Affiliation:
1. Orthopedic Surgery Department New York New York USA
2. Pediatric Orthopedic Surgery Service New York New York USA
3. Orthopedics and Sports Medicine Department Boston Children's Hospital Boston Massachusetts USA
4. Kim Barrett Memorial Library New York New York USA
Abstract
AbstractPurposeThe purpose of this study was to investigate the effect of anterolateral ligament reconstruction (ALLR) or lateral extra‐articular tenodesis (LET) fixation at low versus high flexion angles during anterior cruciate ligament reconstruction (ACLR) on rotation or translational knee stability.MethodsThe inclusion criteria for this study were (1) cadaveric study, (2) cadaveric specimens underwent ACLR, (3) cadaveric specimen underwent ALLR or LET and (4) specimen preparation technique described the knee flexion angle at the time of ALLR or LET tensioning and fixation. A priori, ‘low flexion’ was defined as 0–30° and ‘high flexion’ was defined as 60–90° at graft fixation. Main outcomes of interest included internal rotation and anterior translation.ResultsData from 92 cadaveric knees (from 9 studies) were extracted and included in the meta‐analysis. The mean pooled value for internal rotation was 10.1° (95% confidence interval [CI], 5.7–14.5°) for the low flexion group and 11.5° (95% CI, 7.4–15.7°) for the high flexion group (n.s.). The mean pooled value for anterior translation was 4.3 mm (95% CI, 0.5–8.1 mm) for the low flexion group and 3.0 mm (95% CI, 1.1–5.0 mm) for the high flexion group (n.s.).ConclusionThis meta‐analysis of existing biomechanical research found that the rotational and translational stability of the knee were not significantly different between scenarios in which ALLR or LET fixation was performed at low knee flexion angles (0–30°) versus high knee flexion angles (60–90°).Level of EvidenceLevel IV.