Objectives: Anterior cruciate ligament reconstruction (ACLR) in adolescents poses a unique challenge due to their high rates of reinjury and increased participation in high risk sports. The addition of a Lateral Extraarticular Tenodesis (LEAT) has gained popularity in augmenting ACLR in high risk cases. However, its effect on patient reported outcomes (PROMs), specifically regarding pain and psychological readiness, remains unclear in adolescent populations. This study aimed to assess whether the addition of LEAT influences postoperative pain and confidence levels at 9 months post surgery. The hypothesis was that there would be no significant difference in these outcomes between adolescents undergoing ACLR with and without LEAT. Methods: A retrospective matched cohort analysis was performed including 238 adolescent patients who underwent ACL reconstruction, with 79 receiving additional LEAT and 159 undergoing isolated ACLR. The groups were matched based on age, gender, BMI and hamstring graft usage. International Knee Documentation Committee (IKDC) score, Lysholm score, Tegner activity scale and the Anterior Cruciate Ligament Return to Sport after Injury (ACL-RSI) scores were collected preoperatively and at 9 months postoperatively. The primary outcome was the change in PROMs from baseline to 9 months postop, which was analysed by using the Mann-Whitney U test between the two groups. Results: Both groups demonstrated significant improvement in PROMs from preoperative scores to 9 month follow up. When comparing the two groups, there was no statistically significant difference in the improvement in IKDC, Lysholm or Tegner scores between the LEAT and non-LEAT groups. A borderline trend toward improved psychological readiness, as measured by the ACL-RSI score, was observed in the LEAT group, though this did not reach statistical significance. Conclusions: The findings suggest that the addition of LEAT does not significantly alter short-term pain or confidence levels in adolescents following ACLR.
Pradyumna et al. (Tue,) studied this question.