Lateral Extra-articular Tenodesis Reduces Failure of Hamstring Tendon Autograft Anterior Cruciate Ligament Reconstruction: 2-Year Outcomes From the STABILITY Study Randomized Clinical Trial
Persistent anterolateral rotatory laxity after anterior cruciate ligament (ACL) reconstruction (ACLR) has been correlated with poor clinical outcomes and graft failure. We hypothesized that a single-bundle, hamstring ACLR in combination with a lateral extra-articular tenodesis (LET) would reduce the...
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| Vydáno v: | The American journal of sports medicine Ročník 48; číslo 2; s. 285 |
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| Médium: | Journal Article |
| Jazyk: | angličtina |
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United States
01.02.2020
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| ISSN: | 1552-3365, 1552-3365 |
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| Abstract | Persistent anterolateral rotatory laxity after anterior cruciate ligament (ACL) reconstruction (ACLR) has been correlated with poor clinical outcomes and graft failure.
We hypothesized that a single-bundle, hamstring ACLR in combination with a lateral extra-articular tenodesis (LET) would reduce the risk of ACLR failure in young, active individuals.
Randomized controlled trial; Level of evidence, 1.
This is a multicenter, prospective, randomized clinical trial comparing a single-bundle, hamstring tendon ACLR with or without LET performed using a strip of iliotibial band. Patients 25 years or younger with an ACL-deficient knee were included and also had to meet at least 2 of the following 3 criteria: (1) grade 2 pivot shift or greater, (2) a desire to return to high-risk/pivoting sports, (3) and generalized ligamentous laxity (GLL). The primary outcome was ACLR clinical failure, a composite measure of rotatory laxity or a graft rupture. Secondary outcome measures included the P4 pain scale, Marx Activity Rating Scale, Knee injury Osteoarthritis and Outcome Score (KOOS), International Knee Documentation Committee score, and ACL Quality of Life Questionnaire. Patients were reviewed at 3, 6, 12, and 24 months postoperatively.
A total of 618 patients (297 males; 48%) with a mean age of 18.9 years (range, 14-25 years) were randomized. A total of 436 (87.9%) patients presented preoperatively with high-grade rotatory laxity (grade 2 pivot shift or greater), and 215 (42.1%) were diagnosed as having GLL. There were 18 patients lost to follow-up and 11 who withdrew (~5%). In the ACLR group, 120/298 (40%) patients sustained the primary outcome of clinical failure, compared with 72/291 (25%) in the ACLR+LET group (relative risk reduction [RRR], 0.38; 95% CI, 0.21-0.52;
< .0001). A total of 45 patients experienced graft rupture, 34/298 (11%) in the ACLR group compared with 11/291 (4%) in the ACL+LET group (RRR, 0.67; 95% CI, 0.36-0.83;
< .001). The number needed to treat with LET to prevent 1 patient from graft rupture was 14.3 over the first 2 postoperative years. At 3 months, patients in the ACLR group had less pain as measured by the P4 (
= .003) and KOOS (
= .007), with KOOS pain persisting in favor of the ACLR group to 6 months (
= .02). No clinically important differences in patient-reported outcome measures were found between groups at other time points. The level of sports activity was similar between groups at 2 years after surgery, as measured by the Marx Activity Rating Scale (
= .11).
The addition of LET to a single-bundle hamstring tendon autograft ACLR in young patients at high risk of failure results in a statistically significant, clinically relevant reduction in graft rupture and persistent rotatory laxity at 2 years after surgery.
NCT02018354 ( ClinicalTrials.gov identifier). |
|---|---|
| AbstractList | Persistent anterolateral rotatory laxity after anterior cruciate ligament (ACL) reconstruction (ACLR) has been correlated with poor clinical outcomes and graft failure.
We hypothesized that a single-bundle, hamstring ACLR in combination with a lateral extra-articular tenodesis (LET) would reduce the risk of ACLR failure in young, active individuals.
Randomized controlled trial; Level of evidence, 1.
This is a multicenter, prospective, randomized clinical trial comparing a single-bundle, hamstring tendon ACLR with or without LET performed using a strip of iliotibial band. Patients 25 years or younger with an ACL-deficient knee were included and also had to meet at least 2 of the following 3 criteria: (1) grade 2 pivot shift or greater, (2) a desire to return to high-risk/pivoting sports, (3) and generalized ligamentous laxity (GLL). The primary outcome was ACLR clinical failure, a composite measure of rotatory laxity or a graft rupture. Secondary outcome measures included the P4 pain scale, Marx Activity Rating Scale, Knee injury Osteoarthritis and Outcome Score (KOOS), International Knee Documentation Committee score, and ACL Quality of Life Questionnaire. Patients were reviewed at 3, 6, 12, and 24 months postoperatively.
A total of 618 patients (297 males; 48%) with a mean age of 18.9 years (range, 14-25 years) were randomized. A total of 436 (87.9%) patients presented preoperatively with high-grade rotatory laxity (grade 2 pivot shift or greater), and 215 (42.1%) were diagnosed as having GLL. There were 18 patients lost to follow-up and 11 who withdrew (~5%). In the ACLR group, 120/298 (40%) patients sustained the primary outcome of clinical failure, compared with 72/291 (25%) in the ACLR+LET group (relative risk reduction [RRR], 0.38; 95% CI, 0.21-0.52;
< .0001). A total of 45 patients experienced graft rupture, 34/298 (11%) in the ACLR group compared with 11/291 (4%) in the ACL+LET group (RRR, 0.67; 95% CI, 0.36-0.83;
< .001). The number needed to treat with LET to prevent 1 patient from graft rupture was 14.3 over the first 2 postoperative years. At 3 months, patients in the ACLR group had less pain as measured by the P4 (
= .003) and KOOS (
= .007), with KOOS pain persisting in favor of the ACLR group to 6 months (
= .02). No clinically important differences in patient-reported outcome measures were found between groups at other time points. The level of sports activity was similar between groups at 2 years after surgery, as measured by the Marx Activity Rating Scale (
= .11).
The addition of LET to a single-bundle hamstring tendon autograft ACLR in young patients at high risk of failure results in a statistically significant, clinically relevant reduction in graft rupture and persistent rotatory laxity at 2 years after surgery.
NCT02018354 ( ClinicalTrials.gov identifier). Persistent anterolateral rotatory laxity after anterior cruciate ligament (ACL) reconstruction (ACLR) has been correlated with poor clinical outcomes and graft failure.BACKGROUNDPersistent anterolateral rotatory laxity after anterior cruciate ligament (ACL) reconstruction (ACLR) has been correlated with poor clinical outcomes and graft failure.We hypothesized that a single-bundle, hamstring ACLR in combination with a lateral extra-articular tenodesis (LET) would reduce the risk of ACLR failure in young, active individuals.HYPOTHESISWe hypothesized that a single-bundle, hamstring ACLR in combination with a lateral extra-articular tenodesis (LET) would reduce the risk of ACLR failure in young, active individuals.Randomized controlled trial; Level of evidence, 1.STUDY DESIGNRandomized controlled trial; Level of evidence, 1.This is a multicenter, prospective, randomized clinical trial comparing a single-bundle, hamstring tendon ACLR with or without LET performed using a strip of iliotibial band. Patients 25 years or younger with an ACL-deficient knee were included and also had to meet at least 2 of the following 3 criteria: (1) grade 2 pivot shift or greater, (2) a desire to return to high-risk/pivoting sports, (3) and generalized ligamentous laxity (GLL). The primary outcome was ACLR clinical failure, a composite measure of rotatory laxity or a graft rupture. Secondary outcome measures included the P4 pain scale, Marx Activity Rating Scale, Knee injury Osteoarthritis and Outcome Score (KOOS), International Knee Documentation Committee score, and ACL Quality of Life Questionnaire. Patients were reviewed at 3, 6, 12, and 24 months postoperatively.METHODSThis is a multicenter, prospective, randomized clinical trial comparing a single-bundle, hamstring tendon ACLR with or without LET performed using a strip of iliotibial band. Patients 25 years or younger with an ACL-deficient knee were included and also had to meet at least 2 of the following 3 criteria: (1) grade 2 pivot shift or greater, (2) a desire to return to high-risk/pivoting sports, (3) and generalized ligamentous laxity (GLL). The primary outcome was ACLR clinical failure, a composite measure of rotatory laxity or a graft rupture. Secondary outcome measures included the P4 pain scale, Marx Activity Rating Scale, Knee injury Osteoarthritis and Outcome Score (KOOS), International Knee Documentation Committee score, and ACL Quality of Life Questionnaire. Patients were reviewed at 3, 6, 12, and 24 months postoperatively.A total of 618 patients (297 males; 48%) with a mean age of 18.9 years (range, 14-25 years) were randomized. A total of 436 (87.9%) patients presented preoperatively with high-grade rotatory laxity (grade 2 pivot shift or greater), and 215 (42.1%) were diagnosed as having GLL. There were 18 patients lost to follow-up and 11 who withdrew (~5%). In the ACLR group, 120/298 (40%) patients sustained the primary outcome of clinical failure, compared with 72/291 (25%) in the ACLR+LET group (relative risk reduction [RRR], 0.38; 95% CI, 0.21-0.52; P < .0001). A total of 45 patients experienced graft rupture, 34/298 (11%) in the ACLR group compared with 11/291 (4%) in the ACL+LET group (RRR, 0.67; 95% CI, 0.36-0.83; P < .001). The number needed to treat with LET to prevent 1 patient from graft rupture was 14.3 over the first 2 postoperative years. At 3 months, patients in the ACLR group had less pain as measured by the P4 (P = .003) and KOOS (P = .007), with KOOS pain persisting in favor of the ACLR group to 6 months (P = .02). No clinically important differences in patient-reported outcome measures were found between groups at other time points. The level of sports activity was similar between groups at 2 years after surgery, as measured by the Marx Activity Rating Scale (P = .11).RESULTSA total of 618 patients (297 males; 48%) with a mean age of 18.9 years (range, 14-25 years) were randomized. A total of 436 (87.9%) patients presented preoperatively with high-grade rotatory laxity (grade 2 pivot shift or greater), and 215 (42.1%) were diagnosed as having GLL. There were 18 patients lost to follow-up and 11 who withdrew (~5%). In the ACLR group, 120/298 (40%) patients sustained the primary outcome of clinical failure, compared with 72/291 (25%) in the ACLR+LET group (relative risk reduction [RRR], 0.38; 95% CI, 0.21-0.52; P < .0001). A total of 45 patients experienced graft rupture, 34/298 (11%) in the ACLR group compared with 11/291 (4%) in the ACL+LET group (RRR, 0.67; 95% CI, 0.36-0.83; P < .001). The number needed to treat with LET to prevent 1 patient from graft rupture was 14.3 over the first 2 postoperative years. At 3 months, patients in the ACLR group had less pain as measured by the P4 (P = .003) and KOOS (P = .007), with KOOS pain persisting in favor of the ACLR group to 6 months (P = .02). No clinically important differences in patient-reported outcome measures were found between groups at other time points. The level of sports activity was similar between groups at 2 years after surgery, as measured by the Marx Activity Rating Scale (P = .11).The addition of LET to a single-bundle hamstring tendon autograft ACLR in young patients at high risk of failure results in a statistically significant, clinically relevant reduction in graft rupture and persistent rotatory laxity at 2 years after surgery.CONCLUSIONThe addition of LET to a single-bundle hamstring tendon autograft ACLR in young patients at high risk of failure results in a statistically significant, clinically relevant reduction in graft rupture and persistent rotatory laxity at 2 years after surgery.NCT02018354 ( ClinicalTrials.gov identifier).REGISTRATIONNCT02018354 ( ClinicalTrials.gov identifier). |
| Author | Millan, Francis Declercq, Geert Van Haver, Mieke Asplin, Laura Wanlin, Stacey Daniluk, Michal Vuylsteke, Kristien Zomar, Mauri Simunovic, Nicole Dunne, Debra Moon, Karyn Martindale, Ashley Gullett, LeeAnne Thompson, Pete Dube, Alisen Bryant, Dianne M Firth, Andrew Heard, Mark MacDonald, Peter B Metcalfe, Andrew Rezansoff, Alex Payne, Krystan Pinto, Ryan Campbell, Caitlin Suddens, Charlie-Marie Pritchett, Raely Tynedal, Jeremy Tough, Murray O'Neill, Lindsey Mayer, Michelle Birmingham, Trevor Levy, David Buchko, Gregory M McCormack, Robert G Verdonk, Peter C M Chan, Denise Brown, Jaclyn Skelly, Matt Boyer, Dory Spalding, Tim Legary, Alexandra Bolsover, Alison Litchfield, Robert Hewison, Chris Brown, Holly Mohan, Bindu Turner, Sylvia Garven, Alexandra Bradshaw, Carolyn Ferguson, Celeste Robinson, David Belgrove, Larissa Mohtadi, Nick Peterson, Devin Clarkson, Louise Willits, Kevin Bardana, Davide Stranges, Greg Fan, Brenda Longo, Alison Getgood, Alan M J Christian, Mat Hiemstra, Laurie A Mcrae, Sheila Pulsifer, Karen Lowe, Janet Howells, Fiona Shanmugara |
| AuthorAffiliation | Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada |
| AuthorAffiliation_xml | – name: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada |
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University, London, Ontario, Canada – sequence: 6 givenname: Alex surname: Rezansoff fullname: Rezansoff, Alex organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 7 givenname: Devin surname: Peterson fullname: Peterson, Devin organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 8 givenname: Davide surname: Bardana fullname: Bardana, Davide organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 9 givenname: Peter B surname: MacDonald fullname: MacDonald, Peter B organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 10 givenname: Peter C M surname: Verdonk fullname: Verdonk, Peter C M organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 11 givenname: Tim surname: Spalding fullname: Spalding, Tim organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 12 givenname: Kevin surname: Willits fullname: Willits, Kevin organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 13 givenname: Trevor surname: Birmingham fullname: Birmingham, Trevor organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 14 givenname: Chris surname: Hewison fullname: Hewison, Chris organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 15 givenname: Stacey surname: Wanlin fullname: Wanlin, Stacey organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 16 givenname: Andrew surname: Firth fullname: Firth, Andrew organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 17 givenname: Ryan surname: Pinto fullname: Pinto, Ryan organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 18 givenname: Ashley surname: Martindale fullname: Martindale, Ashley organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 19 givenname: Lindsey surname: O'Neill fullname: O'Neill, Lindsey organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 20 givenname: Morgan surname: Jennings fullname: Jennings, Morgan organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 21 givenname: Michal surname: Daniluk fullname: Daniluk, Michal organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 22 givenname: Dory surname: Boyer fullname: Boyer, Dory organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 23 givenname: Mauri surname: Zomar fullname: Zomar, Mauri organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 24 givenname: Karyn surname: Moon fullname: Moon, Karyn organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 25 givenname: Raely surname: Pritchett fullname: Pritchett, Raely organization: Investigation performed at 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performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 31 givenname: Sarah surname: Kerslake fullname: Kerslake, Sarah organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 32 givenname: Jeremy surname: Tynedal fullname: Tynedal, Jeremy organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 33 givenname: Greg surname: Stranges fullname: Stranges, Greg organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 34 givenname: Sheila surname: Mcrae fullname: Mcrae, Sheila organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 35 givenname: LeeAnne surname: Gullett fullname: Gullett, LeeAnne organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 36 givenname: Holly surname: Brown fullname: Brown, Holly organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 37 givenname: Alexandra surname: Legary fullname: Legary, Alexandra organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 38 givenname: Alison surname: Longo fullname: Longo, Alison organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 39 givenname: Mat surname: Christian fullname: Christian, Mat organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 40 givenname: Celeste surname: Ferguson fullname: Ferguson, Celeste organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 41 givenname: Nick surname: Mohtadi fullname: Mohtadi, Nick organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 42 givenname: Rhamona surname: Barber fullname: Barber, Rhamona organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 43 givenname: Denise surname: Chan fullname: Chan, Denise organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 44 givenname: Caitlin surname: Campbell fullname: Campbell, Caitlin organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 45 givenname: Alexandra surname: Garven fullname: Garven, Alexandra organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 46 givenname: Karen surname: Pulsifer fullname: Pulsifer, Karen organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 47 givenname: Michelle surname: Mayer fullname: Mayer, Michelle organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 48 givenname: Nicole surname: Simunovic fullname: Simunovic, Nicole organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 49 givenname: Andrew surname: Duong fullname: Duong, Andrew organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 50 givenname: David surname: Robinson fullname: Robinson, David organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 51 givenname: David surname: Levy fullname: Levy, David organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 52 givenname: Matt surname: Skelly fullname: Skelly, Matt organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 53 givenname: Ajaykumar surname: Shanmugaraj fullname: Shanmugaraj, Ajaykumar organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 54 givenname: Fiona surname: Howells fullname: Howells, Fiona organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 55 givenname: Murray surname: Tough fullname: Tough, Murray organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 56 givenname: Pete surname: Thompson fullname: Thompson, Pete organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 57 givenname: Andrew surname: Metcalfe fullname: Metcalfe, Andrew organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 58 givenname: Laura surname: Asplin fullname: Asplin, Laura organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 59 givenname: Alisen surname: Dube fullname: Dube, Alisen organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 60 givenname: Louise surname: Clarkson fullname: Clarkson, Louise organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 61 givenname: Jaclyn surname: Brown fullname: Brown, Jaclyn organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 62 givenname: Alison surname: Bolsover fullname: Bolsover, Alison organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 63 givenname: Carolyn surname: Bradshaw fullname: Bradshaw, Carolyn organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 64 givenname: Larissa surname: Belgrove fullname: Belgrove, Larissa organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 65 givenname: Francis surname: Millan fullname: Millan, Francis organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 66 givenname: Sylvia surname: Turner fullname: Turner, Sylvia organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 67 givenname: Sarah surname: Verdugo fullname: Verdugo, Sarah organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 68 givenname: Janet surname: Lowe fullname: Lowe, Janet organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 69 givenname: Debra surname: Dunne fullname: Dunne, Debra organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 70 givenname: Kerri surname: McGowan fullname: McGowan, Kerri organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 71 givenname: Charlie-Marie surname: Suddens fullname: Suddens, Charlie-Marie organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 72 givenname: Geert surname: Declercq fullname: Declercq, Geert organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 73 givenname: Kristien surname: Vuylsteke fullname: Vuylsteke, Kristien organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada – sequence: 74 givenname: Mieke surname: Van Haver fullname: Van Haver, Mieke organization: Investigation performed at The Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/31940222$$D View this record in MEDLINE/PubMed |
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| Keywords | anterolateral complex lateral extra-articular tenodesis anterior cruciate ligament reconstruction young patients graft failure |
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| PublicationTitle | The American journal of sports medicine |
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| References | 33208644 - J Bone Joint Surg Am. 2020 Nov 18;102(22):2009 32003642 - Am J Sports Med. 2020 Feb;48(2):281-284 |
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| SubjectTerms | Adolescent Adult Anterior Cruciate Ligament Reconstruction Female Hamstring Tendons - transplantation Humans Joint Instability - surgery Knee Joint - surgery Male Prospective Studies Quality of Life Tenodesis Treatment Failure Young Adult |
| Title | Lateral Extra-articular Tenodesis Reduces Failure of Hamstring Tendon Autograft Anterior Cruciate Ligament Reconstruction: 2-Year Outcomes From the STABILITY Study Randomized Clinical Trial |
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