684 Lateral Extra-Articular Tenodesis Versus Anterolateral Ligament Reconstruction Lateral Augmentation for Primary Anterior Cruciate Ligament Reconstruction with Minimum 2- Year Follow-Up: A Systematic Review and Meta-Analysis

Abstract

Abstract Background Lateral augmentation (LA) of anterior cruciate ligament reconstruction (ACLR) aims to improve the anterolateral stability of the knee and patient functional outcomes while reducing complication rates. Despite growing evidence and popularity, there have been no studies directly comparing the main two methods of LA; Lateral extra-articular tenodesis (LEAT) and Anterolateral ligament reconstruction (ALLR). Aim To establish level I evidence by assessing studies with minimum two-years follow-up investigating LEAT and ALLR patient-reported outcome measures (PROM) and post-operative complications. Method This is a systematic review and meta-analysis conducted in accordance with the PRISMA guidelines. The primary investigators (AA/FS) on August 1st, 2022 undertook a comprehensive systematic review of electronic databases. Studies that met our inclusion criteria were selected. Results 14 studies were included in our study with a total of 2374 patients. 1273 patients were included in the LEAT studies (666 male, 607 female) and 1101 in the ALLR studies (818 male, 283 female). Statistically significant improved PROM were found in the LEAT group for postoperative International Knee Documentation Committee Scores (MD 2.31; 95% CI: 0.54 – 4.09, P = 0.01), Tegner Activity score (MD 0.79, 95% CI: 0.58 – 0.99, P<0.01), and for both the ALLR (MD 1.43, 95% CI: 0.33 – 2.52, P = 0.01) and LEAT (MD 4.07, 95% CI: 2.67 – 5.47, P<0.01) groups for Lysholm scores. LEAT and ALLR are associated with reduced graft re-rupture risk and improved postoperative knee stability. Conclusions LA is associated with improved PROM, knee stability, and functional outcomes when compared to iACLR. No differences were found between LEAT to ALLR.