2025 ISAKOS Biennial Congress ePoster
The additional use of a lateral extraarticular tenodesis in revision ACL surgery tends to decrease ACL revision failure with no difference in clinical outcome
Lorenz Fritsch, MD, Munich GERMANY
Luca Bausch, Student, Munich, Bavaria GERMANY
Julian Mehl, MD, Munich, Bavaria GERMANY
Philipp Wilhelm Winkler, MD, Assoc. Prof., Linz AUSTRIA
Armin Runer, PD MD, Munich GERMANY
Romed Peter Vieider, MD, Munich GERMANY
Sebastian Siebenlist, MD, MHBA, Prof., Munich, Bavaria GERMANY
Lukas Willinger, MD, Munich GERMANY
Department of Sports Orthopaedics, Technical University of Munich, Munich, Germany., Munich, Bavaria, GERMANY
FDA Status Cleared
Summary
The use of additional LET in revision ACL surgery tends to increase the risk of reinastability
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Abstract
Introduction
Lateral extraarticular tenodesis (LET) has been suggested in revision anterior cruciate ligament reconstruction (ACLR) to decrease failure rate and improve knee laxity. The aim of this study was to compare clinical outcomes, knee laxity, and the failure rate after revision ACLR with and without LET. It was hypothesized that an additional LET reduces failures and improves clinical outcomes.
Methods
A retrospective cohort study was conducted to evaluate patients, who underwent revision ACLR with and without LET between 2017 and 2021 with a minimum follow-up of 24 months. Patients with coronal malalignement (5°), posterior tibial slope > 12° and concomitant injuries to collateral ligaments were excluded. Clinical outcome was evaluated by using the International Knee Documentation Committee (IKDC) subjective knee score, the Lysholm Score, and the Tegner Activity Scale (TAS). Anterior knee laxity was measured with a Rolimeter and side-to-side difference (SSD) was determined. Revision ACLR failure was defined as revision surgery or SSD > 5mm, failures were compared using an Odds Ratio (OR) and Fisher’s exact test. Student’s t-test was used to analyzed differences in means. Statistical significance was set at p < 0.05.
Results
45 of 56 (80%) eligible patients (23 group isolated rACLR vs. 22 with additional LET) were assessed with a mean follow-up of 45.6 15.8 months. Postoperative clinical outcome scores did not statistically differ between groups (IKDC: 73.0 18.9 vs. 68.7 ± 16.6, p > 0.05; Lysholm: 84.8 12.3 vs. 77.7 ± 16.2, p > 0.05). Both groups showed similar TAS (group A: 5 (range, 4-6) vs. group B: 4 (range, 3-5), p > 0.05). Anterior knee laxity SSD was 2.4 1.3 mm in group A and 1.8 1.8 mm in group B (n.s.). Revision ACLR failure rate was 13% in group A compared to 4.5% in group B (OR: 3.1; n.s.).
Conclusion
Isolated revision ACLR revealed equal outcome scores to combined ACLR + LET. Postoperative anterior knee laxity was not different between the study groups. The addition of a LET demonstrated a tendence to decrease the failure rate after revision surgery. However, larger cohorts have to be compared as this study was underpowered