Hollyer Ian, Sholtis Connor, Loughran Galvin, Raji Yazdan, Akhtar Muzammil, Smith Patrick A, Musahl Volker, Verdonk Peter C M, Sonnery-Cottet Bertrand, Getgood Alan, Sherman Seth L
Department of Orthopaedic Surgery, Stanford University Medical Center, Palo Alto, CA, USA.
Department of Orthopaedic Surgery, Stanford University Medical Center, Palo Alto, CA, USA.
J ISAKOS. 2024 Dec;9(6):100356. doi: 10.1016/j.jisako.2024.100356. Epub 2024 Oct 30.
To survey the ACL study group (ACLSG) members to determine the current practice patterns surrounding the use and methodology of lateral extra-articular procedures (LEAPs), including anterolateral ligament reconstruction (ALLR) or lateral extra-articular tenodesis (LET) during ACL reconstruction (ACLR).
A web-based questionnaire was distributed to members of the ACLSG during the 2016, 2018, 2020, and 2023 biennial meetings. Questions explored the indications and techniques when incorporating LEAPs in ACLR.
Analysis of survey responses found that the reported use of LEAPs in both primary and revision ACLR increased between 2016 and 2023 and that surgeons were using lateral augmentation more frequently over time. Surgical techniques were stable across survey years, with most surgeons using iliotibial band (ITB) autograft attached at Gerdy's tubercle, passed under the lateral collateral ligament (LCL), and anchored proximal/posterior to the lateral femoral epicondyle.
Survey responses demonstrate that LEAPs are becoming more common among ACL surgeons in the ACL SG, with the modified Lemaire LET being the predominant technique. This aligns with recent clinical studies showing improved outcomes and reduced risk of failure in ACLR with lateral augmentation compared to ACLR alone.
Level V, Expert Opinion.
对前交叉韧带研究组（ACLSG）成员进行调查，以确定当前围绕外侧关节外手术（LEAPs）的使用和方法的实践模式，包括在 ACL 重建（ACLR）过程中的前外侧韧带重建（ALLR）或外侧关节外腱固定术（LET）。
在 2016 年、2018 年、2020 年和 2023 年的两年一次会议期间，向 ACLSG 成员发放了一份基于网络的调查问卷。问题探讨了在 ACLR 中纳入 LEAPs 的适应症和技术。
对调查回复的分析发现，2016 年至 2023 年期间，在初次和翻修 ACLR 中报告的 LEAPs 使用情况有所增加，并且随着时间的推移，外科医生更频繁地使用外侧增强术。在不同调查年份，手术技术保持稳定，大多数外科医生使用附着于 Gerdy 结节的髂胫束（ITB）自体移植物，从外侧副韧带（LCL）下方穿过，并固定于股骨外侧髁近端/后方。
调查回复表明，LEAPs 在 ACLSG 的 ACL 外科医生中越来越普遍，改良的 Lemaire LET 是主要技术。这与最近的临床研究结果一致，该研究表明与单独的 ACLR 相比，ACLR 联合外侧增强术可改善预后并降低失败风险。
V 级，专家意见。
