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Combined Anterior Cruciate Ligament Repair and Anterolateral Ligament Reconstruction With a Single-Strand Gracilis Graft

ABSTRACT: There has been renewed interest in anterior cruciate ligament (ACL) repair procedures in the past decade. Even though ACL reconstruction is still considered the gold standard, ACL repair is an alternative in selected patients. However, the risk of failure owing to isolated ACL repair remains a concern. Intra-articular augmentation has been proposed to protect the repair during the healing period. In the same way, the protective effect of anterolateral ligament reconstruction on the ACL graft is increasingly recognized. We describe a combined ACL repair and anterolateral ligament reconstruction technique with a single-strand gracilis for the intra-articular portion and as an anterolateral graft to protect the ACL repair during the healing phase. Technique Video Video 1 Combined anterior cruciate ligament (ACL) repair and anterolateral ligament (ALL) reconstruction technique with a single-strand gracilis for the intra-articular portion and as an anterolateral graft to protect the ACL repair during the healing phase. The operation is performed on a proximal ACL tear in the right knee. The patient is placed supine, and standard arthroscopic portals are used. The gracilis tendon is harvested for use both as an intra-articular augmentation and for ALL reconstruction. The gracilis strand is passed from the tibia to the femur through bone tunnels, and after fixation of the intra-articular portion of the gracilis, the remaining ACL is sutured back to its femoral insertion. Reconstruction of the ALL is then performed using the gracilis strand emerging from the femoral tunnel.

SUBMITTER: Fayard J

PROVIDER: S-EPMC8626561 | biostudies-literature |

REPOSITORIES: biostudies-literature

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