2025 ISAKOS Biennial Congress ePoster
Does the Use of Lateral Extra-Articular Tenodesis Reduces Residual Knee Rotatory Laxity After ACL Reconstruction? A Retrospective Randomized Case-Control Study Using Kinematic Rapid Assessment (Kira).
Debora Boncinelli, MD ITALY
Piero Franco, MD, Florence ITALY
Luca Salomone, MD, Florence ITALY
Francesco Giron, MD, PhD, Firenze ITALY
CTO, AOU Careggi, Florence, ITALY
FDA Status Not Applicable
Summary
The use of lateral extra-articular tenodesis reduces residual rotatory laxity of the knee after cruciate ligament reconstruction assessed through a retrospective randomized case-control study using the Kinematic Rapid Assessment (KiRA) measurement tool.
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Abstract
Introduction
The aim of this study is to evaluate whether the combination of ACL reconstruction with modified Coker-Arnold lateral extra-articular tenodesis (LET) could improve knee stability in athletes at a minimum two-year follow up.
Methods
Two hundred fifty four patients undergoing arthroscopic ACL reconstruction with hamstrings graft (out-in technique) were investigated and 70 of them fulfilled all the inclusion criteria and were divided in two groups: G1 35 (ACL) and G2 35 cases (ACL + LET). All patients were involved in level I competitive sport activities with at least three training sessions and one match per week. Surgery was performed by a single senior surgeon. IKDC score, Tegner score, Lysholm score, KiRA test (OrthoKey, Carrara, Italy) and radiographic evaluations were performed preoperatively and at the final follow-up (average 34.6 months).
Results
Seventy athletes with a mean age of 26.4?10.5 years (range 15-45) were collected. Most of them (71.6%) were operated within 6 months, 38 patients had meniscal injury: 21 knees showed medial meniscal tear (11 sutures and 10 partial meniscectomies), and 22 knees a lateral meniscal tear (10 sutures and 12 partial meniscectomies). The mean value of postoperative Lysholm-Tegner score and subjective IKDC score were 96.4 ? 4.4 and 94.53?7.4 in the G1 group and 97.2 ? 4.0 and 98.62?2.27 in the G2 group, respectively. At final follow up 82.1% of patients in G1 group and 98.33% in G2 were involved in competitive sport activities. The remaining 17.9% of patients (11 knee in G1 and 1 in G2 group) did not resume the same level of sport activities for personal reasons. Objective IKDC score demonstrated excellent results (A) in 83% of cases in G1 and 88% in G2 group. Lachman test evaluated with KiRA in G1 was 0.39 (SD?0.47) and 0.076 (SD?0.49) in G2. Pivot shift test was 0.47 (SD?0.21) in G1 and 0.18 (SD?0.27) in G2. No cases showed a tunnel widening more than 20%, nor painful anterior crepitus. Two patients reported a new trauma with ACL failure at 5 and 8 years, follow-up, respectively. Statistical analysis (STATA/BE 17.0) showed that the addiction of LET to the ACL reconstruction significantly increased (p<0.05) the incidence of pre-injury sport activities recovery and knee stability of the operated limb by 93%.
Conclusion
The addiction of LET to the ACL reconstruction with hamstring graft showed a statistically significant reduction of residual postoperative rotatory knee instability and increased the high-level sport activities recovery. The use of KiRA is a helpful tool for knee residual rotatory laxity evaluation