2024 AOSSM Annual Meeting Recordings-General Session Isolated ACL Reconstruction or LET It Be

Video Transcription

Video Summary

This video depicts an academic clinical session where various surgeons discuss techniques and outcomes related to Anterior Cruciate Ligament (ACL) reconstruction and associated procedures, notably Lateral Extra-Articular Tenodesis (LET) and slope-reducing tibial osteotomies. The session's purpose is to examine different approaches, compare results, and determine best practices in treating complex ACL cases.<br /><br />The session begins with the introduction of Walt Lowe's presentation on slow-producing osteotomies alongside ACL reconstruction. This is followed by Bertrand Sonnery-Coté discussing combined ACL and lateral extra-articular procedures, emphasizing their effectiveness in reducing graft failure rates and reoperation rates in patients over 30 years old. Sonnery-Coté shares findings from a large database, showing a significant reduction in graft failure rates with combined procedures compared to isolated ACL reconstructions.<br /><br />Next, Costas Economopoulos addresses the outcomes of isolated LET in patients with instability following ACL reconstruction, highlighting that LET can reduce meniscal and ACL retearing and residual pivot shifts. This is contrasted with primary ACL revision procedures, demonstrating LET's effectiveness in improving rotational stability and patient outcomes.<br /><br />Laura Houston from the MARS study group presents long-term outcomes of ACL revision surgeries, reporting high rates of post-traumatic osteoarthritis and graft failure. Despite improvements in patient-reported outcomes over time, activity levels tend to decline, underscoring the challenges of managing ACL revisions.<br /><br />Walt Lowe returns to share further insights on clinical and radiographic outcomes following ACL reconstruction with slope-reducing osteotomies, emphasizing that these procedures can allow athletes to return to sports without significant detriments to knee function.<br /><br />A debate follows between Dr. Volker Bussall and Dr. Robin West on the appropriateness of LET versus slope-reducing osteotomy for a 16-year-old female with a failed hamstring ACL and a high-grade pivot shift. Bussall advocates for LET, citing its biomechanical benefits and reduced failure rates, while West argues for slope-reducing osteotomy due to its effectiveness in managing increased tibial slope and preventing further failures.<br /><br />In conclusion, the session underscores the complexity of surgical decision-making in ACL reconstructions and the importance of individualized patient care. The surgeons present a range of perspectives and techniques, supported by extensive research and clinical findings.

Asset Caption

9:00 am - 10:00 am

Meta Tag

Concept Lateral Extra-Articular Tenodesis

Concept ACL Reconstruction

Concept Revision Anterior Cruciate Ligament Reconstruction

Concept Slope-Reducing High Tibial Osteotomy

Concept Rotational Instability

Speaker Michael J. Alaia, MD

Speaker Volker Musahl, MD

Speaker Walter R. Lowe, MD

Speaker Bertrand Sonnery-Cottet, MD, PhD

Speaker Kostas Economopoulos, MD

Speaker Laura J. Huston, MS

Speaker Alan M. Getgood, MD, FRCS

Speaker Rachel M. Frank, MD

Speaker Armando F. Vidal, MD

Speaker Robin V. West, MD

Keywords

Michael J. Alaia, MD

Volker Musahl, MD

Walter R. Lowe, MD

Bertrand Sonnery-Cottet, MD, PhD

Kostas Economopoulos, MD

Laura J. Huston, MS

Alan M. Getgood, MD, FRCS

Rachel M. Frank, MD

Armando F. Vidal, MD

Robin V. West, MD

ACL reconstruction

Lateral Extra-Articular Tenodesis

tibial osteotomies

graft failure

rotational stability

post-traumatic osteoarthritis

patient outcomes

surgical techniques

clinical session

complex ACL cases

Lateral Extra-Articular Tenodesis

ACL Reconstruction

Revision Anterior Cruciate Ligament Reconstruction

Slope-Reducing High Tibial Osteotomy

Rotational Instability