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Combined Anterior and Anterolateral Stabilization of the Knee With the Hamstring Tendons.

ABSTRACT: Anterior cruciate ligament reconstruction allows good control of sagittal laxity but insufficient rotary laxity control. Our objective is to describe an original lateral extra-articular tenodesis using gracilis in addition to an intra-articular reconstruction using the semitendinosus in a short 4-strand graft. The principles are as follows: The femoral tunnel for intra-articular and extra-articular reconstruction is unique, the femoral attachment is posterior and proximal to the lateral epicondyle, the graft is under the lateral collateral ligament, and the tibial insertion is isometric from 0° to 60° between the Gerdy tubercle and the fibular head.

SUBMITTER: Robert H

PROVIDER: S-EPMC7917012 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

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Combined Anterior and Anterolateral Stabilization of the Knee With the Hamstring Tendons.

Robert Henri H Vincent Jean-Philippe JP

Arthroscopy techniques 20210106 2

Anterior cruciate ligament reconstruction allows good control of sagittal laxity but insufficient rotary laxity control. Our objective is to describe an original lateral extra-articular tenodesis using gracilis in addition to an intra-articular reconstruction using the semitendinosus in a short 4-strand graft. The principles are as follows: The femoral tunnel for intra-articular and extra-articular reconstruction is unique, the femoral attachment is posterior and proximal to the lateral epicondy ...[more]

PMID: 33680756

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Minimally Invasive Combined Anterior and Anterolateral Stabilization of the Knee Using Hamstring Tendons and Adjustable-Loop Suspensory Fixation Device: Surgical Technique.

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Combined Anterior and Anterolateral Stabilization of the Knee With the Iliotibial Band.

Project description:Interest and knowledge on the anatomy, function, and biomechanical properties of the anterolateral ligament has led to the recognition of the importance of this structure in rotational control of the knee. This article describes a technique that allows for a combined anterior cruciate ligament (ACL) and anterolateral reconstruction, using an Iliotibial band (ITB) autograft. The graft is detached from the vastus lateralis from proximal to distal, at the center portion from ITB, preserving its distal insertion on the Gerdy tubercle. Its width is 1 cm for the distal part, used for the anterolateral ligament reconstruction, and 3 cm for the proximal part. An outside-in femoral tunnel is drilled respecting both the preferred favorable isometric femoral insertion site and the femoral ACL footprint. An ACL reconstruction combined with a lateral tenodesis with a continuous ITB graft respects the anatomical and isometric rules providing superior internal rotational control of the knee in comparison with a stand-alone ACL reconstruction.

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Associated Reconstruction of Anterior Cruciate and Anterolateral Ligaments With Single Asymmetric Hamstring Tendons Graft.

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Anterior Cruciate and Anterolateral Ligament Reconstruction Using Hamstring and Peroneus Longus Tendons: Surgical Technique Description.

Project description:The main objective of this study is to describe a surgical technique that combines intra- and extra-articular techniques using the semitendinosus, gracilis, and peroneus longus to perform reconstruction of the anterior cruciate ligament and anterolateral ligament. This technique offers a more stable, fast, low-cost, and widely accessible procedure and consists of drilling 3 tunnels-1 femoral and 2 tibial tunnels-in which the grafts are fixed with interference screws. The fact that the peroneus longus graft is long and thick allows for robust reconstruction of the aforementioned ligaments.

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Project description:This article presents a surgical technique for combined reconstruction of the anterior cruciate ligament (ACL) and anterolateral ligament (ALL) of the knee using hamstring tendon graft. This approach involves creating a single femoral tunnel and using a triple-strand braided hamstring graft for the ACL and a strand of the gracilis tendon for the ALL. This technique aims to increase strength and improve knee stability, potentially reducing the risk of reinjury. The described method provides anatomic reconstruction of the ACL and ALL and allows for combined reconstruction with just 1 graft donor site. Another advantage is that the triple braided graft takes on a tape-like shape, mimicking the native form of the ACL and theoretically increasing biomechanical strength. Combined reconstruction of the ALL and ACL has shown excellent results in specific patient groups, reducing graft failure and improving outcomes in patients with a high risk of rupture. Thus, we describe a promising option for ligament reconstruction in cases of combined ACL and ALL injuries. This method may be a valuable alternative for orthopaedic surgeons, combining anatomic reconstruction with the use of a single donor site.

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