Download PDF
CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2022; 57(01): 033-040
DOI: 10.1055/s-0041-1736514
Revisão Sistemática e Metanálise
Joelho

Functional Outcome of Lateral Extraarticular Tenodesis (LET) Procedure in Addition to Anterior Cruciate Ligament Reconstruction: A Metaanalysis[*]

Article in several languages: português | English
I Gusti Ngurah Wien Aryana 
1   Departamento de Ortopedia e Traumatologia, Faculdade de Medicina Udayana University, Sanglah General Hospital, Bali, Indonésia
,
I Wayan Subawa 
1   Departamento de Ortopedia e Traumatologia, Faculdade de Medicina Udayana University, Sanglah General Hospital, Bali, Indonésia
,
I Wayan Suryanto Dusak 
1   Departamento de Ortopedia e Traumatologia, Faculdade de Medicina Udayana University, Sanglah General Hospital, Bali, Indonésia
,
Cokorda Gde Oka Dharmayuda 
1   Departamento de Ortopedia e Traumatologia, Faculdade de Medicina Udayana University, Sanglah General Hospital, Bali, Indonésia
,
Hans Kristian Nugraha 
1   Departamento de Ortopedia e Traumatologia, Faculdade de Medicina Udayana University, Sanglah General Hospital, Bali, Indonésia
,
Maria Florencia Deslivia 
1   Departamento de Ortopedia e Traumatologia, Faculdade de Medicina Udayana University, Sanglah General Hospital, Bali, Indonésia
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

Abstract

Objectives The aim of the present study is to systematically review and analyze the functional outcome of lateral extraarticular tenodesis (LET) procedure in addition to anterior cruciate ligament reconstruction (ACLR) in studies with a high level of evidence.

Methods We performed a literature search for clinical studies comparing the LET method as an augmentation to ACL reconstruction with ACL reconstruction alone. The primary outcomes were the International Knee Documentation Committee (IKDC) score, the Lysholm score, and graft failures. Continuous variables were reported as means and 95% confidence intervals (CIs).

Results Six clinical studies with 1,049 patients were included in the metaanalysis. The follow-up period was, in average, 24 months (range, 6–63 months). The addition of the LET procedure to ACLR results in better functional outcome based on the IKDC score (p < 0.05). Graft failure was found to be lower in the ACLR plus LET group (16 of 342 patients) compared with the ACLR-only group (46 of 341 patients) (p < 0.05).

Conclusion There is high-level evidence that LET procedure in addition to ACLR is preferable in terms of functional outcome and graft failure.

Keywords

anterior cruciate ligament reconstruction - anterior cruciate ligament injuries - joint instability - tenodesis

Financial Disclosure

There was no financial support.


* Work developed at Orthopaedics and Traumatology Department, Faculty of Medicine Udayana University, Sanglah General Hospital, Bali, Indonésia.




Publication History

Received: 19 February 2021

Accepted: 15 June 2021

Article published online:
21 January 2022

© 2022. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 

  • Referências

  • 1 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
    CrossrefPubMedGoogle Scholar
  • 2 Schindler OS. Surgery for anterior cruciate ligament deficiency: a historical perspective. Knee Surg Sports Traumatol Arthrosc 2012; 20 (01) 5-47
    CrossrefPubMedGoogle Scholar
  • 3 Draganich LF, Reider B, Ling M, Samuelson M. An in vitro study of an intraarticular and extraarticular reconstruction in the anterior cruciate ligament deficient knee. Am J Sports Med 1990; 18 (03) 262-266
    CrossrefPubMedGoogle Scholar
  • 4 Caterine S, Litchfield R, Johnson M, Chronik B, Getgood A. A cadaveric study of the anterolateral ligament: re-introducing the lateral capsular ligament. Knee Surg Sports Traumatol Arthrosc 2015; 23 (11) 3186-3195
    CrossrefPubMedGoogle Scholar
  • 5 Musahl V, Herbst E, Burnham JM, Fu FH. The Anterolateral Complex and Anterolateral Ligament of the Knee. J Am Acad Orthop Surg 2018; 26 (08) 261-267
    CrossrefPubMedGoogle Scholar
  • 6 Patel RM, Brophy RH. Anterolateral Ligament of the Knee: Anatomy, Function, Imaging, and Treatment. Am J Sports Med 2018; 46 (01) 217-223
    CrossrefPubMedGoogle Scholar
  • 7 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
    CrossrefPubMedGoogle Scholar
  • 8 Ra HJ, Kim JH, Lee DH. Comparative clinical outcomes of anterolateral ligament reconstruction versus lateral extra-articular tenodesis in combination with anterior cruciate ligament reconstruction: systematic review and meta-analysis. Arch Orthop Trauma Surg 2020; 140 (07) 923-931
    CrossrefPubMedGoogle Scholar
  • 9 Hewison CE, Tran MN, Kaniki N, Remtulla A, Bryant D, Getgood AM. Lateral Extra-articular Tenodesis Reduces Rotational Laxity When Combined With Anterior Cruciate Ligament Reconstruction: A Systematic Review of the Literature. Arthroscopy 2015; 31 (10) 2022-2034
    CrossrefPubMedGoogle Scholar
  • 10 Devitt BM, Bell SW, Ardern CL. et al. The Role of Lateral Extra-articular 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
    CrossrefPubMedGoogle Scholar
  • 11 Furlan AD, Malmivaara A, Chou R. et al. Editorial Board of the Cochrane Back, Neck Group. 2015 updated method guideline for systematic reviews in the Cochrane Back and Neck Group. Spine 2015; 40 (21) 1660-1673
    CrossrefPubMedGoogle Scholar
  • 12 Dejour D, Vanconcelos W, Bonin N, Saggin PRF. 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
    CrossrefPubMedGoogle Scholar
  • 13 Lemaire M. Rupture ancienne du ligament croisé antérieur du genou. J Chir (Paris) 1967; 93: 311-320
    Google Scholar
  • 14 Macintosh D, Darby T. Lateral Substitution Reconstruction. J Bone Joint Surg 1976; 58: 142
    Google Scholar
  • 15 Christel P, Djian P. Plastie extra-articulaire antéro-latérale du genou utilisant une ténodèse courte au fascia lata. [Anterio-lateral extra-articular tenodesis of the knee using a short strip of fascia lata]. Rev Chir Orthop Repar Appar Mot 2002; 88 (05) 508-513
    Google Scholar
  • 16 Getgood A, Hewison C, Bryant D. et al. Stability Study Group. No Difference in Functional Outcomes When Lateral Extra-Articular Tenodesis Is Added to Anterior Cruciate Ligament Reconstruction in Young Active Patients: The Stability Study. Arthroscopy 2020; 36 (06) 1690-1701
    CrossrefPubMedGoogle Scholar
  • 17 Ferretti A, Monaco E, Ponzo A. et al. Combined Intra-articular and Extra-articular Reconstruction in Anterior Cruciate Ligament-Deficient Knee: 25 Years Later. Arthroscopy 2016; 32 (10) 2039-2047
    CrossrefPubMedGoogle Scholar
  • 18 Trichine F, Alsaati M, Chouteau J, Moyen B, Bouzitouna M, Maza R. Patellar tendon autograft reconstruction of the anterior cruciate ligament with and without lateral plasty in advanced-stage chronic laxity. A clinical, prospective, randomized, single-blind study using passive dynamic X-rays. Knee 2014; 21 (01) 58-65
    CrossrefPubMedGoogle Scholar
  • 19 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 Radiological Follow-up. Am J Sports Med 2020; 48 (07) 1665-1672
    CrossrefPubMedGoogle Scholar
  • 20 Tramer JS, Fidai MS, Kadri O. et al. Anterolateral Ligament Reconstruction Practice Patterns Across the United States. Orthop J Sports Med 2018; 6 (12) 2325967118811063
    Google Scholar
  • 21 Ferretti A, Conteduca F, Monaco E, De Carli A, D'Arrigo C. Revision anterior cruciate ligament reconstruction with doubled semitendinosus and gracilis tendons and lateral extra-articular reconstruction. J Bone Joint Surg Am 2006; 88 (11) 2373-2379
    CrossrefPubMedGoogle Scholar
  • 22 Spencer L, Burkhart TA, Tran MN. et al. Biomechanical analysis of simulated clinical testing and reconstruction of the anterolateral ligament of the knee. Am J Sports Med 2015; 43 (09) 2189-2197
    CrossrefPubMedGoogle Scholar
  • 23 Ueki H, Katagiri H, Otabe K. et al. Contribution of Additional Anterolateral Structure Augmentation to Controlling Pivot Shift in Anterior Cruciate Ligament Reconstruction. Am J Sports Med 2019; 47 (09) 2093-2101
    CrossrefPubMedGoogle Scholar
  • 24 Slette EL, Mikula JD, Schon JM. et al. Biomechanical Results of Lateral Extra-articular Tenodesis Procedures of the Knee: A Systematic Review. Arthroscopy 2016; 32 (12) 2592-2611
    CrossrefPubMedGoogle Scholar
  • 25 Noyes FR, Barber SD. The effect of an extra-articular procedure on allograft reconstructions for chronic ruptures of the anterior cruciate ligament. J Bone Joint Surg Am 1991; 73 (06) 882-892
    CrossrefPubMedGoogle Scholar
  • 26 Roth JH, Kennedy JC, Lockstadt H, McCallum CL, Cunning LA. Intra-articular reconstruction of the anterior cruciate ligament with and without extra-articular supplementation by transfer of the biceps femoris tendon. J Bone Joint Surg Am 1987; 69 (02) 275-278
    CrossrefPubMedGoogle Scholar
  • 27 Oni OO, Crowder E. A comparison of isokinetics and muscle strength ratios following intra-articular and extra-articular reconstructions of the anterior cruciate ligament. Injury 1996; 27 (03) 195-197
    CrossrefPubMedGoogle Scholar