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Combined lateral extra-articular tenodesis and anterior cruciate ligament reconstruction: risk of osteoarthritis

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

Lateral extra-articular tenodesis (LET) procedure, combined with an intra-articular reconstruction of the anterior cruciate ligament (ACL), is used to reduce rotational laxity and the risk of graft failure. However, concern of overtightening of the lateral compartment and subsequent osteoarthritis remains. The aim of this study is to evaluate the degenerative changes in the lateral compartment and to compare the clinical and radiographical results between two LET techniques.

Methods

Eighty-three patients (86 knees) were retrospectively reviewed at a mean of 67.7 months (range 49–85 months). Forty-two knees had an ACL reconstruction combined with a LET procedure according to the modified Lemaire technique and 44 knees according to the modified Coker–Arnold technique. IKDC, Lysholm, Tegner and VAS scores were used. Osteoarthritis was radiographically evaluated by the Kellgren–Lawrence classification.

Results

There were 12 patients (28.6%) in the modified Lemaire subgroup and 13 patients (29.5%) in the modified Coker–Arnold subgroup that had doubtful or mild radiologic signs of osteoarthritis. No patients had moderate or severe signs at final follow-up. There was no significant difference in radiological signs of osteoarthritis. In the modified Lemaire subgroup, we report a mean IKDC of 86.31 (± 13.794), a mean Lysholm of 87.83 (± 12.802) and a mean Tegner of 5.38 (± 2.556). In the modified Coker–Arnold subgroup, a mean IKDC of 87.27 (± 11.653), a mean Lysholm of 91.89 (± 8.035) and a mean Tegner of 5.16 (± 2.420) were reported. There were no statistical significant differences between both techniques. In eight patients, a complication was identified, 3 of which had a failure of the ACL reconstruction.

Conclusions

The chosen LET-technique seems to have minimal effect on both the clinical and the radiographic results. The LET is a safe procedure, and it does not increase the risk of osteoarthritis in the lateral compartment.

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Abbreviations

ACL:

Anterior cruciate ligament

ALL:

Anterolateral ligament

LET:

Lateral extra-articular tenodesis

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Acknowledgements

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.

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Authors and Affiliations

  1. Ziekenhuis Oost-Limburg, Schiepse Bos 6, 3600, Genk, Belgium

    Jonas Declercq & Jan Truijen

  2. Universiteit Gent, Sint-Pietersnieuwstraat 25, 9000, Gent, Belgium

    Jonas Declercq

  3. Universiteit Hasselt, Martelarenlaan 42, 3500, Hasselt, Belgium

    Margot Schuurmans, Lore Tack, Cato Verhelst & Jan Truijen

Authors
  1. Jonas Declercq
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  2. Margot Schuurmans
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  3. Lore Tack
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  5. Jan Truijen
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Jonas Declercq, Margot Schuurmans, Cato Verhelst and Lore Tack. The first draft of the manuscript was written by Jonas Declercq, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Jonas Declercq.

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Declercq, J., Schuurmans, M., Tack, L. et al. Combined lateral extra-articular tenodesis and anterior cruciate ligament reconstruction: risk of osteoarthritis. Eur J Orthop Surg Traumatol 33, 1075–1082 (2023). https://doi.org/10.1007/s00590-022-03249-4

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