ACL RECONSTRUCTION WITH LET IN FOOTBALLERS

ACL PLUS LET

1. Enhancing Stability and Outcomes in Young Footballers: The Synergistic Effect of ACL Reconstruction With Lateral Extra-Articular Tenodesis Dr.Arumugam S Dr.Suresh Perumal Dr.Parthiban V.J Dr.A.K.Sanjay Dr.Vignesh M Dr.Praveen R Dr.Krishnan N Department of Arthroscopy and Sports Medicine, Sri Ramachandra Institute of Higher Education and Research, Chennai , Tamil Nadu, India

2. P ossibility of graft failure is high in young footballers Anterolateral knee soft tissue structures injury Isolated ACL reconstruction doesn’t address this issue. LET methods were developed to treat the anterolateral otatory laxity. Provides an extra articular constriant to tibial internal rotation Significantly reduced graft failure rates

3. AIM The objective of this study was to assess the clinical results, return to sports, and graft failure rates in young footballers undergoing combined ACL reconstruction and LET

4. METHODOLOGY Prospective study 22 Male footballers aged 18-24 Underwent ACL reconstruction + LET Standardised surgical technique, rehabilitation protocol and clinical protocol Clinical findings at 6 month and 1 year studied through International Knee Documentation Committee (IKDC) Subjective Knee Form and Tegner-Lysholm Knee Scoring Scale. Graft failure and contralateral ACL tears were recorded.

5. SURGICAL TECHNIQUE P osterolateral hockey stick incision on the left knee and exposure of the iliotibial band is performed before harvest of the graft Harvest of the lateral extra-articular tenodesis graft from the iliotibial band is performed on the operative leg

6. SURGICAL TECHNIQUE F ibular collateral ligament has been identified and the iliotibial band graft should be passed beneath it. P roximal fixation of the iliotibial band graft is performed with a 2.8 mm double-loaded all-suture anchor

7. SURGICAL TECHNIQUE From the lateral view on the left knee, image shows post-anterior cruciate ligament reconstruction with lateral extra-articular tenodesis .

8. RESULTS Post-operative right knee X-ray antero -posterior view of the patient showing post-anterior cruciate ligament reconstruction with lateral extra-articular tenodesis Post-operative photograph of the athlete showing achievement of full range of motion.

9. DISCUSSION Procedure Advantages Disadvantages Isolated ACL reconstruction Well-established and widely accepted technique Does not address rotational stability and increased strain on the graft ACL reconstruction with LET Allows for anatomic graft placement Avoids additional surgical dissection and hardware Provides additional rotational stability Reduced risk of residual pivot-shift phenomenon Decreased strain on the ACL graft Theoretical reduced risk of graft failure and re-rupture Higher risk of residual pivot-shift phenomenon Potential for graft failure and re-rupture More invasive and technically demanding procedure Potential for over-constraint and loss of knee range of motion Increased surgical time and complications Additional hardware (e.g., bone staples, screws) required

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