The American journal of sports medicine · 2026 · 系統性回顧＋統合分析（依標題推測）
Lateral Extra-Articular Tenodesis With Anterior Cruciate Ligament Reconstruction in Pediatric and Skeletally Immature Patients: A Systematic Review and Meta-analysis
膝 · 前十字韌帶損傷
中文閱讀摘要
統合分析顯示，兒童及骨骼未成熟患者ACLR加LET較單純ACLR顯著降低移植物再斷裂率並提高重返運動率，且併發症少。
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原始摘要
Background
Lateral extra-articular tenodesis (LET), alongside anterior cruciate ligament reconstruction (ACLR), has been shown to improve rerupture and rotational laxity in patients <25 years. However, safety and efficacy in both general pediatric (<18 years) and skeletally immature patients are important to identify.
Purpose
To assess clinical outcomes and complications after the LET procedure with ACLR in the pediatric and skeletally immature population.
Study design
Meta-analysis; Level of evidence, 4.
Methods
Three databases were searched on December 5, 2024. Data were collected on study characteristics, demographics, surgical details, LET indications, patient-reported outcome measures, return to sport (RTS), rerupture rates, and complications. A meta-analysis of graft rerupture and RTS was performed using a Mantel-Haenszel and fixed-effects model (pooled effect measure: odds ratio [OR] with 95% CI).
Results
Nine studies comprising 317 patients (318 knees) were included, of whom 204 patients (205 knees) were skeletally immature. The mean age of all patients and skeletally immature patients was 14.6 years (range, 8-18 years) and 13.6 years (range, 8-16.1 years), respectively. Common indications for LET included a grade 2+ pivot shift and intention to return to a high level of sport. The pooled RTS rate of ACLR+LET was 96% (92%-99%; I 2 = 48%) and 98% (94%-100%; I 2 = 39%) in general pediatric and skeletally immature patients, respectively. The rerupture rate after ACLR+LET was 1.6% and 2.4% in general pediatric and skeletally immature patients, respectively. Pooled data consisting of 119 patients who underwent ACLR+LET and 87 patients with isolated ACLR found ACLR+LET to have a significantly lower rate of ACLR graft reruptures compared with isolated ACLR of 0.8% and 12.6%, respectively ( I 2 = 0%; OR = 0.12; 95% CI, 0.03-0.53; P = .0036). ACLR+LET was also found to have a significantly higher RTS rate compared with isolated ACLR (92.4% vs 80.5%, respectively) ( I 2 = 0%; OR, 3.06; 95% CI, 1.3-7.18; P = .0104). There were 2 reports of growth disturbances (0.63%), with 1 case being corrected by surgical epiphysiodesis and another being clinically asymptomatic.
Conclusion
The LET procedure, as an adjunct to ACLR in pediatric and adolescent patients, has been shown to be safe with low complication rates-including physeal disturbance. Pooled data from the literature to date demonstrate that ACLR combined with an LET has a lower rate of graft rerupture while maintaining previously described high rates of RTS in pediatric patients compared with isolated ACLR.
至 Europe PMC 閱讀完整來源 ↗ · 擷取日期 2026-10-19
書目、來源與全文狀態
- DOI
- 10.1177/03635465251407326
- PMID／PMCID
- 41560581 / PMC13213001
- 作者
- Kotipalli S, Haidl T, Vivekanantha P, de Sa D, Kay J
- 首次發表日期
- 2026-01-21Europe PMC 提供，部分日期可能依年份或月份推定。
- 卷／期／頁碼或文章編號
- 54 ／ 7 ／ 1747-1756
- 書目來源與查核日期
- Europe PMC · 2026-10-19僅核對書目欄位與來源連結；不代表已評讀研究品質。
- 全文與授權
- 來源列有免費全文（查核 2026-10-19），未逐篇測試 PDF 下載。 來源授權標示：cc by。
可回溯引用
Kotipalli S, Haidl T, Vivekanantha P, de Sa D, Kay J. Lateral Extra-Articular Tenodesis With Anterior Cruciate Ligament Reconstruction in Pediatric and Skeletally Immature Patients: A Systematic Review and Meta-analysis. The American journal of sports medicine. 2026;54(7):1747-1756. PMID: 41560581. PMCID: PMC13213001. doi:10.1177/03635465251407326
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