Clinical and Radiological Results of Anterior Cruciate Ligament Reconstruction with High Pivot Shift with or without Iliotibial Band Tenodesis; a Randomized Comparative Clinical Trial

Background and aim: Following ACL reconstruction surgery, a significant proportion of patients exhibit inadequate results concerning persistent rotational instability. Therefore, this study aimed to assess the clinical and radiological outcomes of combined Anterior Cruciate Ligament Reconstruction and Lateral Extra-articular Tenodesis in knees with high-grade pivot shift in Comparison to Anterior Cruciate Ligament Reconstruction alone. Materials and Methods: A prospective randomized clinical trial evaluating the clinical and radiological results of two cohorts: Group A (20 patients) received Anterior Cruciate Ligament Reconstruction in conjunction with Lateral Extra-articular Tenodesis via the modified Lemaire procedure; group B (20 patients) underwent Anterior Cruciate Ligament Reconstruction alone. They underwent surgery from October 2021 to March 2022 and were monitored for 24 months in the outpatient clinic. Results: Knees subjected to a combined ACL and modified Lemaire lateral extra-articular tenodesis exhibited a reduced incidence of internal rotational instability (pivot shift) compared to those receiving isolated ACL reconstruction, with no associated loss of motion accompanying this reduction in laxity. The Lysholm score indicated no substantial difference between the two groups. The X-ray alterations of the knee during follow-up indicated no substantial difference between the two groups. Conclusion: Knees subjected to a combination of ACL repair and modified Lemaire Lateral Extra-articular Tenodesis exhibited a reduced incidence of internal rotational instability compared to those treated with solitary ACL reconstruction.