen JM, Williams A, Amis AA. Biomechanical comparison of anterolateral procedures combined with anterior cruciate ligament reconstruction. Am J Sports Med 2017;45(02): 347–354
11
Cavaignac E, Mesnier T, Marot V, et al. Effect of lateral extra-articular tenodesis on anterior cruciate ligament graft incorporation. Orthop J Sports Med 2020;8(11):2325967120960097
12
Mayr R, Sigloch M, Coppola C, Hoermann R, Iltchev A, Schmoelz W. Modified Lemaire tenodesis reduces anterior cruciate ligament graft forces during internal tibial torque loading. J Exp Orthop 2022;9(01):45
13
Moher D, Liberati A, Tetzlaff J, Altman DGPRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009;6(07):e1000097
14
Critical Appraisal Tools | JBI. [accessed August 25, 2022]. Available from: https://jbi.global/critical-appraisal-tools
15
Chiba D, Gale T, Nishida K, et al. Lateral extra-articular tenodesis contributes little to change in vivo kinematics after anterior cruciate ligament reconstruction: A randomized controlled trial. Am J Sports Med 2021;49(07):1803-1812
16
Dean RS, DePhillipo NN, McGaver RS, LaPrade RF, Larson CM. Combined anterior cruciate ligament reconstruction and lateral extra-articular tenodesis in skeletally immature patients: Surgical technique. Arthrosc Tech 2020;9(07):e897-e903
17
Declercq J, Schuurmans M, Tack L, Verhelst C, Truijen J. Combined lateral extra-articular tenodesis and anterior cruciate ligament reconstruction: risk of osteoarthritis.. [published online ahead of print, 2022 Apr 1]Eur J Orthop Surg Traumatol 2022;•••; Doi: 10.1007/s00590-022-03249-4 Link DOI
18
Castoldi M, Magnussen RA, Gunst S, et al. A randomized controlled trial of bone-patellar tendon-bone anterior cruciate ligament reconstruction with and without lateral extra-articular tenodesis: 19-year clinical and radio logical follow-up. Am J Sports Med 2020;48(07):1665-1672
19
Getgood AMJ, Bryant DM, Litchfield R, et al; STABILITY Study Group. Lateral extra-articular tenodesis reduces failure of hamstring tendon autograft anterior cruciate ligament reconstruction: 2-year outcomes from the STABILITY study randomized clinical trial. Am J Sports Med 2020;48(02):285-297
20
Dejour D, Vanconcelos W, Bonin N, Saggin PR. Comparative study between mono-bundle bone-patellar tendon-bone, double-bundle hamstring and mono-bundle bone-patellar tendon-bone combined with a modified Lemaire extra-articular procedure in anterior cruciate ligament reconstruction. Int Orthop 2013;37 (02):193-199
21
Eggeling L, Drenck TC, Frings J, et al. Additional lateral extraarticular tenodesis in revision ACL reconstruction does not influence the outcome of patients with low-grade anterior knee laxity. Arch Orthop Trauma Surg 2022;142(02):291-299
22
Rowan FE, Huq SS, Haddad FS. Lateral extra-articular tenodesis with ACL reconstruction demonstrates better patient-reported outcomes compared to ACL reconstruction alone at 2 years minimum follow-up. Arch Orthop Trauma Surg 2019;139(10):1425-1433
23
Na BR, Kwak WK, Seo HY, Seon JK. Clinical outcomes of anterolateral ligament reconstruction or lateral extra-articular tenodesis combined with primary acl reconstruction: A systematic review with meta-analysis. Orthop J Sports Med 2021;9(09): 23259671211023099
24
Onggo JR, Rasaratnam HK, Nambiar M, et al. Anterior cruciate ligament reconstruction alone versus with lateral extra-articular tenodesis with minimum 2-year follow-up: A meta-analysis and systematic review of randomized controlled trials. Am J Sports Med 2022;50(04):1137-1145
25
Grassi A, Zicaro JP, Costa-Paz M, et al; ESSKA Arthroscopy Committee. Good mid-term outcomes and low rates of residual rotatory laxity, complications and failures after revision anterior cruciate ligament reconstruction (ACL) and lateral extra-articular tenodesis (LET). Knee Surg Sports Traumatol Arthrosc 2020;28 (02):418-431
26
Feller JA, Devitt BM, Webster KE, Klemm HJ. Augmentation of primary ACL reconstruction with a Modified Ellison Lateral Extraarticular tenodesis in high-risk patients: A pilot study. Orthop J Sports Med 2021;9(08):23259671211021351
27
Devitt BM, Bell SW, Ardern CL, et al. The role of lateral extraarticular tenodesis in primary anterior cruciate ligament reconstruction: A Systematic review with meta-analysis and best-evidence synthesis. Orthop J Sports Med 2017;5(10): 2325967117731767
28
Engebretsen L, Lew WD, Lewis JL, Hunter RE. The effect of an iliotibial tenodesis on intraarticular graft forces and knee joint motion. Am J Sports Med 1990;18(02):169-176
29
Draganich LF, Reider B, Miller PR. An in vitro study of the Müller anterolateral femorotibial ligament tenodesis in the anterior cruciate ligament deficient knee. Am J Sports Med 1989;17(03): 357-362
30
Di Benedetto P, Buttironi MM, Mancuso F, Roman F, Vidi D, Causero A. Kinetic and Kinematic analysis of ACL reconstruction in association with lateral-extrarticular tenodesis of the knee in revision surgery: a pilot study. Acta Biomed 2021;92(S3): e2021027
31
Feng J, Cao Y, Tan L, et al. Anterior cruciate ligament reconstruction with lateral extra-articular tenodesis reduces knee rotation laxity and graft failure rate: A systematic review and meta-analysis. J Orthop Surg (Hong Kong) 2022;30(01): 10225536221095969