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Revision ACL reconstruction may be an indication for lateral extra-articular tenodesis
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LAS VEGAS — A presenter at the Arthroscopy Association of North American and American Orthopaedic Society for Sports Medicine Specialty Day discussed the use of lateral extra-articular tenodesis or anterolateral ligament reconstruction for augmentation of the ACL.
In his presentation, Alan M. Getgood MPhil MD FRCS (Tr&Orth), consultant knee surgeon at the Fowler Kennedy Sport Medicine Clinic in London, Ontario, Canada, said he preferred to use lateral extra-articular tenodesis with ACL reconstruction.
“[Lateral extra-articular tenodesis] has a longer clinical track record,” Getgood told Healio.com/Orthopedics. “It has been used for many years with success. It’s cost-effective. So, it’s simple to do and cheap to do. It doesn’t add a lot of time to your surgery and it’s easy to teach. Therefore, the translation to clinical practice is more straight forward. Anterolateral ligament (ALL) has been studied, [but] I think it’s more technically challenging to do.”
Getgood’s top indication for lateral extra-articular tenodesis is the need for revision ACL reconstruction. For a primary ACL reconstruction, the indications for lateral extra-articular tenodesis include young patients who have a high risk of re-injury.
He said both the ALL reconstruction and iliotibial band reconstruction with lateral extra-articular tenodesis can be used to augment the ACL reconstruction. Getgood noted there are studies that show ALL reconstruction is an effective procedure; however, one study suggested that the ALL was less effective in recreating the normal kinematics of the knee when augmenting ACL reconstruction compared with lateral extra-articular tenodesis.
The Stability Study, a multicenter randomized clinical trial led by Getgood, which compared primary ACL reconstruction with or without lateral extra-articular tenodesis will be presented later this year at the International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine Biennial congress in Cancun, Mexico. – by Monica Jaramillo
Reference:
Getgood AM. ACL augmentation: ALL or ITB (iliotibial band)- Science or science fiction? Presented at: Arthroscopy Association of North American and American Orthopaedic Society for Sports Medicine Specialty Day at the American Academy of Orthopaedic Surgeons Annual Meeting; March 16, 2019; Las Vegas.
Disclosure: Getgood reports he receives research support from Aesculap/B.Braun, Arthrex Inc., DePuy, A Johnson & Johnson Company, Eupraxia Pharmaceuticals Inc. and Musculoskeletal Transplant Foundation; is on the editorial or governing board of the American Journal of Sports Medicine and Knee Surgery, Sports Traumatology, Arthroscopy; is a paid consultant for Collagen Solutions and Olympus; is a board or committee member of American Orthopaedic Society for Sports Medicine, International Cartilage Repair Society and International Society of Arthroscopy, Knee Surgery, and Orthopaedic Sports Medicine; is a paid presenter or speaker for CONMED Linvatec; is a paid consultant for, a paid presenter or speaker for and receives research support from Ossur and Smith & Nephew.
Reference:
Inderhaug E, et al. Am J Sports Med. 2017; doi: 10.1177/0363546517724422.