Lateral extra-articular tenodesis does not enhance ACL graft healing, however, does reduce graft tunnel widening

George Jacob, Yoong Ping Lim, Cristian Ayet Brito, David Parker

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

Abstract

Purpose
The study hypothesized that the addition of lateral extra-articular tenodesis (LEAT) in anterior cruciate ligament reconstruction (ACLR) had a significant effect on ACL graft healing.

Methods
A total of 80 patients were divided into two cohorts matched for gender, age, body mass index, time from surgery to post-operative MRI and graft diameter. Forty patients underwent ACL reconstruction alone, while 40 underwent ACLR in addition to LEAT. Patients underwent a magnetic resonance imaging scan at 12 months post-surgery; tunnel apertures were measured using multiplanar reformation, graft healing was assessed using signal-to-noise quotient (SNQ) in three regions of interest and finally graft maturity and integration were classified using the Howell and Ge scale, respectively. In addition, clinical evaluation and patient-reported outcome measures were collected.

Results
The mean femoral tunnel widening at 12 months post-surgery was 39.8 ± 14.0% in the ACLR + LEAT group and 55.2 ± 12.7% in the ACLR alone group (p < 0.05). The mean tibial tunnel widening was 29.3 ± 12.7% in the ACLR + LEAT group and 44.4 ± 12.1% in the ACLR group (p < 0.05). The mean adjusted graft SNQ was 9.0 ± 14.9 in the ACLR + LEAT group and 9.5 ± 11.4 in the ACLR group (n.s.).

Conclusion
At 1 year post-operatively, we noted significantly less femoral and tibial tunnel widening in the ACLR + LEAT group. LEAT did not result in a statistically significant effect on graft healing.

Level of Evidence
Level III.
Original languageEnglish
Pages (from-to)2885-2894
Number of pages10
JournalKnee Surgery Sports Traumatology Arthroscopy
Volume32
Issue number11
Early online date11 Jun 2024
DOIs
Publication statusPublished - Nov 2024

Bibliographical note

Publisher Copyright:
© 2024 European Society of Sports Traumatology, Knee Surgery and Arthroscopy.

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