Additional lateral extra-articular tenodesis in revision ACL reconstruction does not influence the outcome of patients with low-grade anterior knee laxity

Introduction There is limited evidence on the indications of lateral extra-articular tenodesis (LET) in revision ACLR. The aim of this study was to evaluate the influence of the LET in patients with revision ACLR with preoperative low-grade anterior knee laxity. Methods Between 2013 and 2018, 78 patients who underwent revision ACLR with preoperative low-grade anterior knee laxity [<= 5 mm side-to-side difference (SSD)] were included in the retrospective cohort study. An additional modified Lemaire tenodesis was performed in 23 patients during revision ACLR and patients were clinically examined with a minimum of 2 years after revision surgery. Postoperative failure of the revision ACLR was defined as SSD in Rolimeter(R) testing >= 5 mm or pivot-shift grade 2/3. Results In total, failure of the revision ACLR occurred in 11.5% (n = 9) of the cases at a mean follow-up of 28.7 +/- 8.8 (24-67) months. Patients with an additional LET and revision ACLR did not show a significantly reduced failure rate (13% vs. 11%) or an improved clinical outcome according to the postoperative functional scores or pain in regards to patients with an isolated revision ACLR (Tegner 5.7 +/- 1.3 vs. 5.9 +/- 1.5, n.s.; IKDC 77.5 +/- 16.2 vs. 80.1 +/- 14.9, n.s., Lysholm 81.9 +/- 14.2 vs. 83.8 +/- 14.5, n.s.; VAS 1.9 +/- 2.2 vs. 1.2 +/- 1.7, n.s.). Conclusions An additional LET in patients with revision ACLR with low-grade anterior knee laxity does not influence patient-related outcomes or failure rates. Subjects with preoperative low-grade anterior knee laxity may not benefit from a LET in revision ACLR.