Comparative Analysis of the Results of Lateral Extra-Articular Tenodesis in Anatomical Anterograde Plasty of the Anterior Cruciate Ligament

Abstract

AIM OF STUDY To analyze the results of lateral extra-articular tenodesis (LET) of the semitendinosus muscle tendon (STMT) and iliotibial tract (ITT) in patients with severe anterior rotational instability of the knee joint during anatomical anterograde reconstruction of the anterior cruciate ligament (rACL) with a BTB graft. MATERIAL AND METHODS We studied 138 patients with the Pivot shift test – 3+ and the Lachman test 2+ or 3+ degree after arthroscopic rACL with a BTB autograft. In 65 cases (47.1%) rACL was supplemented with LET of STMT (group 1), the remaining 73 patients (52.9%) – LET of ITT (group 2). RESULTS According to IKDC-2000, KOSS and Lysholm-Tegner scores, the groups did not differ statistically. However, pain in the LET zone, LET failure with the appearance of the Pivot shift test – 1+, revision reconstructions – were more often observed in group 2 (p<0.05). Popliteal hematomas (p<0.001), longer operations (p<0.01) were more often observed in group 1. CONCLUSION Lateral extra-articular tenodesis is a clinically effective addition to anatomical anterograde reconstruction of the anterior cruciate ligament with BTB autograft in patients with Pivot shift test 3+ and Lachman test 2+ or 3+. However, a more reliable option is lateral extra-articular tenodesis of the semitendinosus muscle tendon. At the same time, lateral extra-articular tenodesis of the iliotibial tract is a simpler, faster and more cost-effective technique, still demonstrating good indicators of knee joint stability.