ACL and Extra-articular Tenodesis



Anterior cruciate ligament reconstruction (ACLR) is one of the most common orthopedic surgical procedures performed. There have been concerns with the inability of an ACLR to reliably restore normal tibial rotation. Various iterations of the lateral extra-articular tenodesis (LET) have been used in an attempt to address anterolateral laxity in an ACL-deficient knee. Initial results with isolated LET were poor in terms of patient satisfaction and subjective clinical testing using a pivot shift test. There is a renewed interest in using LET as an adjunct procedure to a conventional ACLR, as the body of literature looking at a combination procedure has provided more promising results. Our current clinical indications for using LET to augment an ACLR include significant anterolateral laxity (pivot shift grade 2 or greater), young patient age (<20 years), genu recurvatum >10°, or participation in a high-risk pivoting sport.


Lateral extra-articular tenodesis Anterolateral laxity Biomechanics 



We are grateful for research funding for the STAbiLiTY study has been provided through the Multicenter Grant competition from the International Society of Arthroscopy, Knee Surgery, and Orthopedic Sports Medicine (ISAKOS) and the Orthopedic Research and Education Foundation (OREF).

Dr. Getgood also thanks Dr. David Dejour and Dr. Peter Verdonk for demonstrating their respective techniques of lateral extra-articular tenodesis.


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Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  1. 1.Department of Surgery, Fowler Kennedy Sport Medicine ClinicWestern UniversityLondonCanada
  2. 2.Melbourne Orthopaedic Group, Department of Orthopaedic SurgeryThe Alfred HospitalMelbourneAustralia

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