Purpose

There is a general paucity of research regarding the clinical implications of LET as additional procedure to ACLR among patients at moderate- to high-risk of re-rupture. To compare re-rupture rates following anterior cruciate ligament reconstruction (ACLR) and ACLR combined with lateral extra-articular tenodesis (LET) in patients at moderate- to high-risk of re-rupture.

Methods

In this cohort study, patients aged >16 years with a primary ACL injury treated with either ACLR or ACLR+LET were retrospectively included. Re-rupture rates and functional outcomes were retrospectively evaluated. Additionally, patient-reported outcome measures including the International Knee Documentation Committee score and the Marx Activity Rating Scale score were prospectively evaluated by using a questionnaire.

Results

In total, 406 patients were included in the ACLR group and 112 in the ACLR+LET group. With 281 replies, questionnaire response rate was 67.2%. Re-rupture rate was 0.9% in the ACLR+LET group vs. 6.5% in the ACLR group (p=0.02). Additionally, ACLR+LET patients showed less knee instability at three, six and nine months follow-up (p<0.04). No significant differences were observed in patient-reported outcome measures.

Conclusion

This study showed a lower re-rupture rate and more stability in favour of ACLR+LET compared to ACLR in a population at moderate- to high-risk of re-rupture. This can aid clinicians in choosing the right treatment for each individual patient.