Review article
https://doi.org/10.21860/medflum2020_241512
Combined reconstruction of anterior cruciate and anterolateral knee ligaments – a review: Step forward or just a trend in orthopaedic surgery?
Goran Vrgoč
orcid.org/0000-0002-4541-4659
; Zavod za ortopediju, Klinička bolnica Sv.Duh, Zagreb, Hrvatska
Filip Vuletić
orcid.org/0000-0002-7662-5774
; Zavod za ortopediju, Klinička bolnica Sv.Duh, Zagreb, Hrvatska
Alan Ivković
orcid.org/0000-0003-0236-6244
; Zavod za ortopediju, Klinička bolnica Sv.Duh, Zagreb, Hrvatska
Saša Janković
orcid.org/0000-0001-5125-4471
; Zavod za ortopediju, Klinička bolnica Sv.Duh, Zagreb, Hrvatska
Abstract
Isolated anterior cruciate ligament (ACL) reconstruction is the gold standard in surgical treatment of anterior cruciate ligament rupture. However, graft failure rates and residual rotational instability of the knee are still common post-operative complications. The anterolateral ligament (ALL) and its role in controlling rotational stability gained considerable interest in 2013 following the announcement of its ‟rediscovery”. This ligamentous structure, described back in 1879, originates just proximal and posterior of the lateral epicondyle of the femur and it ends on the tibia, midway between Gerdy's tubercle and the head of the fibula. Biomechanical studies have shown that the anterolateral ligament acts as a passive knee stabilizer during internal knee rotation and in the rupture of the ACL and lateral knee structures is responsible for the presence of a pivot-shift knee phenomenon. It has been shown that isolated ACL reconstruction in patients with ACL and ALL injury cannot restore normal knee kinematics unlike their combined reconstruction. In addition, recent literature shows evidence in terms of improving knee stability after a combined ACL and ALL reconstruction procedure. Moreover, recent clinical studies have shown that ALL has a protective effect on the preservation of ACL graft as well as on the faster return to sport and overall patient satisfaction. This review aims to give an overview of our current knowledge of the anatomy, function, and effect of combined ACL and ALL reconstruction in patients with ACL rupture.
Keywords
lateral extra-articular tenodesis; internal rotation; knee; rotation instability
Hrčak ID:
241512
URI
Publication date:
1.9.2020.
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