Functional Outcome of Lateral Extraarticular Tenodesis with Anterior Cruciate Ligament Reconstruction Using Modified Lemaire's Procedure: A Prospective Study
Aims and background: The standard arthroscopic intraarticular anterior cruciate ligament (ACL) reconstruction with various grafts and techniques has failure rates of up to 16%. Modified Lemaire's technique is one procedure done to reduce the rate of revision ACL surgeries by adding a tenodesis...
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| Format: | Article |
| Language: | English |
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Jaypee Brothers Medical Publisher
2024-06-01
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| Series: | Journal of Orthopedics and Joint Surgery |
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| Online Access: | https://www.jojs.in/doi/JOJS/pdf/10.5005/jojs-10079-1150 |
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| author | Varrdhaman H Dhariwal Mathan C Kumar Elayaraja Mani Sukumaran S Subramanian |
| author_facet | Varrdhaman H Dhariwal Mathan C Kumar Elayaraja Mani Sukumaran S Subramanian |
| author_sort | Varrdhaman H Dhariwal |
| collection | DOAJ |
| description | Aims and background: The standard arthroscopic intraarticular anterior cruciate ligament (ACL) reconstruction with various grafts and techniques has failure rates of up to 16%. Modified Lemaire's technique is one procedure done to reduce the rate of revision ACL surgeries by adding a tenodesis laterally, thereby reducing anterolateral laxity. This study has been done to analyze the functional outcome of modified Lemaire's procedure in a 2-year follow-up period.
Materials and methods: A prospective outcome study involving 30 patients who underwent modified Lemaire's procedure with ACL reconstruction in the Department of Orthopedics in Stanley Medical College and Hospital, Chennai, Tamil Nadu, India, were followed up in 6 months, 1 year, and 2 years and their preoperative (pre-op) and postoperative (post-op) pivot shift score, Tegner–Lysholm scoring and International Knee Documentation Committee (IKDC) scoring were analyzed.
Results: All 30 patients who have undergone modified Lemaire's procedure have improved post-op Tegner–Lysholm scores and IKDC scores and reduced pivot shift scores. A statistically significant difference in mean between pre-op Lysholm and at 6 months Lysholm, at 1- and 2-year Lysholm with a <i>p</i>-value of <0.05.
Conclusion: Improved post-op Tegner–Lysholm scoring and IKDC scoring show that the modified Lemaire's technique is a good procedure to reduce the rate of revision ACL surgeries. This procedure also addresses the anterolateral deficiency by reducing the prevalence of pivot-shift.
Clinical significance: By adding modified Lemaire's procedure to ACL reconstruction, we can augment the ACL reconstruction and reduce the anterolateral laxities in patients with high-grade pivot shift. |
| format | Article |
| id | doaj-art-b57457d9b70541208c33c464cac9a0c3 |
| institution | Kabale University |
| issn | 2582-7863 |
| language | English |
| publishDate | 2024-06-01 |
| publisher | Jaypee Brothers Medical Publisher |
| record_format | Article |
| series | Journal of Orthopedics and Joint Surgery |
| spelling | doaj-art-b57457d9b70541208c33c464cac9a0c32025-02-07T11:18:35ZengJaypee Brothers Medical PublisherJournal of Orthopedics and Joint Surgery2582-78632024-06-016211411810.5005/jojs-10079-11506Functional Outcome of Lateral Extraarticular Tenodesis with Anterior Cruciate Ligament Reconstruction Using Modified Lemaire's Procedure: A Prospective StudyVarrdhaman H Dhariwal0https://orcid.org/0000-0001-8700-9603Mathan C Kumar1https://orcid.org/0009-0008-4967-9698Elayaraja Mani2https://orcid.org/0009-0002-4618-2455Sukumaran S Subramanian3https://orcid.org/0009-0007-3152-6282Varrdhaman H Dhariwal, Department of Orthopedics, Stanley Medical College and Hospital, Chennai, Tamil Nadu, India, Phone: +91 9444045056Department of Orthopedics, Stanley Medical College and Hospital, Chennai, Tamil Nadu, IndiaDepartment of Orthopedics, Stanley Medical College and Hospital, Chennai, Tamil Nadu, IndiaDepartment of Orthopedics, Stanley Medical College and Hospital, Chennai, Tamil Nadu, IndiaAims and background: The standard arthroscopic intraarticular anterior cruciate ligament (ACL) reconstruction with various grafts and techniques has failure rates of up to 16%. Modified Lemaire's technique is one procedure done to reduce the rate of revision ACL surgeries by adding a tenodesis laterally, thereby reducing anterolateral laxity. This study has been done to analyze the functional outcome of modified Lemaire's procedure in a 2-year follow-up period. Materials and methods: A prospective outcome study involving 30 patients who underwent modified Lemaire's procedure with ACL reconstruction in the Department of Orthopedics in Stanley Medical College and Hospital, Chennai, Tamil Nadu, India, were followed up in 6 months, 1 year, and 2 years and their preoperative (pre-op) and postoperative (post-op) pivot shift score, Tegner–Lysholm scoring and International Knee Documentation Committee (IKDC) scoring were analyzed. Results: All 30 patients who have undergone modified Lemaire's procedure have improved post-op Tegner–Lysholm scores and IKDC scores and reduced pivot shift scores. A statistically significant difference in mean between pre-op Lysholm and at 6 months Lysholm, at 1- and 2-year Lysholm with a <i>p</i>-value of <0.05. Conclusion: Improved post-op Tegner–Lysholm scoring and IKDC scoring show that the modified Lemaire's technique is a good procedure to reduce the rate of revision ACL surgeries. This procedure also addresses the anterolateral deficiency by reducing the prevalence of pivot-shift. Clinical significance: By adding modified Lemaire's procedure to ACL reconstruction, we can augment the ACL reconstruction and reduce the anterolateral laxities in patients with high-grade pivot shift.https://www.jojs.in/doi/JOJS/pdf/10.5005/jojs-10079-1150anterior cruciate ligamentanterolateral rotatory instabilitylateral extraarticular tenodesismodified lemaire'sprospective outcome studypivot shift. |
| spellingShingle | Varrdhaman H Dhariwal Mathan C Kumar Elayaraja Mani Sukumaran S Subramanian Functional Outcome of Lateral Extraarticular Tenodesis with Anterior Cruciate Ligament Reconstruction Using Modified Lemaire's Procedure: A Prospective Study Journal of Orthopedics and Joint Surgery anterior cruciate ligament anterolateral rotatory instability lateral extraarticular tenodesis modified lemaire's prospective outcome study pivot shift. |
| title | Functional Outcome of Lateral Extraarticular Tenodesis with Anterior Cruciate Ligament Reconstruction Using Modified Lemaire's Procedure: A Prospective Study |
| title_full | Functional Outcome of Lateral Extraarticular Tenodesis with Anterior Cruciate Ligament Reconstruction Using Modified Lemaire's Procedure: A Prospective Study |
| title_fullStr | Functional Outcome of Lateral Extraarticular Tenodesis with Anterior Cruciate Ligament Reconstruction Using Modified Lemaire's Procedure: A Prospective Study |
| title_full_unstemmed | Functional Outcome of Lateral Extraarticular Tenodesis with Anterior Cruciate Ligament Reconstruction Using Modified Lemaire's Procedure: A Prospective Study |
| title_short | Functional Outcome of Lateral Extraarticular Tenodesis with Anterior Cruciate Ligament Reconstruction Using Modified Lemaire's Procedure: A Prospective Study |
| title_sort | functional outcome of lateral extraarticular tenodesis with anterior cruciate ligament reconstruction using modified lemaire s procedure a prospective study |
| topic | anterior cruciate ligament anterolateral rotatory instability lateral extraarticular tenodesis modified lemaire's prospective outcome study pivot shift. |
| url | https://www.jojs.in/doi/JOJS/pdf/10.5005/jojs-10079-1150 |
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