Dataset Information

Complex Anterior Cruciate Ligament Revision and Lateral Extra-Articular Tenodesis With Achilles Tendon Allograft: The "Monoloop" Technique.

ABSTRACT: Revision of anterior cruciate ligament reconstruction (ACL-R) presents many challenges that are not encountered in the primary setting and, therefore, requires thorough preoperative planning. Recently, there has been growing evidence showing that combining the anterolateral ligament (ALL) reconstruction with ACL-R revision reduces the risk of postoperative ACL rupture and meniscal tears, and therefore, the ALL reconstruction becomes essential to a complex ACL revision. The technique that we describe is mainly used in the setting of complex ACL revision with extensive tunnel osteolysis associated with rotational instability of the knee. This article presents a technique for a one-stage complex ACL-R revision combined with ALL reconstruction using an Achilles tendon allograft with a bone plug.

SUBMITTER: Chirico M

PROVIDER: S-EPMC11258670 | biostudies-literature | 2024 Jun

REPOSITORIES: biostudies-literature

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Publications

Complex Anterior Cruciate Ligament Revision and Lateral Extra-Articular Tenodesis With Achilles Tendon Allograft: The "Monoloop" Technique.

Chirico Mattia M Taha Zyad Ayman ZA Carminati Mattia M Civinini Roberto R Matassi Fabrizio F

Arthroscopy techniques 20231218 6

Revision of anterior cruciate ligament reconstruction (ACL-R) presents many challenges that are not encountered in the primary setting and, therefore, requires thorough preoperative planning. Recently, there has been growing evidence showing that combining the anterolateral ligament (ALL) reconstruction with ACL-R revision reduces the risk of postoperative ACL rupture and meniscal tears, and therefore, the ALL reconstruction becomes essential to a complex ACL revision. The technique that we desc ...[more]

PMID: 39036402

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Project description:Purpose To identify the risk of anterior cruciate ligament (ACL) femoral tunnel penetration with the use of a staple for lateral extra-articular tenodesis (LET) graft fixation and to determine whether this varied between 2 different techniques for ACL femoral tunnel drilling. Methods Twenty paired, fresh-frozen, cadaver knees underwent ACL reconstruction with a LET. Left and right knees were randomized to ACL reconstruction with femoral tunnel creation by use of either a rigid guide pin and reamer through the accessory anteromedial portal or by the use of a flexible guide pin and reamer through the anteromedial portal. Immediately after tunnel creation, the LET was performed and fixated with a small Richard’s staple. Fluoroscopy was used to obtain a lateral view of the knee to determine staple position, and visualization of the ACL femoral tunnel was performed with the arthroscope to investigate penetration of the staple into the femoral tunnel. The Fisher exact test was conducted to determine whether there was any difference in tunnel penetration between tunnel creation techniques. Results The staple was noted to penetrate the ACL femoral tunnel in 8 of 20 (40%) extremities. When stratified by tunnel creation technique, the Richards staple violated 5 of 10 (50%) of the tunnels made via the rigid reaming technique compared with 3 of 10 (30%) of those created with a flexible guide pin and reamer (P = .65). Conclusions A high incidence of femoral tunnel violation is seen with lateral extra-articular tenodesis staple fixation. Level of Evidence Level IV, controlled laboratory study. Clinical Relevance The risk of penetrating the ACL femoral tunnel with a staple for LET graft fixation is not well understood. Yet, the integrity of the femoral tunnel is important for the success of ACL reconstruction. Surgeons can use the information in this study to consider adjustments to operative technique, sequence, or fixation devices used when performing ACL reconstruction with concomitant LET to avoid the potential for disruption of ACL graft fixation.

Dataset Information

Complex Anterior Cruciate Ligament Revision and Lateral Extra-Articular Tenodesis With Achilles Tendon Allograft: The "Monoloop" Technique.

Publications

Complex Anterior Cruciate Ligament Revision and Lateral Extra-Articular Tenodesis With Achilles Tendon Allograft: The "Monoloop" Technique.

Similar Datasets

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