Summary

Adding LET to ACLR does not appear to significantly influence functional outcomes in terms of extensor and flexor muscle strength balance 12 months postoperatively.

Abstract

Introduction

Recent studies have shown that combining anterior cruciate ligament reconstruction (ACLR) with lateral extra-articular tenodesis (LET) can reduce the re-rupture rate by 2.5 times. However, since this procedure involves the iliotibial band, it could affect the recovery of knee muscle strength.

Hypothesis

The combination of LET with ACLR would not result in impaired knee muscle strength 12 months postoperatively.

Methods

A retrospective cohort study included 68 patients, divided into two groups: ACLR with LET (n=20) and isolated ACLR (n=48). Knee extensor and flexor muscle strength was measured 12 months post-surgery using a HUMAC NORM isokinetic dynamometer, evaluating peak torque at 60°/s (Nm) following our center’s protocol. Statistical analyses were conducted using univariate and multivariate logistic regression models in STATA v.18.0, with results expressed as odds ratios (OR) and 95% confidence intervals (CI).

Results

66.2% of the patients were male (n=45), with an average age of 23.9 years (SD=8.0). The ACLR with LET group showed less imbalance in extensor and flexor muscle strength compared to the isolated ACLR group; however, these differences were not statistically significant (p=0.55 and p=0.63).

Conclusion

Adding LET to ACLR does not appear to significantly influence functional outcomes in terms of extensor and flexor muscle strength balance 12 months postoperatively.

Keywords: anterior cruciate ligament; extra-articular tenodesis; isokinetic; muscle strength