Editorial Commentary: Is the Key to Successful Revision Anterior Cruciate Ligament Reconstruction Addressing the Anterolateral Complex With a Lateral Extra-articular Tenodesis?

As the overall incidence of anterior cruciate ligament (ACL) ruptures continues to rise, the failure rates in reconstructive surgery remain relatively stable. Despite advances in our understanding of graft selection, anatomic reconstruction, addressing concomitant injuries, and the importance of rehabilitation, we continue to see failure rates in primary ACL reconstructions of up to 15%. Thus as the number of primary ACL reconstructions rises, so too does the number of revision ACL surgeries. This rising need for revision ACL reconstructions presents an even more daunting task because failure rates of up to 25% have been reported. Much of the current literature's focus is on improving outcomes and lowering these failure rates. Could adding a lateral extra-articular tenodesis to revision ACL surgery be the magic bullet we have been searching for to lower our failure rates? We question whether it is that simple.