Purpose: To compare postoperative activity levels between patients who received an anterior cruciate ligament reconstruction (ACLR) with- and without a lateral extra-articular procedure (LEAP).
Objectives: The primary objective is to examine whether patients treated with an ALCR and LEAP have a greater chance to return to sport (RTS) and return to their pre-injury level of sport (RTPS). The re-rupture rates between the two groups will also be analysed as this is of great influence on the RTS and RTPS.
Methods: A thorough search according to PRISMA guidelines was conducted through the PubMed and Embase databases in May 2024. Randomised controlled trials (RCT) and retrospective cohort studies on patients who underwent primary ACLR with- or without a LEAP were included. Postoperative Tegner score, RTS, RTPS and re-rupture rate were evaluated. All articles were revised according to Cochrane risk of bias tools (RoB 2.0 and ROBINS-I).
Results: Twenty-four studies were included after examining 966 titles, abstracts and manuscripts. A total of 33,527 patients were included in this review with a weighted mean age of 24.9 years. Pooled data demonstrates that the ACLR + LEAP group shows significantly higher postoperative Tegner scores (MD, 0.43 [95% confidence interval, 0.21-0.65]; < 0.01). 62% of patients who underwent ACLR + LEA returned to their pre-injury level of sport compared to 40% in ACLR group (reported in nine studies).
Conclusion: This meta-analysis demonstrates that patients undergoing a LEAP procedure in addition to ACLR return to higher postoperative activity levels and are more likely to return to their pre-injury level of sport. These results -in addition to further research- may help dictate when to add a LEAP, and whether LEAP in addition to ACLR should become the golden standard.
Level Of Evidence: Level III, retrospective cohort studies have been analysed, alongside RCT's, and thus this is the level of evidence.
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http://dx.doi.org/10.1002/jeo2.70196 | DOI Listing |
Purpose: To compare postoperative activity levels between patients who received an anterior cruciate ligament reconstruction (ACLR) with- and without a lateral extra-articular procedure (LEAP).
Objectives: The primary objective is to examine whether patients treated with an ALCR and LEAP have a greater chance to return to sport (RTS) and return to their pre-injury level of sport (RTPS). The re-rupture rates between the two groups will also be analysed as this is of great influence on the RTS and RTPS.
Ulus Travma Acil Cerrahi Derg
March 2025
Department of Orthopedics and Traumatology, Kars Harakani State Hospital, Kars-Türkiye.
Background: This prospective case series aimed to evaluate the short- to medium-term radiological and clinical outcomes of intramedullary screw (IMS) fixation in pediatric patients with extra-articular proximal phalanx fractures.
Methods: Eleven patients (eight boys and three girls) aged 5-15 years underwent IMS fixation between January 2020 and June 2022. Antegrade or retrograde techniques were used depending on the fracture location.
Orthop J Sports Med
March 2025
Clinica II, IRCCS, Istituto Ortopedico Rizzoli, Via Pupilli, Bologna, Italy.
Background: Anterior cruciate ligament (ACL) tears combined with medial collateral ligament (MCL) injury has been associated with an increased rate of ACL reconstruction (ACLR) failure, high-grade pivot shift (PS), and lower return to sports rate. On the other hand, medial-sided procedures in the setting of ACLR are associated with knee stiffness and arthrofibrosis.
Purpose/hypothesis: This study aimed to compare clinical scores, objective knee laxity, failure, and complication rates in 2 different patient groups.
Arthrosc Sports Med Rehabil
February 2025
Keck Medicine of the University of Southern California, Department of Orthopedics, Los Angeles, California, U.S.A.
Purpose: To analyze the incidence of spin in the abstracts of systematic reviews and meta-analyses investigating anterolateral ligament augmentation or lateral extra-articular tenodesis as treatment for anterior cruciate ligament injuries.
Method: Studies were identified using the Preferred Reporting Items for Systematic Reviews and Meta Analysis guidelines searching PubMed, Web of Science, and Scopus in November 2023. The abstracts were graded for the incidence of the 15 most common types of spin, and full texts were reviewed for AMSTAR 2 classification.
Arthrosc Tech
February 2025
Department of Orthopedic Surgery and Traumatology, Hospital General Universitario Reina Sofía, Murcia, Spain.
The past decade has seen changing trends in anterior cruciate ligament reconstruction surgery, with the hamstring becoming the most commonly used graft. Furthermore, the importance of extra-articular lateral tenodesis has been demonstrated to offer greater control of rotational laxity and a protective effect during cruciate ligament reconstruction. In this technical note, we describe a way to elaborate the graft with quadrupled semitendinosus tendon to obtain a compact and reliable graft.
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