Editorial Commentary: The Ideal Combination of Anterior Cruciate Ligament Reconstruction and Lateral Extra-articular Procedures Has Yet to Be Determined, But We Are Getting Closer.

Abstract

In recent years, the addition of lateral extra-articular procedures (LEAPs) to primary and revision anterior cruciate ligament (ACL) reconstructions has been recommended in patients with appropriate indications. Possible indications for combined primary ACL reconstructions and LEAPs include a preoperative high-grade pivot shift, generalized ligamentous hyperlaxity, genu recurvatum, chronic injury (>6 months), and young patients (<25 years) who intend to return to high-demand sporting activities such as pivot or contact sports. Different LEAPs are described in the current literature. The combination of ACL reconstructions and LEAPs leads to decreased graft rupture and reoperation rates, improved graft survival, and increased knee stability. Nevertheless, the most promising combination of ACL graft and LEAP has yet to be determined.