Reconstrução Primária Do Ligamento Cruzado Anterior Associada À Tenodese Extra-Articular Lateral Versus Reconstrução Isolada: Uma Revisão Sistemática

This systematic review compared primary anterior cruciate ligament reconstruction (ACLR) combined with lateral extra-articular tenodesis (LET) versus isolated ACLR, assessing graft failure, knee stability, functional outcomes, return to sport, and complications. The review followed the PRISMA 2020 recommendations, with searches conducted in PubMed/MEDLINE, LILACS, and SciELO without date restrictions. Comparative clinical studies were included, and risk of bias was assessed using the RoB 2 and ROBINS-I tools. Of 62 records identified, 12 publications were included. Overall, LET was associated with lower graft failure rates and improved rotational stability, particularly in young patients, athletes participating in pivoting sports, and individuals with high-grade pivot shift. Benefits regarding functional outcomes and return to sport were less consistent. No relevant overall increase in complications was observed, while findings regarding graft maturation and long-term degenerative changes were conflicting. In conclusion, LET may represent a complementary strategy to primary ACLR, particularly in patients at higher risk of failure or rotational instability, and its indication should be individualized.