Are there any complications after lateral extra-articular tenodesis in anterior cruciate ligament reconstruction? – a systematic review

Abstract Introduction Lateral extra-articular tenodesis (LET) is a surgical technique that can be used in conjunction with anterior cruciate ligament reconstruction (ACLR), improving rotational stability and reducing the risk of anterior cruciate ligament (ACL) re-rupture. However, as with any surgi...

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Main Authors: Jan Zabrzyński, Jakub Erdmann, Maria Zabrzyńska, Łukasz Łapaj, Shahbaz S. Malik, Adam Kwapisz
Format: Article
Language:English
Published: BMC 2025-05-01
Series:Journal of Orthopaedic Surgery and Research
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Online Access:https://doi.org/10.1186/s13018-025-05880-3
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author Jan Zabrzyński
Jakub Erdmann
Maria Zabrzyńska
Łukasz Łapaj
Shahbaz S. Malik
Adam Kwapisz
author_facet Jan Zabrzyński
Jakub Erdmann
Maria Zabrzyńska
Łukasz Łapaj
Shahbaz S. Malik
Adam Kwapisz
author_sort Jan Zabrzyński
collection DOAJ
description Abstract Introduction Lateral extra-articular tenodesis (LET) is a surgical technique that can be used in conjunction with anterior cruciate ligament reconstruction (ACLR), improving rotational stability and reducing the risk of anterior cruciate ligament (ACL) re-rupture. However, as with any surgical procedure, LET carries a risk of complications. Despite numerous articles published in recent decades discussing LET in the context of ACLR, relatively few complications associated with the LET procedure have been documented in the literature. This study aimed to systematically review adverse events associted with the LET procedure when combined with ACLR. Material and methods The following key terms were used: (extra-articular OR extraarticular) AND (tenodesis OR plasty OR augmentation OR procedure or reconstruction OR reconstructive OR surgical OR surgery OR technique) AND (ACL OR anterior cruciate ligament), with no limits regarding the year of publication in PubMed, ScienceDirect, Cochrane Central, Web of Science, and Embase databases. English-language clinical human studies with evidence levels I-IV were included. Results This analysis evaluated seven articles published between 1999 and 2023. Level IV evidence was identified in the majority of studies (n = 5), level III evidence was found in one (n = 1), and level I evidence was noted in another (n = 1). Nine distinct types of complications were identified with rates rangingfrom 0.6% to 17% across the analysed studies. The modified Lemaire technique had the highest complication rate, reaching 7.5%. Overall, the complication rate across all reviewed LET techniques in this study was 4.2%. Conclusion This is the first study to systematically document the occurrence of complications in LET. The most common problems included LET hardware irritation – predominantly after staple fixation, and subsequent removal, haematoma over the LET site, and pain over the LET site. The analysed studies show that combining LET with ACLR appears to be a safe procedure associated with infrequent and mild side effects.
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spelling doaj-art-b854054a46aa41f48b7b3fc7d99b3db32025-08-20T01:49:40ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2025-05-012011910.1186/s13018-025-05880-3Are there any complications after lateral extra-articular tenodesis in anterior cruciate ligament reconstruction? – a systematic reviewJan Zabrzyński0Jakub Erdmann1Maria Zabrzyńska2Łukasz Łapaj3Shahbaz S. Malik4Adam Kwapisz5Department of Orthopaedics and Traumatology, Faculty of Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in ToruńDepartment of Orthopaedics and Traumatology, Faculty of Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in ToruńDepartment of Family Medicine, Collegium Medicum, Nicolaus Copernicus UniversityDepartment of General Orthopaedics, Musculoskeletal Oncology and Trauma Surgery, University of Medical SciencesWorcestershire Acute Hospitals NHS TrustClinic of Orthopedics and Pediatric Orthopedics, Medical University of ŁódźAbstract Introduction Lateral extra-articular tenodesis (LET) is a surgical technique that can be used in conjunction with anterior cruciate ligament reconstruction (ACLR), improving rotational stability and reducing the risk of anterior cruciate ligament (ACL) re-rupture. However, as with any surgical procedure, LET carries a risk of complications. Despite numerous articles published in recent decades discussing LET in the context of ACLR, relatively few complications associated with the LET procedure have been documented in the literature. This study aimed to systematically review adverse events associted with the LET procedure when combined with ACLR. Material and methods The following key terms were used: (extra-articular OR extraarticular) AND (tenodesis OR plasty OR augmentation OR procedure or reconstruction OR reconstructive OR surgical OR surgery OR technique) AND (ACL OR anterior cruciate ligament), with no limits regarding the year of publication in PubMed, ScienceDirect, Cochrane Central, Web of Science, and Embase databases. English-language clinical human studies with evidence levels I-IV were included. Results This analysis evaluated seven articles published between 1999 and 2023. Level IV evidence was identified in the majority of studies (n = 5), level III evidence was found in one (n = 1), and level I evidence was noted in another (n = 1). Nine distinct types of complications were identified with rates rangingfrom 0.6% to 17% across the analysed studies. The modified Lemaire technique had the highest complication rate, reaching 7.5%. Overall, the complication rate across all reviewed LET techniques in this study was 4.2%. Conclusion This is the first study to systematically document the occurrence of complications in LET. The most common problems included LET hardware irritation – predominantly after staple fixation, and subsequent removal, haematoma over the LET site, and pain over the LET site. The analysed studies show that combining LET with ACLR appears to be a safe procedure associated with infrequent and mild side effects.https://doi.org/10.1186/s13018-025-05880-3LET complicationsLateral extra-articular tenodesisTenodesisACL reconstructionLateral knee ligamentsLemaire technique
spellingShingle Jan Zabrzyński
Jakub Erdmann
Maria Zabrzyńska
Łukasz Łapaj
Shahbaz S. Malik
Adam Kwapisz
Are there any complications after lateral extra-articular tenodesis in anterior cruciate ligament reconstruction? – a systematic review
Journal of Orthopaedic Surgery and Research
LET complications
Lateral extra-articular tenodesis
Tenodesis
ACL reconstruction
Lateral knee ligaments
Lemaire technique
title Are there any complications after lateral extra-articular tenodesis in anterior cruciate ligament reconstruction? – a systematic review
title_full Are there any complications after lateral extra-articular tenodesis in anterior cruciate ligament reconstruction? – a systematic review
title_fullStr Are there any complications after lateral extra-articular tenodesis in anterior cruciate ligament reconstruction? – a systematic review
title_full_unstemmed Are there any complications after lateral extra-articular tenodesis in anterior cruciate ligament reconstruction? – a systematic review
title_short Are there any complications after lateral extra-articular tenodesis in anterior cruciate ligament reconstruction? – a systematic review
title_sort are there any complications after lateral extra articular tenodesis in anterior cruciate ligament reconstruction a systematic review
topic LET complications
Lateral extra-articular tenodesis
Tenodesis
ACL reconstruction
Lateral knee ligaments
Lemaire technique
url https://doi.org/10.1186/s13018-025-05880-3
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