Lateral Extra-articular Procedures Decrease Rates of Graft Failure and Positive Pivot Shift in Primary Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis.
Matthew Macciacchera, Nicholas Nucci, Emmitt Hayes et al.
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In 30 seconds
This systematic review and meta-analysis evaluated the impact of lateral extra-articular procedures (LEAP) on clinical outcomes following primary anterior cruciate ligament reconstruction (ACLR) in skeletally mature patients. The analysis included 1327 patients and found a significant reduction in graft failure (P < .001) and lower rates of positive pivot shift in patients undergoing ACLR with LEAP compared to ACLR alone.
Key findings
- Graft failure rates were significantly reduced in the ACLR plus LEAP group (P < .001).
- The rate of positive postoperative pivot shift was significantly lower in the ACLR plus LEAP group (P < .001).
- Lysholm scores favored the addition of LEAP to ACLR (P = .001).
- Ceiling effects were significant in 3 of 4 studies for International Knee Documentation Committee scores.
Why it matters
The findings suggest that incorporating lateral extra-articular procedures during ACL reconstruction may enhance surgical outcomes, particularly in reducing graft failure and improving stability, which are critical for patient recovery and long-term function.