Lateral extra-articular tenodesis in patients with revision anterior cruciate ligament (ACL) reconstruction and high-grade anterior knee instability
Standard
Lateral extra-articular tenodesis in patients with revision anterior cruciate ligament (ACL) reconstruction and high-grade anterior knee instability. / Alm, Lena; Drenck, Tobias C; Frosch, Karl-Heinz; Akoto, Ralph.
In: KNEE, Vol. 27, No. 5, 10.2020, p. 1451-1457.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Lateral extra-articular tenodesis in patients with revision anterior cruciate ligament (ACL) reconstruction and high-grade anterior knee instability
AU - Alm, Lena
AU - Drenck, Tobias C
AU - Frosch, Karl-Heinz
AU - Akoto, Ralph
N1 - Copyright © 2020 Elsevier B.V. All rights reserved.
PY - 2020/10
Y1 - 2020/10
N2 - BACKGROUND: Additional lateral extra-articular procedures can reduce the risk of failure of primary anterior cruciate ligament reconstruction (ACLR). There is limited evidence on the effect of lateral extra-articular procedures in revision ACL surgery. The purpose of this study was to evaluate the clinical outcome of patients with lateral extra-articular tenodesis (LET) in combination with revision ACLR for combined ACL graft failure and high-grade anterior knee instability.METHODS: Between 2016 and 2018, 75 patients with graft failure after primary ACLR and high-grade anterior knee instability who received revision ACLR were included in the retrospective study. High-grade anterior knee instability was defined as high-grade pivot-shift or side-to-side difference of more than six millimeters in Rolimeter®-testing. An additional modified Lemaire tenodesis was performed in 59 patients during revision ACLR. Seventy-three patients were clinically examined with a minimum of two years after revision surgery.RESULTS: Failure of the revision ACLR occurred in 8.2% (n = 6) of the cases. LET lead to significant decreased failure rates (five percent vs. 21%, p = .045) and decreased incidence of a positive pivot-shift in patients with revision ACLR and high-grade anterior knee instability in comparison to patients without LET. Also, postoperative functional scores were significantly increased in the group of additional LET.CONCLUSIONS: Additional LET in patients with revision ACLR and high-grade anterior instability significantly reduces the risk of failure of revision ACLR, the incidence of pivot-shift and increases postoperative functional outcome.
AB - BACKGROUND: Additional lateral extra-articular procedures can reduce the risk of failure of primary anterior cruciate ligament reconstruction (ACLR). There is limited evidence on the effect of lateral extra-articular procedures in revision ACL surgery. The purpose of this study was to evaluate the clinical outcome of patients with lateral extra-articular tenodesis (LET) in combination with revision ACLR for combined ACL graft failure and high-grade anterior knee instability.METHODS: Between 2016 and 2018, 75 patients with graft failure after primary ACLR and high-grade anterior knee instability who received revision ACLR were included in the retrospective study. High-grade anterior knee instability was defined as high-grade pivot-shift or side-to-side difference of more than six millimeters in Rolimeter®-testing. An additional modified Lemaire tenodesis was performed in 59 patients during revision ACLR. Seventy-three patients were clinically examined with a minimum of two years after revision surgery.RESULTS: Failure of the revision ACLR occurred in 8.2% (n = 6) of the cases. LET lead to significant decreased failure rates (five percent vs. 21%, p = .045) and decreased incidence of a positive pivot-shift in patients with revision ACLR and high-grade anterior knee instability in comparison to patients without LET. Also, postoperative functional scores were significantly increased in the group of additional LET.CONCLUSIONS: Additional LET in patients with revision ACLR and high-grade anterior instability significantly reduces the risk of failure of revision ACLR, the incidence of pivot-shift and increases postoperative functional outcome.
U2 - 10.1016/j.knee.2020.06.005
DO - 10.1016/j.knee.2020.06.005
M3 - SCORING: Journal article
C2 - 33010761
VL - 27
SP - 1451
EP - 1457
JO - KNEE
JF - KNEE
SN - 0968-0160
IS - 5
ER -