Purpose: To determine whether comparative clinical studies demonstrate significant advantages of revision anterior cruciate ligament reconstruction (RACLR) combined with a lateral extra-articular procedure (LEAP), with respect to graft rupture rates, knee stability, return to sport rates, and patient-reported outcome measures, compared with isolated RACLR. Methods: A systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews & Meta-Analyses Guidelines. A PubMed search was conducted using the key words "revision anterior cruciate ligament reconstruction" combined with any of the following additional terms, "lateral extra-articular tenodesis" OR "anterolateral ligament reconstruction" OR "Lemaire." All relevant comparative clinical studies were included. Key clinical data were extracted and evaluated. Results: Eight comparative studies (seven Level III studies and a one Level IV study) were identified and included. Most studies reported more favorable outcomes with combined procedures with respect to failure rates (0%-13% following RACLR+LEAP, and 4.4%-21.4% following isolated RACLR), postoperative side-to-side anteroposterior laxity difference (1.3-3.9 mm following RACLR+LEAP and 1.8-5.9 mm following isolated RACLR), and high-grade pivot shift (0%-11.1% following RACLR+LEAP and 10.2%-23.8% in patients following isolated RACLR). There were no consistent differences between isolated and combined procedures with respect to return to sport or patient-reported outcome measures. Conclusions: This systematic review demonstrates that the addition of a LEAP to RACLR was associated with an advantage with respect to ACL graft failure rates and avoidance of high-grade postoperative knee laxity across almost all included studies. Level of evidence: IV, Systematic review of level III to IV studies.

Anterior cruciate ligament revision plus lateral extra-articular procedure results in superior stability and lower failure rates than does isolated anterior cruciate ligament revision but shows no difference in patient-reported outcomes or return to sports / Saithna, Adnan; Monaco, Edoardo; Carrozzo, Alessandro; Marzilli, Fabio; Cardarelli, Silvia; Lagusis, Benson; Rossi, Giorgio; Dutra-Vieira, Thais; Ferretti, Andrea; Sonnery-Cottet, Bertrand. - In: ARTHROSCOPY. - ISSN 0749-8063. - (2023), pp. 1-11. [10.1016/j.arthro.2022.12.029]

Anterior cruciate ligament revision plus lateral extra-articular procedure results in superior stability and lower failure rates than does isolated anterior cruciate ligament revision but shows no difference in patient-reported outcomes or return to sports

Edoardo Monaco
Secondo
;
Alessandro Carrozzo;Fabio Marzilli;Silvia Cardarelli;
2023

Abstract

Purpose: To determine whether comparative clinical studies demonstrate significant advantages of revision anterior cruciate ligament reconstruction (RACLR) combined with a lateral extra-articular procedure (LEAP), with respect to graft rupture rates, knee stability, return to sport rates, and patient-reported outcome measures, compared with isolated RACLR. Methods: A systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews & Meta-Analyses Guidelines. A PubMed search was conducted using the key words "revision anterior cruciate ligament reconstruction" combined with any of the following additional terms, "lateral extra-articular tenodesis" OR "anterolateral ligament reconstruction" OR "Lemaire." All relevant comparative clinical studies were included. Key clinical data were extracted and evaluated. Results: Eight comparative studies (seven Level III studies and a one Level IV study) were identified and included. Most studies reported more favorable outcomes with combined procedures with respect to failure rates (0%-13% following RACLR+LEAP, and 4.4%-21.4% following isolated RACLR), postoperative side-to-side anteroposterior laxity difference (1.3-3.9 mm following RACLR+LEAP and 1.8-5.9 mm following isolated RACLR), and high-grade pivot shift (0%-11.1% following RACLR+LEAP and 10.2%-23.8% in patients following isolated RACLR). There were no consistent differences between isolated and combined procedures with respect to return to sport or patient-reported outcome measures. Conclusions: This systematic review demonstrates that the addition of a LEAP to RACLR was associated with an advantage with respect to ACL graft failure rates and avoidance of high-grade postoperative knee laxity across almost all included studies. Level of evidence: IV, Systematic review of level III to IV studies.
2023
anterior; cruciate; ligament; revision; lateral; extra-articular; procedure
01 Pubblicazione su rivista::01g Articolo di rassegna (Review)
Anterior cruciate ligament revision plus lateral extra-articular procedure results in superior stability and lower failure rates than does isolated anterior cruciate ligament revision but shows no difference in patient-reported outcomes or return to sports / Saithna, Adnan; Monaco, Edoardo; Carrozzo, Alessandro; Marzilli, Fabio; Cardarelli, Silvia; Lagusis, Benson; Rossi, Giorgio; Dutra-Vieira, Thais; Ferretti, Andrea; Sonnery-Cottet, Bertrand. - In: ARTHROSCOPY. - ISSN 0749-8063. - (2023), pp. 1-11. [10.1016/j.arthro.2022.12.029]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1667789
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