Giovanni Felice Trinchese1, Francesco Oliva2, Nicola Maffulli3. 1. Department of Orthopaedics and Traumatology, "San Francesco d'Assisi" Hospital, Oliveto Citra (SA), Italy. 2. Department of Orthopaedics and Traumatology, University of Rome "Tor Vergata", Rome, Italy. 3. Department of Musculoskeletal Surgery, Azienda Ospedaliera San Giovanni di Dio e Ruggi d'Aragona, University of Salerno, Italy; Queen Mary University of London, Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Mile End Hospital, London, UK.
Abstract
BACKGROUND: There has been much interest in understanding the anatomy and biomechanics of the anterolateral ligament (ALL). Several recon struction procedures have been proposed to correct rotatory instability after Anterior Cruciate Ligament (ACL) and anterolateral soft tissues injuries. METHODS: We propose a new anatomic minimally invasive ALL reconstruction using the ipsilateral gracilis tendon. Through small skin incisions, the femoral attachment and the tibial insertion of the ALL can be identified, and half tunnels drilled. Then, the neo-ligament can be passed under the fascia lata into the tunnels. Fixation to the tibia is accomplished with a biotenodesis screw, and to the femur with a TightRope RT (Arthrex). CONCLUSION: This procedure allows to reconstruct in a minimally invasive fashion the ALL in selected patients with chronic anterolateral instability in ACL deficient knees. LEVEL OF EVIDENCE: V.
BACKGROUND: There has been much interest in understanding the anatomy and biomechanics of the anterolateral ligament (ALL). Several recon struction procedures have been proposed to correct rotatory instability after Anterior Cruciate Ligament (ACL) and anterolateral soft tissues injuries. METHODS: We propose a new anatomic minimally invasive ALL reconstruction using the ipsilateral gracilis tendon. Through small skin incisions, the femoral attachment and the tibial insertion of the ALL can be identified, and half tunnels drilled. Then, the neo-ligament can be passed under the fascia lata into the tunnels. Fixation to the tibia is accomplished with a biotenodesis screw, and to the femur with a TightRope RT (Arthrex). CONCLUSION: This procedure allows to reconstruct in a minimally invasive fashion the ALL in selected patients with chronic anterolateral instability in ACL deficient knees. LEVEL OF EVIDENCE: V.
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