Rotational stability after ACL reconstruction using anatomic double bundle technique versus anatomic single bundle technique plus anterolateral ligament augmentation

2019 ◽  
Vol 6 (2) ◽  
pp. 108-113 ◽  
Author(s):  
Begad Hesham Abdelrazek ◽  
Ahmed Mahmoud Gad ◽  
Ahmed Abdel-Aziz
Keyword(s):  
Acl Reconstruction ◽  
Double Bundle ◽  
Anterolateral Ligament ◽  
Rotational Stability ◽  
Single Bundle ◽  
Double Bundle Technique ◽  
Ligament Augmentation

scholarly journals The anterolateral ligament of the knee joint: a review of the anatomy, biomechanics, and anterolateral ligament surgery

2019 ◽  
Vol 31 (1) ◽  
Author(s):  
Ji Hyun Ahn ◽  
Nilay A. Patel ◽  
Charles C. Lin ◽  
Thay Q. Lee
Keyword(s):  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Double Bundle ◽  
Anterolateral Ligament ◽  
Rotational Stability ◽  
Single Bundle ◽  
Graft Choice ◽  
Surgical Methods ◽  
Anterior Cruciate

AbstractResidual knee instability and low rates of return to previous sport are major concerns after anterior cruciate ligament (ACL) reconstruction. To improve outcomes, surgical methods, such as the anatomical single-bundle technique or the double-bundle technique, were developed. However, these reconstruction techniques failed to adequately overcome these problems, and, therefore, new potential answers continue to be of great interest. Based on recent anatomical and biomechanical studies emphasizing the role of the anterolateral ligament (ALL) in rotational stability, novel surgical methods including ALL reconstruction and anterolateral tenodesis have been introduced with the possibility of resolving residual instability after ACL reconstruction. However, there is still little consensus on many aspects of the ALL, including: several anatomical issues, appropriate indications for ALL surgery, and the optimal surgical method and graft choice for reconstruction surgery. Therefore, further studies are necessary to advance our knowledge of the ALL and its contribution to knee stability.

Long-Term Results of ACL Reconstruction Using a Nonanatomic Double-Bundle Technique with Extra-Articular Reinforcement

2019 ◽  
Author(s):  
J. Dalla-Rosa ◽  
A. Espejo-Reina ◽  
I. Tamimi ◽  
M. J. Espejo-Reina ◽  
M. Lombardo-Torre ◽  
...  
Keyword(s):  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Double Bundle ◽  
Degenerative Changes ◽  
Long Term Results ◽  
Rotational Stability ◽  
X Rays ◽  
Double Bundle Technique

AbstractExtra-articular procedures for the improvement in rotational stability after anterior cruciate ligament (ACL) reconstruction have gained popularity in the last decade. This surgical gesture hoped to improve resistance to the high tensional forces affecting the ACL graft during cutting and pivoting movements of the lower extremity and eventually prevent ACL reconstruction failure. We performed this study to analyze the long-term results of patients undergoing ACL reconstruction using a nonanatomic double-bundle technique with an additional extra-articular augmentation. All the cases that underwent an ACL reconstruction using a nonanatomic double-bundle technique with an extra-articular reinforcement during the period between 1992 and 1997 were reviewed. The inclusion criteria for this study included a minimum follow-up of 10 years and age between 14 and 45 years at the time of the surgery. Forty patients were included in this series (34 males and 6 females). The mean Lysholm score after a minimum follow-up period of 10 years was 92.3 (standard deviation [SD], 9.4). The average preoperative Tegner score of the participants was 7.0 (SD, 1.1). This score decreased to 5.7 (SD, 1.2) at the end of follow-up. Follow-up X-rays were reviewed to assess the degenerative changes in the three knee compartments. Degenerative changes ≥ Kellgren–Lawrence grade 2 were observed in our six (15%) patients, all of them in the medial knee compartment. With these results, we conclude that double-bundle nonanatomic ACL reconstruction combined with an extra-articular reinforcement resembling the anterolateral ligament offers good overall long-term results, with relatively low rates of osteoarthritis.

scholarly journals Review Article: Anatomic Double Bundle Anterior Cruciate Ligament Reconstruction

2007 ◽  
Vol 15 (2) ◽  
pp. 216-221 ◽  
Author(s):  
W Shen ◽  
S Jordan ◽  
F Fu
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Clinical Investigation ◽  
Cruciate Ligament ◽  
Double Bundle ◽  
Rotational Stability ◽  
Single Bundle ◽  
Osteoarthritic Change ◽  
Anterior Cruciate ◽  
Double Bundle Acl Reconstruction

The anterior cruciate ligament (ACL) consists of 2 bundles: a slightly larger anteromedial bundle and a posterolateral bundle, named according to their relative tibial insertion sites. Both bundles are crucial to knee stability. Although it is more technically demanding, a double bundle ACL reconstruction restores the knee biomechanics better and provides more rotational stability than a single bundle ACL reconstruction. Intermediate and long-term clinical investigation including the measurement of rotational laxity and the evaluation of osteoarthritic change is needed to confirm biomechanical and short-term clinical outcomes.

Biomechanical Evaluation of Anterolateral Ligament Repair augmented with Internal Brace

2021 ◽  
Author(s):  
Ryan P. Roach ◽  
David P. Beason ◽  
Jonathan S. Slowik ◽  
A. Ryves Moore ◽  
Ajay C. Lall ◽  
...  
Keyword(s):  
Internal Rotation ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Surgical Techniques ◽  
Anterolateral Ligament ◽  
Torsional Stiffness ◽  
Rotational Stability ◽  
Gap Formation ◽  
Internal Brace ◽  
Acl Deficient

AbstractInjuries to the anterolateral ligament (ALL) of the knee are commonly associated with anterior cruciate ligament (ACL) ruptures. Biomechanical studies have demonstrated conflicting results with regard to the role of the ALL in limiting tibial internal rotation. Clinically, residual pivot shift following ACL reconstruction has been reported to occur up to 25% and has been correlated with poor outcomes. As such, surgical techniques have been developed to enhance rotational stability. Recent biomechanical studies have demonstrated restoration of internal rotational control following ALL reconstruction. The purpose of our study was to understand the biomechanical effects of ACL reconstruction with an ALL internal brace augmentation. We hypothesized that (1) sectioning of the ALL while preserving other lateral extra-articular structures would lead to significant internal rotation laxity and gap formation and (2) ALL repair with internal brace augmentation would lead to reduction in internal rotation instability and gap formation. In total, 10 fresh-frozen cadaveric knees were thawed and biomechanically tested in internal rotation for 10 cycles of normal physiologic torque in the intact, ACL-deficient, ACL/ALL-deficient, ACL-reconstructed, and ALL-repaired conditions. Each condition was tested at 30, 60, and 90 degrees of flexion. Following the final ALL-repaired condition, specimens were additionally subjected to a final internal rotation to failure at 1 degree at the last-tested degree of flexion. Kinematic measurements of angle and linear gap between the femur and tibia were calculated in addition to torsional stiffness and failure torque. As hypothesized, ALL repair with internal brace augmentation significantly reduced internal rotation angular motion and gap formation at flexion angles greater than 30 degrees. Additionally, ALL sectioning produced nonsignificant increases in internal rotation laxity and gap formation compared with ACL-deficient and ACL-reconstructed states, which did not support our other hypothesis.

scholarly journals Anterolateral ligament of the knee: back to the future in anterior cruciate ligament reconstruction

2015 ◽  
Vol 7 (2) ◽  
Author(s):  
Davide Edoardo Bonasia ◽  
Andrea D'Amelio ◽  
Pietro Pellegrino ◽  
Federica Rosso ◽  
Roberto Rossi
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Double Bundle ◽  
Anterolateral Ligament ◽  
Rotational Instability ◽  
Small Subset ◽  
Acl Injuries ◽  
Anterior Cruciate ◽  
Double Bundle Acl Reconstruction

Although the importance of the anterolateral stabilizing structures of the knee in the setting of anterior cruciate ligament (ACL) injuries has been recognized since many years, most of orthopedic surgeons do not take into consideration the anterolateral structures when performing an ACL reconstruction. Anatomic single or double bundle ACL reconstruction will improve knee stability, but a small subset of patients may experience some residual anteroposterior and rotational instability. For this reason, some researchers have turned again towards the anterolateral aspect of the knee and specifically the anterolateral ligament. The goal of this review is to summarize the existing knowledge regarding the anterolateral ligament of the knee, including anatomy, histology, biomechanics and imaging. In addition, the most common anterolateral reconstruction/tenodesis techniques are described together with their respective clinical outcomes.

Single-bundle patellar tendon versus non-anatomical double-bundle hamstrings ACL reconstruction: a prospective randomized study at 8-year minimum follow-up

2010 ◽  
Vol 19 (3) ◽  
pp. 390-397 ◽  
Author(s):  
Stefano Zaffagnini ◽  
Danilo Bruni ◽  
Giulio Maria Marcheggiani Muccioli ◽  
Tommaso Bonanzinga ◽  
Nicola Lopomo ◽  
...  
Keyword(s):  
Acl Reconstruction ◽  
Patellar Tendon ◽  
Randomized Study ◽  
Double Bundle ◽  
Prospective Randomized Study ◽  
Single Bundle
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