A lateral extra-articular tenodesis (LET) with a modified Lemaire technique (MLT) in conjunction with anterior cruciate ligament reconstruction (ACLR) is associated with favorable patient-reported outcome at two years for adolescents at high risk for failed ACLR, according to a study presented at the annual meeting of the American Academy of Orthopaedic Surgeons, held from March 22 to 26 in Chicago.
Frank A. Cordasco, M.D., from the Hospital for Special Surgery in New York City, and colleagues reviewed a series of 61 patients aged 19 years or younger who underwent simultaneous ACLR and LET with a minimum of two years of follow-up data. The participants were at high risk for failed ACLR.
Fifty-nine of the patients participated in organized sports, including soccer, basketball, football, and lacrosse. The researchers found that 10 patients underwent revision ACLR procedures. Seven and 54 (11 and 89 percent) of the patients underwent all-epiphyseal and complete transphyseal techniques for ACLR, respectively. Forty-two and 19 (69 and 31 percent) cases employed full-thickness quadriceps tendon autograft and bone-patellar tendon-bone autograft, respectively. All patients underwent LET with MLT. The mean Single Assessment Numeric Evaluation score was 95; the median Pediatric International Knee Documentation Committee score was 91, and the median Hospital for Special Surgery Functional Activity Brief Scale score was 27 at two-year follow-up. The rate of return-to-sport was 91.8 percent. Subsequent surgical procedures were performed in 10 patients.
"Not only does this technique not disturb children's growth plates or cause postoperative stiffness, but we also found that this demonstrates a remarkably low re-tear rate in this high-risk group," Cordasco said in a statement.