Anatomic anterior cruciate ligament (ACL) reconstruction vs. non-anatomic ACL reconstruction with lateral tenodesis

Anterior cruciate ligament (ACL) reconstruction is one of the most common knee surgical procedure. The overall outcome of the ACL-reconstruction is very satisfactory, however, some patients continue to experience dynamic instability and therefore reduced clinical outcome and lower return to sports rate even after a technically correct surgery. Different approaches have been proposed to address the rotatory instability: an anatomical ACL reconstruction or an intra-articular ACL reconstruction with an extra-articular augmentation or tenodesis (EAT). This review is focused on the historical and contemporary rationale of the combined procedure (EAT).