Combined ACL Reconstruction Surgery with Lateral Extra - articular Procedure

Torn Anterior Cruciate Ligament (ACL) can occur in anyone, especially in athletes constantly using their knees changing directions.  If the ACL is torn, the knees will be loosened and unable to work normally. It can also create injuries in other parts of the knee, such as meniscus tear and articular cartilage injury, resulting in untimely knee degeneration.  Therefore, ACL reconstruction is a must, especially for athletes.  Key-hole surgery for ACL reconstruction helps restore pro-level career once again.

In some cases, the surgeon may recommend a combined ACL reconstruction surgery with Lateral Extra-articular procedure, such as Lateral Extra – Articular Tenodesis (LET) or Anterolateral Ligament Reconstruction (ALL – R), to reduce further re-injuries of ACL in the athletes.

Who Needs A Combined ACL Reconstruction with Lateral Extra-articular Procedure?

Specialists may recommend Lateral Extra-articular Procedure if there are any of the following indications:

• Generalized Laxity
• High-Grade Pivot Shift
• Knee Hyperextension
• Increase Posterior Tibial Slope
• Young Athletes Returning to a Pivoting Sport
• Revision ACL Reconstruction

Benefits of LET and ALL-R

Studies have shown that anterolateral complex (ALC) is integral to the stability of the knee joints, especially to protect from rotary knee injury secondary to the ACL. In addition, concomitant ALC and ACL injuries have been observed.

Lateral Extra-articular procedure in conjunction with ACL reconstruction helps stabilize knee joints and reduce load to the ACL. Studies in younger patients with a high risk of re-injury to the ACL showed that LET/ALL-R help reduce the chance of reinjury to the ACL after surgery up to 3 times.

Moreover, rehabilitation and physical therapy after LET/ALL-R, in addition to ACLR, are required in the same manner. A team of multidisciplinary sports medicine specialists will design rehabilitation programs suitable for each individual after surgery.

What We Should Know About Lateral Extra-articular Procedure

• Additional procedure can take some time, and special equipment is necessary

• There will be some surgical incisions on the outer knee

• Some complications include hematoma or over-constraint from mal-position or over-tension

Nevertheless, whether treatment requires ACL Reconstruction surgery and LET/ALL-R, they aim for the best outcome for the patients and athletes as per FIFA Medical Centre of Excellence standards. A sports medicine professional specializing in arthroscopic knee surgery will consider multiple factors affecting the patient to assess and offer consultant regarding the most suitable treatment selection for each patient so they can return to their athletic endeavours with full potential again.