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

Recruiting now · Not applicable

Conditions studied: Anterior Cruciate Ligament Rupture, Anterior Cruciate Ligament Injuries, Anterior Cruciate Ligament Tear

In brief

This study aims to compare the over-the-top (OTT) anterior cruciate ligament (ACL) reconstruction (ACL-R) technique with the anteromedial ACL-R + lateral extraarticular tenodesis (LET). It aims to provide valuable insights into two different surgical approaches aimed at enhancing knee stability. The over-the-top ACL-R technique, which involves routing the graft over the posterior aspect of the lateral femoral condyle, is known for its simplicity and ability to preserve the anatomical footprint of the ACL. Although a non-anatomical reconstruction, the OTT technique has shown comparable clinical results and good return to sports (RTS) ratios when compared to the conventional ACLR alone. It is also favored in revision surgeries or when there is difficulty accessing the femoral tunnel through conventional approaches. However, concerns regarding its ability to fully restore rotational stability persist, especially in high-demand athletes. In contrast, the anteromedial portal technique for ACL-R, combined with LET, has gained popularity due to its effectiveness in controlling both anterior tibial translation and rotational instability. LET augments the intra-articular reconstruction by providing additional restraint against pivot shifts, which can be critical in patients with high-risk profiles for re-injury, such as those participating in pivoting sports. Comparing these two approaches in terms of clinical outcomes, graft integrity, rotational control, and return-to-sport rates with a prospectively randomized controlled trial will help clarify their roles in contemporary ACL surgery and could guide surgeons in choosing the most appropriate method based on patient-specific factors.

Key facts

Study ID

NCT06664047

Run by

Ankara City Hospital Bilkent

People needed

150

Starts

2024-10-24

Expected to finish

2028-11-01

Last updated by the study team

2024-10-31

Who can join

Age: 18 and older, up to 50. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Presence of an isolated anterior cruciate ligament (ACL) tear (isolated ligament injury).
• Age between 18 and 50 years.
• No previous history of surgery on the same knee.
• MRI and CT scans performed at the end of the first postoperative year.

You may not qualify if…

• Presence of additional ligamentous injury (e.g., posterior cruciate ligament or collateral ligament) along with the ACL tear.
• Incomplete clinical scores.
• History of previous surgery on the same knee.
• Presence or history of infection.

Where it is running

• Ankara Bilkent City Hospital — Ankara, Turkey (Türkiye) (enrolling)

Full record on ClinicalTrials.gov

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