Combined ACL and Anterolateral Ligament Reconstruction

• DOI: 10.2106/jbjs.st.17.00045
• Publication Date: 2018-01-10T15:47:17Z
• Authors: Adnan Saithna; Mathieu Thaunat; Jean Romain Delaloye; Hervé Ouanezar; Jean Marie Fayard; Bertrand Sonnery-...
• Keywords: Anterolateral ligament

Background: Clinical results of combined anterior cruciate ligament (ACL) and anterolateral (ALL) reconstruction have demonstrated a significant reduction in ACL graft rupture rates improved return to sports compared with isolated 1 . This finding is supported by laboratory studies that lateral extra-articular tenodesis procedures protect the load-sharing it more reliably restoring normal knee kinematics reconstruction. Description: The formed from tripled semitendinosus tendon single strand gracilis tendon. femoral tunnel drilled provide an anatomic location intra-articularly exit femur just posterior proximal epicondyle. additional length therefore exits at origin ALL then routed (under iliotibial band [ITB]) through tibial tunnel, back origin, reconstruct ALL. Alternatives: Many different types nonanatomic been reported. most frequently performed were Lemaire MacIntosh procedures; however, these, others, widely abandoned after poor reported 1980s. Rationale: differs other tenodesis-type because procedure anatomically based can be percutaneously performed. Nonanatomic (typically ITB passed under collateral [LCL]) associated overconstraint, early arthritis, increased risk infection 2–5 In contrast, has shown restore avoid overconstraint when correctly fixed full extension neutral rotation 6 main concern any type on historical reports outcomes 2,3 However, recent study reoperation rate comparable seen reconstruction, very low complications 7 makes compelling argument for being choice considering procedure. further fact that, even though previous trend toward reduced procedures, they not improvement 8 Combined currently only significantly reduce improve