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Role of anterolateral reconstruction in ACL surgery. Why, When and How?

Journal of Clinical Orthopaedics | Vol 6 | Issue 1 |  Jan-Jun 2021 | page: 45-52 | Philippe Landreau


Author: Philippe Landreau [1]

[1] DxBone, Bone and Joint Excellence Center Dubai, United Arab Emirates

Address of Correspondence
Dr. Philippe Landreau,
DxBone, Bone and Joint Excellence Center Dubai, United Arab Emirates
E-mail: landreau@mac.com


Abstract

Ruptures of the anterior cruciate ligament (ACL) cause both abnormal anterior translation and anterolateral rotation of the tibia under the femur. Isolated intra-articular ACL reconstruction has evolved significantly over the past years, but in many cases it is insufficient to correct rotational laxity. There are several justifications for anterolateral plasty in the context of ACL surgery: The persistence of anterolateral laxity after some isolated ACL intra-articular reconstructions, the evidence of traumatic lesions of these anterolateral structures after ACL tear and the recent anatomical and biomechanical research on the anterolateral complex of the knee. One more justification is that some recent studies comparing the outcomes after isolated ACL reconstruction and those after ACL reconstruction combined with anterolateral reconstruction are in favor of the simultaneous procedures. The addition of an extra-articular procedure to the intra-articular reconstruction of the ACL can improve the outcomes particularly in these situations: Young age (<25 ans), sports with pivot contact particularly if high level, pivot-shift Grades 2–3, recurvatum of the knee and generalized hyperlaxity, posterior tibial slope superior to 12°, meniscus deficiency, and ACL revision. Different surgical techniques have been proposed and described. They can be classified in two groups: The techniques using an ilio-tibial band graft to perform a lateral tenodesis and the procedures aiming to reconstruct the anterolateral ligament. Both techniques intend to control the anterolateral displacement of the tibial plateau.
Keywords: Anterolateral ligament, anterior cruciate ligament, anterolateral reconstruction, lateral tenodesis, condylar strap


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How to Cite this article: SLandreau P. Role of anterolateral reconstruction in ACL surgery, why, when and how?. Journal of Clinical Orthopaedics Jan-Jun 2021;6(1):45-52.

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