2023 ISAKOS Biennial Congress ePoster
Mid-Term Results of Anterior Cruciate Ligament Reconstruction with Anterolateral Augmentation, Lemaire Tenodesis, in Soccer Players. Functional Results and Return to Play
Pedro Alvarez-Diaz, MD, PhD, Prof., Barcelona SPAIN
Enrique Pavez, MD, Temuco, Araucania CHILE
Gilbert Steinbacher, MD, Viladecans , Barcelona SPAIN
Eduard Alentorn-Geli, MD, PhD, MSc, FEBOT, FACGME, Barcelona SPAIN
David Barastegui, MD, PhD, MSc, L'hospitalet De Llobregat, BARCELONA SPAIN
Jorge Ramirez Haua, MD, Granollers, Barcelona-Cataluña SPAIN
Maria Victoria Pomenta, MD, Barcelona, Barcelona SPAIN
Esther Sala, MD, Barcelona SPAIN
Sebatian Grossi, MD, Barcelona, Barcelona SPAIN
Aleix Pons Bartroli, MD , Barcelona SPAIN
Patricia Laiz Boada, BSc, Barcelona SPAIN
Ramon Cugat Bertomeu, MD, PhD, Barcelona, Barcelona SPAIN
Instituto Cugat. Hospital Quiron Barcelona. Mutualidad de Futbolistas Españoles.UIC-Barcelona, Barcelona, Barcelona, SPAIN
FDA Status Not Applicable
Summary
ACL revision surgery with modified Lemaire-type tenodesis is a procedure that restores knee stability in a high percentage, with excellent functional results, allowing a return to professional and semi-professional football, without further objective functional deterioration.
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Abstract
Introduction
Rotational instability associated with anterior cruciate ligament (ACL) injuries is a common decompensating factor in knee stability. The rate of persistence of rotational instability, measured by Pivot Shift, is a frequent cause of stress and is usually associated with surgery failure. Previous anatomical and biomechanical studies have shown the important role of anterolateral structures in rotational stability 2-3 . Although management techniques for anterolateral structures are indicated in the context of rotational instability, few studies have documented their results.
Purpose
To describe our results in a period of 6 years with (2015-20) a minimum follow-up of 2 years, regarding the use of anterolateral augmentation (LET) with Lemaire-type tenodesis associated with revision ACL Reconstruction. In terms of functional results and sports return.
Study Design: Case series; Level of evidence, 4.
Material And Methods
We evaluated the functional results and sporting return of 51 patients operated on over a period of 6 years( 2015-2020) at the Mutualidad del Futbolistas Españoles. These patients underwent ACL revision reconstruction using the HTH autograft contralateral in 25 cases and Bone-Aquiles tendon in 26 technique with modified Lemaire-type anterolateral augmentation (LET), according to the previously published technique.The primary outcome was the clinical result measured by a validated instrument: the Tegner-Lysholm Scale. And as a secondary outcome, return to sports was taken, evaluated by means of the Sports Return After Injury scale (ACL RSI).Patients who did not complete follow-up or who underwent other lower extremity interventions during this period were excluded.
Results
Most of the patients (50 of 51) presented an excellent result on the Tegner-Lysholm functional scale, only one patient presented a score compatible with a good result (89 points). This demonstrates the excellent functional results of surgery in the medium term. All were able to return to their activities of daily living. No differen are findindg betwen boht groups. Regarding sports reintegration, the Post Injury Return Scale (ACL RSI) showed excellent results in most patients with results greater than 90%. However, when asked if they still played soccer, 18 patients no longer practiced that sport for reasons unrelated to the injury.
Conclusions
ACL revision surgery with modified Lemaire-type tenodesis is a procedure that restores knee stability in a high percentage, with excellent functional results, allowing a return to professional and semi-professional football, without further objective functional deterioration.
Keywords: Modified Lemaire technique ( LET); Revision ACL; sports injury; soccer