Maimonides Evening of Research
Fellow Winner
Bhavya Sheth, MD
Department of Orthopedics and Rehabilitation
Impact of Lateral Extra-Articular Tenodesis on Return to Sports Following Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-Analysis
Objective
Anterior Cruciate Ligament Reconstruction (ACLR) has a high failure rate in young athletes and individuals participating in pivoting sports. Lateral extra-articular tenodesis (LET), specifically the modified Lemaire technique, has been increasingly used to enhance rotational stability, reduce graft rupture rates and potentially improve return to sports (RTS) outcomes. This systematic review and meta-analysis is aimed to compare RTS rates between athletes undergoing ACLR+LET versus ACLR alone.
Methods
A systematic review was conducted following PRISMA guidelines. A comprehensive search was performed in PubMed, Embase and Cochrane Central Register of Controlled Trials to identify studies referencing “Lateral Extra-Articular Tenodesis” and “Modified Lemaire” in the context of ACLR. Two independent researchers screened abstracts, reviewed full texts and extracted the data. Studies were included if they reported RTS outcomes for ACLR+LET compared to ACLR alone. A meta-analysis was performed, with p < 0.05 considered statistically significant.
Results
Of 1,861 studies screened, five met the inclusion criteria, comprising 858 patients (463 ACLR+LET, 395 ACLR alone). The RTS rate was 90.5% in the ACLR+LET group (419/463 patients) versus 79.49% in the ACLR-only group (314/395 patients). While RTS rates were relatively higher in the LET augmentation group, the difference was not statistically significant (OR: 4.55, 95% CI: 0.18–114.93, p = 0.36).
Conclusion
ACLR augmented with LET provides additional rotational stability and may contribute to improved RTS rates in athletes engaged in pivoting sports. However, current data does not demonstrate a statistically significant advantage in RTS outcomes. Further high-quality long-term studies are needed to determine whether LET augmentation offers a clinically meaningful benefit for high-risk athletes.