Editorial Commentary: Return to Sport Following Extra-Articular Augmentation of Anterior Cruciate Ligament Reconstruction—Let the LET (Lateral Extra-Articular Tenodesis) Games Commence!

Getgood, Alan

doi:10.1016/j.arthro.2020.07.041

Cited by 6 publications

(4 citation statements)

References 12 publications

(19 reference statements)

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“…Put another way, we need to know which ACL patients will benefit significantly from concurrent extra-articular augmentation. 10 Although now an ALL believer, I admit to some initial skepticism. I did not regard the ALL as "new" during the press frenzy of late 2013, because it appeared to be the same "pearly, resistant, fibrous band" that Segond described in 1879.…”

Section: See Related Article On Page 1654mentioning

confidence: 97%

Editorial Commentary: This Is the Way: Extra-Articular Augmentation Is an Essential Consideration in Contemporary Anterior Cruciate Ligament Surgery

Shybut¹

2021

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Since the rediscovery of the anterolateral ligament, extra-articular augmentation (EA) has evolved from controversial to an essential consideration in contemporary anterior cruciate ligament reconstruction surgery. Anterolateral ligament (ALL) reconstruction and lateral extra-articular tenodesis are 2 common methods. Indications among early adopters pioneering anterolateral ligament reconstruction at anterior cruciate ligament surgery included revision anterior cruciate ligament (ACL) case, chronic ACL tear, high-grade pivot shift, and patients with hyperlax, hypermobile knees. Newer indications include young patient age, pivoting sport/high-demand/high-risk athlete, and concurrent medial meniscus repair. Questions remain regarding best practices as indications continue to evolve regarding technique, graft choice, angle/position of reconstruction fixation, and whether EA should be reconstructed routinely. This fast-moving surgical evolution serves as a reminder of 2 key concepts; first, that anterior cruciate ligament tears occur more fundamentally in the setting of anterolateral rotatory instability, in which concurrent soft tissue injuries are common, and, second, that even our best "anatomic" reconstructions do not fully recapitulate the native ACL, both of which give impetus to reconstructing the ALL.

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Section: See Related Article On Page 1654mentioning

confidence: 97%

Editorial Commentary: This Is the Way: Extra-Articular Augmentation Is an Essential Consideration in Contemporary Anterior Cruciate Ligament Surgery

Shybut¹

2021

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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show abstract

“…The ultimate goal of ACLR, whether it is a primary or revision case, is to return to the level of sports activity prior to the injury [ 15 ]. To achieve this goal, regaining dynamic postural stability of the affected limb, thus improving asymmetrical control in single-leg balance has been reported to be important [ 16 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

Additional Anterolateral Ligament Reconstruction Helps Patients Improve Dynamic Postural Stability in Revision Anterior Cruciate Ligament Reconstruction

et al. 2023

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Background and Objectives: The goal in treating anterior cruciate ligament (ACL) injury especially in revision cases is return to sports activity by regaining dynamic postural stability. Among various methods to achieve this goal, additional anterolateral ligament reconstruction (ALLR) is gaining attention. The purpose of this study was to evaluate the effects of additional ALLR in revision ACL reconstruction (RACLR). Materials and Methods: Patients who underwent RACLR between July 2015 and June 2018 were enrolled. The exclusion criteria were less than 1-year follow-up, age older than 45 years, concomitant multiple ligament injuries, contralateral knee injury, subtotal or total meniscectomized state, and articular cartilage lesions worse than Outerbridge grade 3. Thirty-nine patients (20 patients; RACLR only (Group A), 19 patients; RACLR with additional ALLR (Group B)) were included. Clinical scores (Lysholm score, subjective International Knee Documentation Committee (IKDC) score, Tegner activity scale), isokinetic strength test, single-leg-hop for distance test (SLHDT), Y-balance test (YBT) were checked preoperatively and 1-year postoperatively. Results: Limb symmetry index values in YBT showed significantly better result in Group B 1-year postoperatively (Group A: 97.2 ± 4.0, Group B: 100.3 ± 2.9, p = 0.010), although there were no differences preoperatively between groups (Group A: 90.4 ± 6.7, Group B: 89.3 ± 5.5, p = 0.594). Regarding clinical scores, isokinetic strength tests, and SLHDT, there were no differences between groups preoperatively nor 1-year postoperatively. Conclusions: Additional ALLR in RACLR helped patients gain better dynamic postural stability at 1-year postoperative follow-up.

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“…The ultimate goal of ACLR, whether it is a primary or revision case, is to return to the level of sports activity prior to the injury 15 . To achieve this goal, regaining dynamic postural stability of the affected limb, thus improving asymmetrical control in single-leg balance has been reported to be important 16,17 .…”

Section: Introductionmentioning

confidence: 99%

Additional anterolateral ligament reconstruction helps patients improve dynamic postural stability in revision anterior cruciate ligament reconstruction

Lee

Cho

Lee

et al. 2022

Preprint

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Introduction: The goal in treating anterior cruciate ligament (ACL) injury, especially in revision cases is to return to sports activity by regaining dynamic postural stability. Additional anterolateral ligament reconstruction (ALLR) is gaining attention to achieve this goal. The purpose was to evaluate the effects of additional ALLR in revision ACL reconstruction (RACLR). Methods: Patients who underwent RACLR between July 2015 and June 2018 were enrolled. The exclusion criteria were less than the 1-year follow-up, age older than 45 years, concomitant multiple ligament injuries, contralateral knee injury, subtotal or total meniscectomized state, and cartilage lesions worse than Outerbridge grade 3. Thirty-nine patients (20 patients; RACLR only (Group A), 19 patients; RACLR with additional ALLR (Group B)) were included. Clinical scores, isokinetic strength test, single-leg-hop for distance test (SLHDT), and Y-balance test (YBT) were checked preoperatively and 1-year postoperatively.Results: Limb symmetry index values in YBT showed significantly better results in Group B 1-year postoperatively, although there were no differences preoperatively between groups. Regarding clinical scores, isokinetic strength tests, and SLHDT, there were no differences between groups preoperatively or 1-year postoperatively.Conclusion: Additional ALLR in RACLR helped patients gain better dynamic postural stability at 1-year postoperative follow-up.

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Editorial Commentary: Return to Sport Following Extra-Articular Augmentation of Anterior Cruciate Ligament Reconstruction—Let the LET (Lateral Extra-Articular Tenodesis) Games Commence!

Cited by 6 publications

References 12 publications

Editorial Commentary: This Is the Way: Extra-Articular Augmentation Is an Essential Consideration in Contemporary Anterior Cruciate Ligament Surgery

Editorial Commentary: This Is the Way: Extra-Articular Augmentation Is an Essential Consideration in Contemporary Anterior Cruciate Ligament Surgery

Additional Anterolateral Ligament Reconstruction Helps Patients Improve Dynamic Postural Stability in Revision Anterior Cruciate Ligament Reconstruction

Additional anterolateral ligament reconstruction helps patients improve dynamic postural stability in revision anterior cruciate ligament reconstruction

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