The Role of an Extra-Articular Tenodesis in Revision of Anterior Cruciate Ligament Reconstruction

Abstract

Patients who present for anterior cruciate ligament (ACL) revision with a high-grade pivot shift at the time of an index ACL revision procedure and subsequent reconstruction failure or a high-grade pivot shift at revision surgery, patients with generalized joint laxity, and those requiring softs tissue grafts should be considered candidates for lateral tenodesis to supplement intraarticular graft revision. Although there is no consensus regarding the optimal lateral tenodesis technique, due to the tibial positioning associated with tensioning and fixation of extra-articular procedures, a lateral tenodesis should not be used in patients with posterolateral corner injuries or lateral compartment articular disease.

Keywords: ACL revision; Anterolateral ligament; Extra-articular tenodesis; High-grade laxity; Iliotibial tract; Pivot shift.