Browse
Submit Data
Databases
API
Help

Dataset Information

0 Views

0 Connections

0 Citations

0 Reanalyses

0 Downloads

Omics score: 0

Minimally Invasive Anterolateral Ligament Reconstruction in the Setting of Anterior Cruciate Ligament Injury.

ABSTRACT: Recent evidence on the anatomy, function, and biomechanical properties of the anterolateral ligament has led to the recognition of the importance of this structure in the rotational control of the knee. This article describes a technique that allows for minimally invasive anterolateral ligament reconstruction as a complement to most techniques of anterior cruciate ligament reconstruction. A gracilis tendon autograft is harvested and prepared in a double-strand, inverted V-shaped graft. The graft is percutaneously placed through a femoral stab incision, and each strand is then passed deep to the iliotibial band, emerging through each tibial stab incision. After the femoral-end loop graft is fixed, the tibial fixation of each strand is performed in full extension for optimal isometry.

SUBMITTER: Sonnery-Cottet B

PROVIDER: S-EPMC4886145 | biostudies-literature | 2016 Feb

REPOSITORIES: biostudies-literature

ACCESS DATA

Json Xml

Publications

Minimally Invasive Anterolateral Ligament Reconstruction in the Setting of Anterior Cruciate Ligament Injury.

Sonnery-Cottet Bertrand B Barbosa Nuno Camelo NC Tuteja Sanesh S Daggett Matt M Kajetanek Charles C Thaunat Mathieu M

Arthroscopy techniques 20160229 1

Recent evidence on the anatomy, function, and biomechanical properties of the anterolateral ligament has led to the recognition of the importance of this structure in the rotational control of the knee. This article describes a technique that allows for minimally invasive anterolateral ligament reconstruction as a complement to most techniques of anterior cruciate ligament reconstruction. A gracilis tendon autograft is harvested and prepared in a double-strand, inverted V-shaped graft. The graft ...[more]

PMID: 27274456

Similar Datasets

Combined Double-Bundle Anterior Cruciate Ligament Reconstruction and Anterior Cruciate Ligament-Mimicking Anterolateral Structure Reconstruction.

Project description:The outcomes of double-bundle anterior cruciate ligament (ACL) reconstruction leave room for improvement. We hope to augment double-bundle ACL reconstruction with the reconstruction of an ACL-mimicking anterolateral structure (ALS). Thus, we would like to introduce a combined double-bundle ACL reconstruction and ACL-mimicking ALS reconstruction technique. The main indication for this technique is ACL injury with a high degree of pivot shift test, general laxity, or near critical value of the posterior tibial slope. The main steps in this technique include preparation of an isolated graft for the anteromedial bundle of the ACL and a combined graft for the posterolateral bundle of the ACL and ALS, creation of three tibial tunnels and two femoral tunnels, graft placement, and final graft fixation at an adjustable loop. We have obtained promising clinical outcomes with this technique and consider that this report will provide new options in ACL reconstruction.

| S-EPMC7451438 | biostudies-literature

Combined Anterior Cruciate Ligament Repair and Anterolateral Ligament Reconstruction.

Project description:There has been a renewed interest in anterior cruciate ligament (ACL) repairs over the last decade with some early promising results in the right patient population. Additionally, the anterolateral ligament has been extensively studied and has recently been shown to have a protective effect on standard ACL reconstructions in a clinical trial. Given its protective effect on ACL reconstructions, we believe this phenomenon is also relevant to ACL repairs and can decrease rerupture rates. In this publication, we demonstrate a surgical technique for ACL repair using an internal brace combined with an anterolateral ligament reconstruction using a gracilis autograft.

| S-EPMC6408622 | biostudies-literature

Combined Double Bundle Anterior Cruciate Ligament Reconstruction and Anterolateral Ligament Reconstruction.

Project description:A double-bundle anterior cruciate ligament (ACL) reconstruction associated with an anterolateral ligament (ALL) reconstructions is performed. The semitendinosus and gracilis are harvested. At knee maximum flexion, the anteromedial (AM) femoral tunnel is performed in the AM footprint area. Through the anterolateral portal, the tip of the outside-in femoral guide is placed in the posterolateral footprint area. The guide sleeve is pushed onto the lateral femoral cortex at the ALL attachment. At 110° knee flexion, the posterolateral-ALL tunnel is performed. The tibial ACL tunnel is performed as usual. The tibial guide is placed between the ALL tibial attachment and the tibial ACL tunnel entrance to perform the ALL tibial tunnel. The gracilis graft is introduced from caudal to cranial, achieving fixation with a 6-mm diameter screw (outside-in). The AM femoral fixation is achieved with a suspension device. ACL tibial graft fixation is achieved with a screw. Afterward, the gracilis is passed under the fascia lata to the tibial entry point. A 6-mm diameter screw is placed from the external cortex into the tibial ALL tunnel. The biomechanical advantage of the double-bundle ACL reconstruction with the biomechanical advantage of the ALL anatomic reconstruction is achieved.

| S-EPMC6112256 | biostudies-literature

Combined Anterior Cruciate Ligament and Anterolateral Ligament Reconstruction.

Project description:Despite technologic advances in the surgical technique for anterior cruciate ligament (ACL) reconstruction, some patients continue to have rotational instability postoperatively. Recently, authors have reported the anatomic and functional characteristics of the anterolateral ligament (ALL), a structure that originates near the lateral epicondyle on the femur and inserts on the tibia between the Gerdy tubercle and the fibular head. Recent biomechanical studies have shown the ALL is an important stabilizer against anterolateral tibial rotation, and its reconstruction has shown excellent initial clinical results. Several techniques have been developed to try to anatomically address this structure in the setting of an ACL reconstruction. This article details a simple anatomic technique to reconstruct the ACL and the ALL of the knee using hamstring tendon autograft and maintaining the semitendinosus insertion.

| S-EPMC5263705 | biostudies-other

Minimally Invasive Anterolateral Ligament Reconstruction of the Knee.

Project description:Anterior cruciate ligament (ACL) tears are among the most common knee injuries, and multiple reconstructive techniques have been described. However, studies frequently report an inability to duplicate native, dynamic knee function, particularly rotationally. This residual joint laxity that occasionally follows an ACL reconstruction can cause further problems post surgical intervention, including meniscal tears and especially late osteoarthritic change. Additionally, ACL graft retears are a concern, particularly in young patients. Although these undesired sequelae of ACL reconstruction could be a by-product of insufficient ACL reconstruction methods related to either graft placement or problems with graft healing and biology, it is also possible that failure to additionally address lateral extra-articular structures after ACL injury could play a role in the residual knee laxity of the affected knee. The purpose of this article is to show a minimally invasive technique for extra-articular anterolateral ligament reconstruction.

| S-EPMC5439160 | biostudies-literature

Combined Anatomic Anterior Cruciate Ligament and Double Bundle Anterolateral Ligament Reconstruction.

Project description:The results of arthroscopic anterior cruciate ligament (ACL) reconstruction are so far satisfactory and improving over time as a result of the improved understanding of the anatomy and biomechanics of the ACL. Rotational instability confirmed by a positive pivot shift is present in more than 15% of cases who underwent successful ACL reconstruction. Persistent rotational instability interferes with performing pivoting sports, and also may lead to meniscal and chondral injuries, or re-rupture of the reconstructed ACL. Surgeons reconsidered the anatomy and biomechanics of the ACL and introduced the double bundle ACL reconstruction technique aiming to achieve a more rotational control by reconstructing the anteromedial and anterolateral bundles of the ACL. To date, the results of double bundle ACL reconstruction are mixed and inconsistent. The improved understanding of the existence, function, and biomechanical role of the anterolateral ligament (ALL) in controlling the rotational instability of the knee has redirected and refocused attention on a supplemental extra-articular reconstruction of the ALL in conjunction with the intra-articular ACL reconstruction so as to restore normal kinematics of the knee. In this Technical Note, we describe a technique that allows for a combined ACL and double bundle ALL reconstruction using autogenous hamstring graft (semitendinosus and gracilis) tendons. This technique is an extension of our previously described technique of a combined anatomic ACL and single bundle ALL reconstruction. The improved understanding of the anatomy of the ALL makes a double bundle ALL reconstruction more anatomic than single bundle ALL reconstruction, as the native ALL is triangular or inverted Y in shape, with a narrow proximal femoral attachment and a broad distal tibial attachment between Gerdy's tubercle and the head of the fibula.

| S-EPMC5621982 | biostudies-literature

Modified Technique for Combined Reconstruction of Anterior Cruciate Ligament and Anterolateral Ligament.

Project description:During the past few decades, surgical techniques for anterior cruciate ligament (ACL) reconstruction have been developing significantly. To date, studies have shown that after ACL reconstruction, rotational stability has a greater impact on the patient's satisfaction, functional scores, and return to sports than translational stability. Although challenged by many authors in the literature, biomechanical studies on the anterolateral ligament (ALL) of the knee and clinical studies regarding ALL reconstruction have been revealing promising results. Thus, the potentially significant role of the ALL in biomechanical load sharing and improving rotational control of the knee has led to the development of various reconstruction techniques whose goal is to achieve simplicity and yield the best results possible. Guided by this idea, we have developed a modified ACL-ALL reconstruction surgical technique. In this article, our simple, bone-saving, anatomic technique to reconstruct both the ACL and ALL using hamstring tendon autograft is described.

| S-EPMC7917388 | biostudies-literature

Anterolateral Ligament Repair Augmented With Suture Tape in Acute Anterior Cruciate Ligament Reconstruction.

Project description:Several extra-articular surgical techniques in addition to anterior cruciate ligament reconstruction have been proposed to better restore rotational instability of the knee. One option is surgical repair of the anterolateral ligament in acute cases to achieve an anatomic reconstruction. An additional augmentation to the repair could allow a load-sharing-and thus protective-effect for the repair during the healing process. The purpose of this Technical Note is to describe a primary repair of the anterolateral ligament with suture tape augmentation (Internal Brace; Arthrex, Naples, FL) in a patient with an acute anterior cruciate ligament tear.

| S-EPMC6506759 | biostudies-literature

Minimally Invasive Quadriceps Tendon Harvest and Graft Preparation for All-Inside Anterior Cruciate Ligament Reconstruction.

Project description:The quadriceps tendon is an infrequently used graft option for anterior cruciate ligament reconstruction despite favorable clinical results in the literature with low donor site morbidity. It is a versatile graft that can be harvested with bone or as a soft tissue graft alone. In addition, it can be used for anatomic, double-bundle, transtibial, and all-inside reconstructions. The unique characteristics of the quadriceps tendon allow for the ability to harvest a single-bundle large-diameter graft and minimize disruption of normal anatomy, which makes the quadriceps tendon an excellent choice for all-inside techniques. Recently developed minimally invasive harvest techniques described in this note allow for a reproducible predictable and efficient harvest through a small incision.

| S-EPMC5124375 | biostudies-literature

Minimally Invasive Quadriceps Tendon Anterior Cruciate Ligament Reconstruction Using the Quadriceps Tendon Harvest Guide System

Project description: Not available

| S-EPMC10995694 | biostudies-literature