ACL Surgery Update: Preventing Re-Tears with LET Procedure (Dr. Kristin Hopkins) | The Sports Medicine Research Rundown - Ep. 12

In this month's "Sports Medicine Research Rundown," we welcome Dr. Kristin Hopkins, Team Physician for Stony Brook University athletics. Dr. Hopkins, an acclaimed orthopedic surgeon, shares insights on cutting-edge ACL reconstruction techniques, specifically the Lateral Extra-Articular Tenodesis (LET) procedures. Learn why these "LEAPs" are becoming crucial for preventing re-tears in high-risk patients, especially adolescent athletes. We break down the science, discuss surgical considerations, and explore rehabilitation expectations.Topics Covered:0:03 – Welcoming Dr. Kristin Hopkins1:08 – Introduction to ALL (Anterior Lateral Ligament) and LET (Lateral Extra-Articular Tenodesis) procedures2:05 – The concept of LEAPs (Lateral Extra-Articular Procedures) and Segond Fracture3:05 – LET technique using the IT band and its benefits over ALL3:56 – Increasing commonality of LET procedures and differing surgeon approaches6:21 – Indications for LET High-grade pivot shift, high-risk patients (re-tears, contralateral tears, hyperlaxity, adolescent athletes)8:16 – Risks and considerations: Increased stiffness and initial pain9:16 – Over-constraining and potential for arthritis (long-term unknown)11:42 – ACL injury and arthritis predisposition13:22 – Graft choices: Quad and BTB vs. Hamstring13:34 – Evidence supporting LEAP effectiveness in preventing re-rupture15:02 – Discussion of the article: "Impact of lateral extraarticular procedure augmentation on rerupture risk and tegner activity scale outcomes in adolescent ACL patients" by Muhammad Musa (AGSM, 2024)17:53 – Rehabilitation protocols: Full extension, early weight-bearing, and prehab importance20:54 – Study results: Significant decrease in re-ruptures with LEAP (18 vs. 3)21:40 – No increased re-operations or arthrofibrosis with LEAP22:02 – No difference in return to sport timelines or outcome scores24:02 – Typical return to play around 8-9 months24:25 – Bracing for the first season back25:25 – Bracing for offensive linemen in football26:59 – Study limitations: Omission of pre-operative rotational instability and lack of randomization27:28 – Why LEAP isn't for everyone28:00 – Hardware irritation: Use of all-suture anchors28:26 – Will LEAP become standard for all comers?28:59 – Case selection for LEAP: Young, high-level athletes in pivot/plant sports30:16 – Anecdotal return to play outcomes with LEAP patientsGuest Bio: Dr. Kristin Hopkins is a Team Physician for Stony Brook University athletics, specializing in contact sports like lacrosse and football. She is a sports medicine fellow graduate of the Nicholas Institute of Sports Medicine and Athletic Trauma.Disclaimer:This podcast is for educational purposes only and is not a substitute for professional medical advice. Always consult with a qualified healthcare provider for any health concerns or before making any decisions related to your health or treatment.