Lateral tenodesis procedures increase lateral compartment pressures more than anterolateral ligament reconstruction, when performed in combination with ACL reconstruction: a pilot biomechanical study

ObjectivesGiven the common occurrence of residual laxity and re-injury post anterior cruciate ligament reconstruction (ACLR), additional anterolateral procedures are increasingly used in combination with an ACLR. Despite perception that there is a risk over-constraining lateral tibiofemoral (LTF) compartment, potentially leading to osteoarthritis, assessment on their effect intra-articular compartment pressures still lacking. Our objective was therefore, through pilot biomechanical study, compare LTF contact after most commonly procedures.MethodsA controlled laboratory study performed using 4 fresh-frozen cadaveric whole lower limbs. Through 0° 90° flexion, were measured Tekscan sensor, located under meniscus. Knee kinematics obtained 3 conditions rotation (NR: neutral, ER: external IR: internal rotation) record position knees for each loading condition. A Motion Analysis system coordinate based CT scans 3D bone modelling used. After ACLR, defined as reference baseline, 5 compared: (ALLR), modified Ellison, deep Lemaire, superficial Lemaire MacIntosh procedures. The last randomised. For procedure, graft fixed NR at 30° flexion tension 20 N.ResultsCompared isolated addition either ALLR or Ellison procedure did not increased overall pressure (all p>0.05) full range IR Conversely, p<0.05) increase compared ACLR IR. No significant difference observed ER conditions.ConclusionThis comparing main procedures, revealed change knee flexion. In contrast, significantly when internally rotated. Given N. Compared conditions. This