Dataset Information

Lateral Tenodesis Associated With an Intra-articular Anterior Cruciate Ligament Reconstruction Without Proximal Disinsertion of Iliotibial Band.

ABSTRACT: The persistence of rotational instability after anterior cruciate ligament (ACL) reconstruction has been studied by several authors in the past 10 years. Although ACL lesions are currently treated arthroscopically, in the recent past, they were treated with isolated extra-articular tenodesis alone. Understanding the role and importance of anterolateral structures in the pathophysiology of rotational knee instability has increased since the rediscovery of the anterolateral ligament, and combined intra- and extra-articular reconstructions have been increasingly investigated. We sought to describe an option of lateral tenodesis associated with the ACL reconstruction through an iliotibial band tenodesis, without the need for large incisions or extra fixation devices, in a simple, fast, and reproducible manner.

SUBMITTER: da Silva Araujo HR

PROVIDER: S-EPMC7000314 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

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Lateral Tenodesis Associated With an Intra-articular Anterior Cruciate Ligament Reconstruction Without Proximal Disinsertion of Iliotibial Band.

da Silva Araújo Helder Rocha HR Rocha de Faria José Leonardo JL Heyn Renan Simões RS da Silva Filho Ulbiramar Correia UC de Sousa Eduardo Branco EB Mozella Alan de Paula AP Pavão Douglas Mello DM

Arthroscopy techniques 20190921 10

The persistence of rotational instability after anterior cruciate ligament (ACL) reconstruction has been studied by several authors in the past 10 years. Although ACL lesions are currently treated arthroscopically, in the recent past, they were treated with isolated extra-articular tenodesis alone. Understanding the role and importance of anterolateral structures in the pathophysiology of rotational knee instability has increased since the rediscovery of the anterolateral ligament, and combined ...[more]

PMID: 32042576

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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

Lateral Tenodesis Associated With an Intra-articular Anterior Cruciate Ligament Reconstruction Without Proximal Disinsertion of Iliotibial Band.

Publications

Lateral Tenodesis Associated With an Intra-articular Anterior Cruciate Ligament Reconstruction Without Proximal Disinsertion of Iliotibial Band.

Similar Datasets

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