Researchers in London have reached some very encouraging conclusions when it comes to one of the more common knee injuries suffered by athletes.
According to a study by researchers at the Lawson Health Research Institute, a surgical procedure called lateral extra-articular tenodesis (LET) can reduce the risk of re-injury in young people who have had reconstructive surgery on a torn anterior cruciate ligament (ACL). When an ACL tear is fixed with surgery, there is a high risk of re-injury among patients under the age of 25. By performing the LET procudure, a new ligament-like structure is created outside the knee to offer additional support.
“Although the LET procedure has shown potential in improving patient outcomes, a randomized clinical trial was needed to assess whether or not it reduces the risk of re-injury,” said Dr. Alan Getgood, a scientist at Lawson and orthopaedic knee surgeon at the Fowler Kennedy Sport Medicine Clinic.
The study looked at 624 research participants from nine centres across Canada and Europe. Of those, 196 were patients from the Fowler Kennedy Sport Medicine Clinic who were treated at the London Health Sciences Centre. Participants were under the age of 25, undergoing ACL reconstruction using a hamstring graft and at high risk for re-injury. Half of the participants received ACL reconstruction without LET, and the other half received ACL reconstruction with the additional LET procedure. Re-injury occurred in 11 per cent of patients receiving the standard of care compared to only four per cent of patients who received ACL reconstruction with LET.
“Adding the LET procedure resulted in a 65 per cent relative risk reduction for graft failure,” said Dr. Getgood. “Our results suggest patients under the age of 25 should consider the LET procedure when they have decided on ACL reconstruction using a hamstring graft.”
Researchers also found the patients that underwent the LET procedure resulted in slightly higher levels of post-operative pain and slightly decreased muscle strength in the three months following surgery, but these complications did not persist. There were no differences in outcomes one and two years after surgery.
