Modified ACL reconstruction technique may reduce retear rate in adolescent athletes
Click Here to Manage Email Alerts
Results showed adolescent athletes did not experience retear at a minimum 2-year follow-up after quadriceps autograft ACL reconstruction and iliotibial band tenodesis with a modified Lemaire technique.
“ACL revision rate may be significantly diminished in high-risk young adolescent athletes if [lateral extra-articular tenodesis] LET is performed at the time of quadriceps autograft ACL reconstruction,” Frank A. Cordasco, MD, co-author of the study from Hospital for Special Surgery, told Healio Orthopedics. “Our study is one of the first studies in the world demonstrating that a LET at the time of an ACL reconstruction can be performed safely in young skeletally immature athletes.”
Cordasco, Daniel W. Green, MD, and colleagues collected preoperative demographic, radiographic and intraoperative data for 28 adolescent athletes who underwent ACL reconstruction with quad tendon autograft and a lateral extra-articular tenodesis procedure using the iliotibial band with a modified Lemaire technique. Researchers performed a quality of movement assessment on all athletes prior to release for return to sport. Researchers followed athletes for a minimum of 24 months with serial clinic visits and recorded information regarding return to sport and second surgeries.
Results showed 24 patients underwent complete transphyseal ACL reconstruction and four patients underwent all-epiphyseal ACL reconstruction. Researchers found 11.5% of patients required concomitant hemi-epiphysiodesis to address valgus deformity. Revision ACL reconstructions comprised 28.5% of patients included in the study, all of which had complete transphyseal ACL reconstruction, according to results.
Researchers noted no patients experienced postoperative graft failure. Although one patient experienced a twisting injury 3.8 years postoperatively, researchers found the patient had a meniscus tear but intact ACL graft via MRI. Results showed one patient had a contralateral ACL tear. Patients had an 11.5% rate of second surgery on the ipsilateral knee, all of which were removal of hardware for hemi-epiphysiodesis, according to results.
“Our study demonstrates that the addition of a lateral extra-articular tenodesis in the form of a modified Lemaire iliotibial band tenodesis performed at the time of quadriceps autograft ACL reconstruction for those athletes with non-modifiable risk factors and those in the eighth- and ninth-grade age group provides significantly better outcomes compared to ACL reconstruction alone,” Green, of Hospital for Special Surgery, told Healio Orthopedics. “We believe that the LET should be considered in young adolescent athletes with non-modifiable risk factors and those in the eighth and ninth grade at the time of ACL reconstruction who are at high risk for revision ACL reconstruction.”
Collapse
Cordasco FA, et al. Poster 0928. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 24-28, 2020 (meeting canceled).
Click Here to Manage Email Alerts