Lateral Extra-articular Tenodesis: The Onlay Technique.
expert_opinion · Level V
Where this comes from
- Record sourced from PubMed, PMID 37654867.
- Also identified by DOI 10.1016/j.eats.2023.04.007 and PMC identifier 10466252.
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Abstract
Tibial anterolateral rotary instability associated with anterior cruciate ligament (ACL) tears is a well-documented and difficult problem with a long history of solutions. The lateral extra-articular tenodesis (LET) has undergone multiple refinements in technique, largely focusing on the femoral site insertion using either an interference screw versus a staple for adequate fixation. In this article, we present an improved technique using a suture anchor as an alternative to a staple or an interference screw with secure fixation to insert the LET graft onto the femur. This technique diminishes the chance of ACL tunnel-LET drilling convergence, minimizes the footprint required for adequate graft fixation, and allows the surgeon to dial in the correct tension necessary for adequate augmentation of an ACL reconstruction.