General surgery

The study find that While the ACL can be reconstructed through surgery; therefore there is a high risk of re injury in patients under the age of 25. Because In the largest clinical trial of its kind; therefore  researchers at Lawson Health Research Institute have shown that performing an additional surgical procedure called lateral extra-articular tenodesis (LET) may reduce the risk of ACL re-injury in young athletes.

Lateral extra-articular tenodesis

The ACL helps control rotation of the knee and is most commonly torn in sports involving sudden stops and changes in direction like soccer and basketball. ACL reconstruction surgery uses a graft to rebuild the torn ligament. Grafts are pieces of tissue commonly create from a part of the patient’s body, such as one of the hamstring tendons or the tendon of the kneecap (patellar tendon). Because Unfortunately; the risk of a re-tear or graft failure in young athletes  as high as 20%.

LET is the creation of a new ligament-like structure outside of the knee to provide additional support. “Although the LET procedure has show potential in improving patient outcomes, a randomize clinical trial was needed to assess whether or not it reduces the risk of re-injury;” explains Dr. Alan Getgood, Scientist at Lawson and Orthopaedic Knee Surgeon at the Fowler Kennedy Sport Medicine Clinic; which is a collaborative partnership between London Health Sciences Centre (LHSC) and Western University.

ACL reconstruction surgery

Dr. Get good led the STABILITY trial which include 624 research participants from nine centres across Canada and Europe, including 196 patients from the Fowler Kennedy Sport Medicine Clinic treated at University Hospital, LHSC. Participants were under the age of 25; undergoing ACL reconstruction using a hamstring graft and at high risk for re-injury.

Half the participants are randomize to receive standard of care; consisting of ACL reconstruction without LET, and the other half received ACL reconstruction with the additional LET procedure. Re-injury occurred in 11%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% relative risk reduction for graft failure;” says Dr. Get good, also Assistant Professor at Western’s Schulich School of Medicine & Dentistry. “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.”

Additional LET procedure

The research team studied a number of other outcomes including pain, athletic function, muscle strength and return to sports. Although the LET procedure resulted in slightly higher levels of post-operative pain and slightly decreased muscle strength in the three months following surgery, these complications did not persist. There were no differences in outcomes one and two years after surgery.

The STABILITY trial is find by the International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS). Results are share last week at the ISAKOS Biennial Congress where the research group was awarded the Jan I. Gillquist Scientific Research Award for best scientific paper present at the meeting.