Anterior Cruciate Ligament Reconstruction With or Without Lateral Extra-articular Tenodesis: A Systematic Review and Meta-analysis of Comparative Outcomes From Randomized Controlled Trials.

Study Summary

10 randomized controlled trials (RCTs) involving 1221 patients undergoing primary anterior cruciate ligament reconstruction (ACLR) were included in this systematic review and meta-analysis comparing ACLR combined with lateral extra-articular tenodesis (LET) versus isolated ACLR. Pooled outcomes included graft failure, rotational and anterior knee stability, International Knee Documentation Committee (IKDC) scores, Lysholm scores, Knee injury and Osteoarthritis Outcome Score (KOOS), Tegner activity scores, and return-to-sport rates. Adding LET significantly reduced graft failure and improved rotational stability, as demonstrated by better pivot-shift outcomes. Additionally, modest improvements were observed in IKDC subjective and Lysholm scores, although no significant differences were identified in anterior knee laxity, KOOS, Tegner scores, or return-to-sport rates. These findings suggested that LET augmentation may improve graft survival and rotational stability, particularly in patients at increased risk of graft failure.