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