Radiological and Clinical Outcomes of Over-the-Top ACL Reconstruction vs. Anteromedial ACL Reconstruction With Additional Lateral Extraarticular Tenodesis: A Prospectively Randomized Controlled Trial

What this Trial Is About

Researchers are evaluating two surgical methods for reconstructing the anterior cruciate ligament (ACL) to improve knee stability and return to sports. The study compares the over-the-top (OTT) ACL reconstruction technique, which routes the graft over the lateral femoral condyle and is simpler, with the anteromedial ACL reconstruction combined with lateral extraarticular tenodesis (LET), which aims to better control rotational instability. This randomized controlled trial seeks to clarify the benefits and outcomes of these techniques for patients with ACL tears. Participants will receive either the OTT technique, which includes intra-articular and extra-articular components functioning as LET, or the conventional anteromedial ACL reconstruction combined with LET using the iliotibial band. Both surgical approaches aim to restore knee function but differ in how the graft is positioned and how additional rotational stability is provided. The trial observes patients for one year post-surgery, including imaging and clinical assessments. Throughout the study, patients will be monitored with MRI and CT scans at one year after surgery. Outcomes measured include graft re-rupture rates, tibial tunnel widening, activity levels using the Tegner Activity Scale, and knee function and osteoarthritis outcomes using the KOOS score. This follow-up will help determine the clinical and radiological effectiveness of each technique in restoring knee stability and supporting return to sport activities.

Over-the-Top vs. Anteromedial ACLR With Lateral Extraarticular Tenodesis