Anterolateral Instability and LET: Basic Science and Current Evidence

Description

In this presentation by Al Getgood, a consultant knee surgeon at Fowler Kennedy Sports Medicine Clinic, he discusses the topic of anterolateral instability and lateral extra-articular tenodesis (LET) in the context of ACL reconstruction. He opens with a case study of a 17-year-old female soccer player who experienced an acute knee injury and is seeking advice on her surgical options with the aim of returning to competitive sports. Getgood highlights the significant risks associated with graft failure and re-injury in younger individuals, particularly those with additional factors like generalized knee laxity and concomitant meniscal injuries.



The talk examines the anatomy and biomechanics of the anterolateral complex, emphasizing the importance of this structure in stabilizing the knee. Getgood presents findings from various studies that outline the predictors of graft failure, including age, knee laxity, and bony morphology. He advocates for considering the addition of LET in primary ACL reconstructions, especially in high-risk patients, citing evidence from recent clinical trials that support its benefit in reducing rotational laxity and graft failure rates without increasing overall complications.



The presentation concludes with a detailed description of the surgical technique for performing the LET, reinforcing the method's relevance in knee surgeries aimed at optimizing outcomes for patients with high re-injury risks. This comprehensive overview serves to educate colleagues on the evolving strategies in orthopedic surgery related to knee instability.

DOI: 10.1302/3114-210629

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