ACL reconstruction in high risk patients

Risk Factors for ACL Tears

Twelve months ago, I discussed ACL reconstruction in “high risk” patients. Being “high risk” means that person is at a higher risk for graft failure and therefore may need an additional procedure. This person may require an extra-articular reconstruction in addition to a traditional hamstring reconstruction. This procedure on the outside of the knee is commonly referred to as a lateral extra-articular tenodesis (LEAT).

The factors I use to assess risk are:

  • Age less than 25, and particularly those under 20
  • A family history of ACL tears
  • Previous ACL reconstruction in the other knee
  • Playing pivoting sports such as netball, football (all codes) and basketball.
  • Elite or professional sports people
  • High-grade instability when the knee is examined
  • Knee hyperextension and laxity in other joints