| Title: |
POST-OPERATIVE STABILITY VARIES WITH DIFFERENT LATERAL EXTRA-ARTICULAR TENODESIS TECHNIQUES IN PRIMARY ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION: A SYSTEMATIC REVIEW. |
| Authors: |
MAMERI, E. S.; JACKSON, G. R.; KERZNER, B.; CONDON, J. J.; DE WALD, D.; KHAN, Z. A.; KAPLAN, D. J.; FAMILIARI, F.; RUSSO, A.; ALLAHABADI, S.; SUGRAÑES, J.; KNAPIK, D. M.; LA PRADE, R. F.; VERMA, N. N.; CHAHLA, J. |
| Source: |
Joints; 2023, Issue 1, p1-12, 12p |
| Subject Terms: |
TENODESIS; ANTERIOR cruciate ligament surgery; SUTURING; TISSUE fixation (Histology); POSTOPERATIVE pain |
| Abstract: |
Objective: This study aimed to systematically review and compare the post-operative stability of lateral extra-articular tenodesis (LET) techniques based on fixation type in the setting of primary anterior cruciate ligament (ACL) reconstructions. Materials and Methods: Scopus, PubMed, and EMBASE databases were queried from database inception through August 2022, using 2020 PRISMA guidelines. Level I to IV human clinical studies that evaluated patient-reported out-comes and post-operative stability following primary ACL reconstruction with a LET were included. Pa-tients were divided into three groups based on the LET fixation technique: proximal bony fixation, distal bony fixation, and soft-tissue fixation. A methodological quality assessment of the included studies was performed using the Newcastle-Ottawa Scale and the National Institute of Health Quality Assessment. Results: Twenty-nine studies (30 cohorts), consisting of 2,545 patients (mean age range: 11.2-48 years) were identified. Mean follow-up ranged from 12 to 294 months. Forty percent (n = 1,019) of patients underwent soft-tissue fixation, while 37.1% (n = 945) underwent proximal bony and 22.8% (n = 581) distal bony LET fixation, in combination with ACL reconstruction. A residual pivot-shift finding was more commonly reported following distal bony fixation relative to the proximal bony (p = 0.037) and soft-tissue (p = 0.0002) fixation, whereas no significant difference was observed between the proximal bony vs. soft-tissue fixation (p = 0.081). The residual objective anterior translation was greater following bony distal fixation when compared to proximal bony (p = 0.036) and soft-tissue fixation (p = 0.001), while no difference was found between proximal bony vs. soft-tissue fixation (p = 0.159). A residual positive Lachman was less frequently reported following proximal bony fixation relative to distal bony (p = 0.001) and soft-tissue (p = 0.028) fixation groups, with no difference between distal bony vs. soft-tissue fixation (p = 0.171). Conclusions: Proximal bony and soft tissue fixation techniques result in lower reported rates of residual anterior and rotational instability relative to distal bony fixation techniques. [ABSTRACT FROM AUTHOR] |
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| Database: |
Complementary Index |