Lateral Extra-Articular Tenodesis B - The Argument For

Description

In this presentation, Andrew Metcalfe discusses the topic of lateral tenodesis, particularly in the context of high-risk patients undergoing ACL (anterior cruciate ligament) reconstruction. He begins by introducing the concept of anterolateral instability, emphasizing the increased awareness and consideration of this condition in patients, especially those at higher risk of re-injury. Metcalfe explains that younger patients, particularly those under 25, are more likely to experience re-ruptures, and factors such as participation in high-level pivoting sports, tibial slope, and degree of ligamentous laxity contribute to the identification of high-risk individuals.



He highlights the importance of additional stabilization on the lateral side of the knee in conjunction with ACL reconstruction, presenting data from the stability study which involved 600 patients. The study indicated significant reductions in revision rates and graft failures in patients who underwent lateral extra-articular tenodesis (LET), thereby suggesting that this procedure can enhance outcomes for high-risk patients.



Metcalfe further explains the technical aspects of performing LET, noting the importance of isometry and correct fixation techniques to avoid complications. He concludes by stressing the need to recognize the specific subgroup of high-risk patients and the potential benefits of including lateral tenodesis in their surgical management strategies, while maintaining awareness of potential complications and emphasizing the importance of careful technique.

DOI: 10.1302/3114-230386

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