Combining ACL Reconstruction with Lateral Extra-Articular Tenodesis Reduces Long-Term Osteoarthritis Risk Versus Isolated ACL Reconstruction: A Systematic Review and Meta-Analysis.

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Study Summary

6 studies including 444 patients undergoing anterior cruciate ligament reconstruction (ACLR) were included in this systematic review and meta-analysis comparing ACLR combined with lateral extra-articular tenodesis (LET) vs isolated ACLR. Pooled outcomes of interest included moderate-to-severe radiographic osteoarthritis in the lateral and medial knee compartments, osteoarthritis according to Kellgren-Lawrence and International Knee Documentation Committee (IKDC) classifications, and osteoarthritis risk in meniscectomized and non-meniscectomized knees. The addition of LET significantly reduced the risk of moderate-to-severe osteoarthritis in the lateral compartment, particularly when assessed using Kellgren-Lawrence and IKDC grading systems. The protective effect was most pronounced in patients who had undergone meniscectomy, while no significant benefit was observed in the medial compartment. These findings suggest that LET may help mitigate long-term osteoarthritis progression following ACLR, especially in patients with compromised meniscal integrity.