Lateral extra-articular tenodesis and anterolateral procedures

KEY POINTS Combined injuries involving the anterior cruciate ligament (ACL) and anterolateral structures have been found to result in greater rotational instability, necessitating a reevaluation of lateral extra-articular procedures (LEAPs). LEAPs show promising results in certain populations and warrant consideration as a valu- able adjunct to ACL reconstruction (ACLR) to achieve satisfactory outcomes, particularly in high-risk populations. The addition of LEAPs, such as nonanatomic lateral extra-articular tenodesis or anatomic anterolateral ligament reconstruction, to ACLR has demonstrated significant advantages in specific patient populations.