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

Boutsiadis, Achilleas; Brossard, Paul; Panisset, Jean-Claude; Graveleau, Nicolas; Barth, Johannes

doi:10.1016/j.eats.2016.10.019

Cited by 9 publications

(11 citation statements)

References 17 publications

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“…Different fixation methods have been reported in the literature when ACLR and ALLR are considered. 19 Sonnery-Cottet et al 19 fixed their autologous hamstring tendon with aperture screws, and Boutsiadis et al 20 used adjustableloop suspensory fixation device with aperture screws. Both groups recreated SB ACLR and ALLR successfully.…”

Section: Discussionmentioning

confidence: 99%

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Anatomic Double-Bundle ACL Reconstruction With Extra-articular Anterolateral Ligament Reconstruction and Internal Brace

Chiu

Chi

Huang

et al. 2021

Arthroscopy Techniques

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Anterior cruciate ligament reconstruction (ACLR) with additional procedures could be necessary for patients with increased preoperative pivot shift. Double-bundle (DB) ACLR provides more footprint coverage and recreates the 2 functional anteromedial (AM) and posterolateral (PL) bundles, which are believed to give better joint function and stability than single-bundle (SB) ACLR. Internal brace augmentation with suture tape is proposed along with tendon graft in ACLR to protect the newly reconstructed ligament during rehabilitation. Additional reconstruction with anterolateral ligament (ALL) during ACLR has shown significant reduction in the level of persistent pivot shift. In Technical Note we present a modified surgical technique of combined anatomic DB ACLR and ALLR with hamstring autograft and internal brace, using button suspensory fixation device and aperture screws. The objective of this technique is to decrease residual anterior and rotational instability after ACLR and ALLR.

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Section: Discussionmentioning

confidence: 99%

“… 19 fixed their autologous hamstring tendon with aperture screws, and Boutsiadis et al. 20 used adjustable-loop suspensory fixation device with aperture screws. Both groups recreated SB ACLR and ALLR successfully.…”

Section: Discussionmentioning

confidence: 99%

Anatomic Double-Bundle ACL Reconstruction With Extra-articular Anterolateral Ligament Reconstruction and Internal Brace

Chiu

Chi

Huang

et al. 2021

Arthroscopy Techniques

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“…This ACLR+LET technique was previously described by Boutsiadis et al 2 It entailed the same skin incision and approach as for the ST4 group. The gracilis and semitendinosus tendons were harvested and completely detached from their tibial attachment.…”

Section: Methodsmentioning

confidence: 99%

Incidence and Risk Factors for Residual High-Grade Pivot Shift After ACL Reconstruction With or Without a Lateral Extra-articular Tenodesis

Jacquet

Pioger

Seil

et al. 2021

Orthopaedic Journal of Sports Medicine

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Background: Residual rotatory knee laxity at midterm follow-up after isolated anterior cruciate ligament reconstruction (ACLR) versus ACLR with lateral extra-articular tenodesis (LET) remains an issue. Purpose/Hypothesis: To evaluate the outcomes of ACLR with or without additional LET at a minimum 2-year follow-up in patients with preoperative high-grade pivot shift (PS). Our hypothesis was that the addition of LET would decrease the risk of secondary meniscal injury and the presence of residual high-grade PS at follow-up. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective analysis performed at 3 sports medicine centers identified 266 study patients; all had a high-grade PS (grade 2 or 3) preoperatively and underwent isolated ACLR with or without LET. Four different ACLR techniques were used: single-strand quadrupled semitendinosus (ST4) ACLR without LET (ST4 group; n = 55), ST4 with anatomic LET (ST4+LET group; n = 77), bone–patellar tendon and modified Lemaire LET (BTB+LET group; n = 43), and quadriceps tendon and modified Lemaire LET (QT+LET group; n = 91). At follow-up, we evaluated for the presence of high-grade (grade ≥2) PS. Preoperative meniscal tears and their treatment were recorded. Results: Overall, 185 (69.5%) patients had at least 1 meniscal tear at index surgery. The mean follow-up period was 44.3 months; 47 (17.7%) patients had a new meniscal tear and 64 (24%) patients had a high-grade PS at follow-up. Compared with meniscal repair, significant predictors for high-grade PS at follow-up were meniscectomy (odds ratio [OR] = 2.65 [95% CI, 1.19-5.63]; P = .02) and nonrepair of preoperative meniscal tear (OR = 3.26 [95% CI, 1.27-9.43]; P = .007). The appearance of a new symptomatic meniscal tear was the strongest significant predictor of high-grade PS at follow-up (OR = 4.31 [95% CI, 2.31-8.06]; P < .001). No significant correlation was observed between the addition of LET and the presence of high-grade PS at follow-up. Conclusion: In the current study, 1 in 4 patients with high-grade PS before ACLR with or without LET was at risk of residual rotatory knee laxity at mean 44-month follow-up, regardless of the technique used. Repairing a pre-existing meniscal lesion was more effective than performing LET to decrease the presence of a high-grade PS at follow-up.

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“…Recently, LET has been used in addition to ACLR to add restriction to internal tibial rotation forces, 4 and different authors have shown their techniques to achieve this task. 5 , 6 , 7 , 8 , 9 Also, biomechanical studies have compared different techniques for LET procedures. 10 …”

mentioning

confidence: 99%

“…4 Recently, LET has been used in addition to ACLR to add restriction to internal tibial rotation forces, 4 and different authors have shown their techniques to achieve this task. [5][6][7][8][9] Also, biomechanical studies have compared different techniques for LET procedures. 10 This article aims to describe our technique performing a modified Macintosh LET as an addition to ACLR in selected patients who require extra internal tibial rotation control.…”

mentioning

confidence: 99%

Lateral Extra-articular Tenodesis: A Technique With an Iliotibial Band Strand Without Implants

Abusleme

Strömbäck

Caracciolo

et al. 2021

Arthroscopy Techniques

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The main goal in anterior cruciate ligament reconstruction (ACLR) should be to restore normal knee biomechanics so the chances of failure decrease. The persistence of knee instability after ACLR goes from 0.7% to 20%. Several factors have been identified and studied, but there are some selected cases in which it seems that without adding lateral extra-articular tenodesis (LET) it is not possible to control rotational instability. Data exist supporting that LET could reduce pivot shift (PS), without losing flexion/extension range of motion nor adding risk of osteoarthritis. Recently, LET has been used in addition to ACLR to add restriction to internal tibial rotation forces, and different authors have shown their techniques to achieve this task. Also, biomechanical studies have compared different techniques for LET procedures. This article aims to describe our technique performing a modified Macintosh LET as an addition to ACLR in selected patients who require extra internal tibial rotation control. This is a reproducible, easy to learn, and inexpensive procedure in terms that only a high resistance suture is needed and not any other implant, such as a stapler, anchors, or screws, reducing the risk of tunnel coalition.

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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

Cited by 9 publications

References 17 publications

Anatomic Double-Bundle ACL Reconstruction With Extra-articular Anterolateral Ligament Reconstruction and Internal Brace

Anatomic Double-Bundle ACL Reconstruction With Extra-articular Anterolateral Ligament Reconstruction and Internal Brace

Incidence and Risk Factors for Residual High-Grade Pivot Shift After ACL Reconstruction With or Without a Lateral Extra-articular Tenodesis

Lateral Extra-articular Tenodesis: A Technique With an Iliotibial Band Strand Without Implants

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