Functional Outcomes of ACL Reconstruction with Lateral Extra-articular Tenodesis Using Modified Lemaire Procedure Versus Modified MacIntosh Procedure: A Systematic Review

Abstract

Introduction: There is a wide variety of operating procedures for the treatment of ACL rupture with a variety of different functional outcomes. The purpose of this study was to systematically review the functional outcomes between two lateral extraarticular tenodesis (LET) procedures compared to Anterior Cruciate Ligament Reconstruction (ACLR) alone in studies with high levels of evidence. Two LET procedure was Modified Lemaire procedure and MacIntosh modified by Cocker-Arnold procedure. Methods: We performed a literature search for clinical studies comparing the two LET as an augmentation to ACL reconstruction with ACL reconstruction alone. The primary outcomes were the International Knee Documentation Committee (IKDC) score, the Lysholm score, and graft failures. We filtered all literature use inclusion and exclusion criteria to get the best quality literature that match with purpose of this study. Result: A systematic literature search was conducted online in July 2022. A total of 123 records were excluded, based on abstract and title screening. This selection process resulted in the final 6 articles for inclusion in the systematic review. The best functional outcomes were obtained from the ACL reconstruction procedure with the addition of the LET procedure, whereas between the two LET procedures did not give different results. Conclusion: ACL reconstruction with the addition of the LET procedure can maintain better rotational stability so as to reduce the incidence of graft failure and will provide better functional results compared to ACL reconstruction alone. However, the two LET procedures do not show different functional outcomes because they have the same role, which is to increase the rotational stability of the knee joint.