Specialized Toolkit Series: ACL Reconstruction-Lateral Extra-Articular Tenodesis

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Video Summary

This presentation outlines the modified LAMIRE technique for lateral extra-articular tenodesis (LAT), commonly performed alongside ACL reconstruction. Despite advancements in ACL techniques, many patients experience persistent rotatory laxity. LAT helps reduce pivot shift and graft failure. Indications include patients under 25, those with high-grade pivot shift, generalized ligamentous laxity, increased posterior tibial slope, meniscal deficiency, participation in pivoting sports, and ACL reconstruction revisions. Benefits include improved rotational stability and reduced graft ruptures, though risks like lateral compartment over-constraint and postoperative hematoma exist. The STABILITY trial corroborates the efficacy of LAT in reducing ACL graft failures.

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Jason Ina, M.D. | Brandon Cabarcas, M.D. | Aaron Krych, M.D.
Mayo Clinic, Rochester, MN

Keywords

LAMIRE technique

lateral extra-articular tenodesis

ACL reconstruction

rotational stability

graft rupture

STABILITY trial