scholarly journals Lateral Extraarticular Tenodesis in Combined ACL and ALL Reconstruction. Case presentation

2019 ◽  
Vol 69 (12) ◽  
pp. 3749-3752
Author(s):  
Radu Paraschiv ◽  
George Dinache ◽  
Marinel Drignei ◽  
Eric Jovenet ◽  
Dumitru Ferechide ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Pivot Shift ◽  
Cruciate Ligament ◽  
Case Presentation ◽  
Cruciate Ligament Reconstruction ◽  
Anterior Cruciate ◽  
Grade 3 ◽  
Graft Selection

The purpose of this paper was to evaluate the necesity of associating a lateral extraarticular tenodesis in patients that will undergo an anterior cruciate ligament reconstruction or revision and to briefly describe the surgical procedure. Multiple lateral extraarticular tenodesis techniques were described and also graft selection and fixation types are also important. In conclusion acute ACL tears with grade 3+ pivot shift can be succesfully treated by combined ACL reconstruction and LEAT association.

scholarly journals Limited evidence for graft selection in pediatric ACL reconstruction: a narrative review

2022 ◽  
Vol 9 (1) ◽  
Author(s):  
Gianni De Petrillo ◽  
Thierry Pauyo ◽  
Corinna C. Franklin ◽  
Ross S. Chafetz ◽  
Marie-Lyne Nault ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Sport Participation ◽  
Cruciate Ligament ◽  
Ligament Injury ◽  
Iliotibial Band ◽  
Cruciate Ligament Reconstruction ◽  
Anterior Cruciate ◽  
Graft Selection

AbstractAnterior cruciate ligament reconstruction is the preferred treatment to anterior cruciate ligament injury. With the increase in anterior cruciate ligament injuries in both adults and skeletally immature patients comes the need for individualized anterior cruciate ligament reconstruction graft selection whether it is the type of graft (auto vs. allograft) or the harvesting site (hamstrings, iliotibial band, quadriceps, patella). Several factors need to be considered preoperatively in order to optimize the patients’ recovery and restore anterior cruciate ligament strength and function. These include age and bone maturity, preoperative knee flexor/extensor strength, sport participation, patient’s needs and anatomical characteristics. This paper aims at bringing evidence supporting the use of a personalized approach in graft selection for faster and more efficient return to sport and propose a theoretical framework to support the approach.

Anatomical anterior cruciate ligament reconstruction (ACLR) results in fewer rates of atraumatic graft rupture, and higher rates of rotatory knee stability: a meta-analysis

2020 ◽  
Vol 5 (6) ◽  
pp. 359-370
Author(s):  
Yousif Eliya ◽  
Khaled Nawar ◽  
Benjamin B Rothrauff ◽  
Bryson P Lesniak ◽  
Volker Musahl ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Failure Rate ◽  
Ligament Reconstruction ◽  
Pivot Shift ◽  
Cruciate Ligament ◽  
Meta Analysis ◽  
Knee Stability ◽  
Cruciate Ligament Reconstruction ◽  
Anterior Cruciate

ImportanceThis review highlights the differences in outcomes between anatomical and non-anatomical anterior cruciate ligament reconstruction (ACLR) techniques.ObjectiveTo compare clinical and functional outcomes between anatomical and non-anatomical ACLR techniques.Evidence reviewA search of MEDLINE, Embase and PubMed from 1 January 2000 to 24 October 2019 was conducted. Randomised and prospective primary ACLR studies using autograft and a minimum of 2 years of follow-up were included. The Anatomic Anterior Cruciate Ligament Reconstruction Checklist (AARSC) was used to categorise studies as anatomical. Outcomes analysed included failure rate, knee stability and functional outcomes. A meta-analysis using risk ratio and mean differences was conducted using a random effects model.FindingsThirty-six studies were included, representing 3710 patients with a follow-up range of 24–300 months. The overall failure rate was 96/1470 (6.5%) and 131/1952 (6.7%) in the anatomical group and non-anatomical group, respectively. The pooled results of the overall failure rate showed that there was no statistically significant difference between the anatomical and the non-anatomical groups (p=0.96). There were 37/60 (61.7%) and 29/67 (43.3%) traumatic failures in the anatomical and non-anatomical groups, respectively. The number of patients with the negative postoperative pivot-shift test was 995/1252 (79.5%) and 1140/1589 (71.1%) in the anatomical and non-anatomical groups, respectively. The pooled results indicated a statistically significant higher number of patients with a positive pivot shift in the non-anatomical group compared with the anatomical group (p=0.03).Conclusions and relevanceThis study demonstrated that the overall failure rate was similar between the anatomical and non-anatomical approaches. However, the anatomical ACLR demonstrated a significantly superior restoration of rotatory stability, as evidenced by a higher percentage with a negative postoperative pivot-shift test. Non-anatomical ACLR resulted in higher rates of atraumatic graft ruptures and persistent rotatory knee instability. Surgeons should consider anatomical ACLR when treating rotatory knee stability in patients.Level of evidenceII, systematic review and meta-analysis of level I and II studies.

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