Modified Iliotibial Band Tenodesis Is Indicated to Correct Intraoperative Residual Pivot Shift After Anterior Cruciate Ligament Reconstruction Using an Autologous Hamstring Tendon Graft: A Prospective Randomized Controlled Trial

Porter, Mark D; Shadbolt, Bruce

doi:10.1177/0363546520910148

Cited by 26 publications

(53 citation statements)

References 63 publications

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“…These kinematic effects of adding LET in the initial postoperative year may in part explain the reported improvement of clinical results and lower revision rate after ACLR 1 LET in comparison with iACLR. 4,13,14,37,42,43 Moreover, the combined lateral extra-articular procedure provides clinicians with insight into considering the rehabilitation protocol or a return to sports 6 months after surgery.…”

Section: Discussionmentioning

confidence: 99%

Lateral Extra-articular Tenodesis Contributes Little to Change In Vivo Kinematics After Anterior Cruciate Ligament Reconstruction: A Randomized Controlled Trial

et al. 2021

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Background: Lateral extra-articular tenodesis (LET) in combination with anterior cruciate ligament (ACL) reconstruction (ACLR) has been proposed to improve residual rotatory knee instability in patients having ACL deficiency. Purpose/Hypothesis: The purpose was to compare the effects of isolated ACLR (iACLR) versus LET in combination with ACLR (ACLR+LET) on in vivo kinematics during downhill running. It was hypothesized that ACLR+LET would reduce the internal rotation of the reconstructed knee in comparison with iACLR. Study Design: Controlled laboratory study. Methods: A total of 18 patients with ACL deficiency were included. All participants were randomly assigned to receive ACLR+ LET or iACLR during surgery. Six months and 12 months after surgery, knee joint motion during downhill running was measured using dynamic biplane radiography and a validated registration process that matched patient-specific 3-dimensional bone models to synchronized biplane radiographs. Anterior tibial translation (ATT; positive value means “anterior translation”) and tibial rotation (TR) relative to the femur were calculated for both knees. The side-to-side differences (SSDs) in kinematics were also calculated (operated knee–contralateral healthy knee). The SSD value was compared between ACLR+LET and iACLR groups using a Mann-Whitney U test. Results: At 6 months after surgery, the SSD of ATT in patients who had undergone ACLR+LET (–1.9 ± 2.0 mm) was significantly greater than that in patients who had undergone iACLR (0.9 ± 2.3 mm) at 0% of the gait cycle (foot strike) ( P = .031). There was no difference in ATT 12 months after surgery. Regarding TR, there were no differences between ACLR+LET and iACLR at either 6 months ( P value range, .161-.605) or 12 months ( P value range, .083-.279) after surgery. Conclusion: LET in combination with ACLR significantly reduced ATT at the instant of foot strike during downhill running at 6 months after surgery. However, this effect was not significant at 12 months after surgery. The addition of LET to ACLR had no effect on TR at both 6 and 12 months after surgery. Clinical Relevance: LET in combination with ACLR may stabilize sagittal knee motion during downhill running in the early postoperation phase, but according to this study, it has no effect on 12-month in vivo kinematics. Registration: NCT02913404 ( ClinicalTrials.gov identifier)

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Section: Discussionmentioning

confidence: 99%

Lateral Extra-articular Tenodesis Contributes Little to Change In Vivo Kinematics After Anterior Cruciate Ligament Reconstruction: A Randomized Controlled Trial

et al. 2021

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“…Three studies used an ITB based LET as an additional procedure (375 patients, 45%), again with different types of described techniques and grafts [ 1 , 14 , 50 ]. One publication described a Modified Iliotibial Band Tenodesis (28 patients, 3%) [ 45 ], as another study used a Cocker-Arnold (Modified Lemaire) procedure as their preferred LA technique (27 patients, 3%) [ 58 ]. Five publications were RCTs (925 unique patients, 465 ACLR and 460 ACLR + LA) [ 1 , 14 , 18 , 26 , 45 ] and six were prospective cohort studies (967 subjects, 592 ACLR and 375 ACLR + LA) [ 15 , 21 , 22 , 50 , 55 , 58 ].…”

Section: Resultsmentioning

confidence: 99%

“…Five publications were RCTs (925 unique patients, 465 ACLR and 460 ACLR + LA) [ 1 , 14 , 18 , 26 , 45 ] and six were prospective cohort studies (967 subjects, 592 ACLR and 375 ACLR + LA) [ 15 , 21 , 22 , 50 , 55 , 58 ].…”

Section: Resultsmentioning

confidence: 99%

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Clinical outcomes of contemporary lateral augmentation techniques in primary ACL reconstruction: a systematic review and meta-analysis

et al. 2021

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Purpose The purpose of this investigation was to systematically review the contemporary literature to determine if a lateral augmentation (LA) added to an Anterior Cruciate Ligament Reconstruction (ACLR) provides better clinical and patient reported outcomes compared to an isolated ACLR. Methods A systematic review and meta-analysis was performed according to the Preferred Reporting Items for Systematic reviews and Meta-analyses (PRISMA) criteria. Two authors independently conducted an electronic search using MEDLINE® and Embase® on February 6th, 2021 for level I-III randomized controlled trials (RCT) and prospective cohort studies without randomization, published after 2012 and with a minimum of two year follow-up. Publications were included when they reported on the objective knee stability examination, patient reported outcome scores, return to sports or graft rupture rate of any type of primary, isolated ACLR compared to ACLR combined with any type of LA. Results A total of 11 studies that reported on a combined total of 1892 unique patients were eligible for data extraction, including five RCTs and six prospective cohort studies. In 6 studies, an Anterolateral Ligament reconstruction (ALLR) was the LA of choice, while the 5 other publications used different types of Lateral Extra-articular Tenodesis (LET). A significant reduction in graft ruptures was found in patients treated with ACLR + LA (3%) compared to isolated ACLR (12%). Rotational laxity was significantly higher in isolated ACLR (14%) compared to ACLR + LA (6%). Addition of a LA reduced anterior translation when assessed via instrumented laxity testing. No significant difference was found in the patient reported outcome scores (IKDC and Tegner) between both patient groups, except for the Lysholm Score which was significant in favour of the ACLR + LA group. Conclusion Combination of a primary ACLR with a LA can significantly reduce the risk of graft rupture and provide better rotatory stability, without jeopardizing patient reported outcomes. Level of evidence Level III, Systematic Review of Level I, II and III studies.

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“…In their STABILITY trial, Getgood et al 32 randomized 618 young patients (<25 years) to single-bundle ACLR with or without lateral extra-articular tenodesis and reported a statistically significant reduction in graft rupture and persistent rotatory laxity at 2 years after surgery, although there were no statistically significant differences in patientreported or functional outcome scores. Porter and Shadbolt 33 compared a modified iliotibial band tenodesis with standard ACLR at 2 years in 55 patients. They also reported reduced graft failure and better scores on some reported outcome measures; Knee injury and Osteoarthritis Outcome Score subscale of sport/recreation, Lysholm score, and Tegner activity scale.…”

Section: Additional Proceduresmentioning

confidence: 99%

A Systematic Review of Randomized Controlled Trials in Anterior Cruciate Ligament Reconstruction: Standard Techniques Are Comparable (299 Trials With 25,816 Patients)

Matar

Platt

Bloch

et al. 2021

Arthroscopy, Sports Medicine, and Rehabilitation

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To provide an overview of all published randomized controlled trials (RCTs) in anterior cruciate ligament reconstruction (ACLR) summarizing the available evidence. Methods: Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we searched the Cochrane FIGCentral Register of Controlled Trials, Ovid MEDLINE, and Embase for RCTs of ACLR from their inception to August 26, 2020. Outcome measure was whether RCTs reported statistically significant findings. RCTs were then classified according to their intervention groups in a narrative synthesis of the evidence. Results: In total, 299 RCTs met the inclusion criteria and were included with a total number of 25,186 patients. Only 30 RCTs (10%) reported significant differences between the intervention and the control groups. These included 101 RCTs on grafts, 20 RCTs on tunnel placements, 48 RCTs on graft fixation, 42 RCTs on singlebundle compared with double-bundle reconstructions, 11 RCTs on additional procedures, 11 RCTs on graft tensioning, 5 RCTs on timing of surgery, 25 RCTs on technical variations from standard techniques, 6 RCTs on ACL repair, 5 RCTs on navigation, 16 RCTs on perioperative management, and 9 RCTs on other aspects of ACLR. Only 14 RCTs (4.7%) reported outcomes beyond 10 years with greater allograft failures compared with autografts, high incidence of osteoarthritic changes in reconstructed knees (22%-100%), with no significant differences in outcomes between bioabsorbable or metal screws for graft fixation, patellar versus hamstrings or single-versus double-bundle reconstructions. Conclusions: The evidence indicates that a standard arthroscopic single-or double-bundle ACLR with hamstrings/patella autografts, transportal technique, and fixation techniques familiar to the surgeon leads to comparable results. This evidence offers surgeons the flexibility to use standard and cost-effective techniques and achieve comparable outcomes. Level of Evidence: Level II; systematic review of Level I-II randomized controlled trials.

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Modified Iliotibial Band Tenodesis Is Indicated to Correct Intraoperative Residual Pivot Shift After Anterior Cruciate Ligament Reconstruction Using an Autologous Hamstring Tendon Graft: A Prospective Randomized Controlled Trial

Cited by 26 publications

References 63 publications

Lateral Extra-articular Tenodesis Contributes Little to Change In Vivo Kinematics After Anterior Cruciate Ligament Reconstruction: A Randomized Controlled Trial

Lateral Extra-articular Tenodesis Contributes Little to Change In Vivo Kinematics After Anterior Cruciate Ligament Reconstruction: A Randomized Controlled Trial

Clinical outcomes of contemporary lateral augmentation techniques in primary ACL reconstruction: a systematic review and meta-analysis

A Systematic Review of Randomized Controlled Trials in Anterior Cruciate Ligament Reconstruction: Standard Techniques Are Comparable (299 Trials With 25,816 Patients)

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