Anterior Cruciate Ligament Reconstruction with and without Lateral Extra-Articular Tenodesis between high demand patients

It is a randomized control trial comparing between isolated anterior cruciate ligament reconstruction with and without lateral extra articular tenodesis between high demand and high risk groups with high pivot regarding failure rate (primary out come) and patient reported functions score (IKDC and Lysholm)

Inclusion Criteria:

• High demand patients (manual workers, athletes,...etc.).

• Normal average body mass index ( 18.5 - 24.9 ).

• Age <40 years old.

• Patients will be diagnosed as ACL tear by the following:

  1. History of knee traumatic event.
  2. Clinical examination ( positive Lachman test and pivot shift test).
  3. Radiological evidence of ACL tear by MRI.

• patient with high pivot shift test.

Exclusion Criteria:

• Generalized ligamentous laxity.
• Other intra or extra articular knee injuries.
• Previous ACL surgery on the affected knee.
• Bilateral ACL injuries.
• Significant Articular surface injury.
• Medical comorbidities
• Patients with malalignment ( genu varum, genu valgum or genu recurvatum )
• Neuromuscular disorders
• Knee arthritic changes.