Skip to main content
Top
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 11/2015

01-11-2015 | Knee

Combined anterolateral ligament and anatomic anterior cruciate ligament reconstruction of the knee

Authors: James O. Smith, Sam K. Yasen, Breck Lord, Adrian J. Wilson

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 11/2015

Login to get access

Abstract

Although anatomic anterior cruciate ligament (ACL) reconstruction is established for the surgical treatment of anterolateral knee instability, there remains a significant cohort of patients who continue to experience post-operative instability. Recent advances in our understanding of the anatomic, biomechanical and radiological characteristics of the native anterolateral ligament (ALL) of the knee have led to a resurgent interest in reconstruction of this structure as part of the management of knee instability. This technical note describes our readily reproducible combined minimally invasive technique to reconstruct both the ACL and ALL anatomically using autologous semitendinosus and gracilis grafts. This method of ALL reconstruction can be easily integrated with all-inside ACL reconstruction, requiring minimal additional operative time, equipment and expertise.
Level of evidence V.
Footnotes
1
An online video demonstration of this combined technique can be viewed at: https://​www.​vumedi.​com/​video/​combined-all-inside-acl-anterolateral-ligament-reconstruction/​.
 
Literature
1.
go back to reference Anderson AF, Snyder RB, Lipscomb AB Jr (2001) Anterior cruciate ligament reconstruction. A prospective randomized study of three surgical methods. Am J Sports Med 29:272–279PubMed Anderson AF, Snyder RB, Lipscomb AB Jr (2001) Anterior cruciate ligament reconstruction. A prospective randomized study of three surgical methods. Am J Sports Med 29:272–279PubMed
2.
go back to reference Ardern CL, Webster KE, Taylor NF, Feller JA (2011) Return to sport following anterior cruciate ligament reconstruction surgery: a systematic review and meta-analysis of the state of play. Br J Sports Med 45:596–606CrossRefPubMed Ardern CL, Webster KE, Taylor NF, Feller JA (2011) Return to sport following anterior cruciate ligament reconstruction surgery: a systematic review and meta-analysis of the state of play. Br J Sports Med 45:596–606CrossRefPubMed
3.
go back to reference Campos JC, Chung CB, Lektrakul N, Pedowitz R, Trudell D, Yu J, Resnick D (2001) Pathogenesis of the Segond fracture: anatomic and MR imaging evidence of an iliotibial tract or anterior oblique band avulsion. Radiology 219:381–386CrossRefPubMed Campos JC, Chung CB, Lektrakul N, Pedowitz R, Trudell D, Yu J, Resnick D (2001) Pathogenesis of the Segond fracture: anatomic and MR imaging evidence of an iliotibial tract or anterior oblique band avulsion. Radiology 219:381–386CrossRefPubMed
4.
go back to reference Caterine S, Litchfield R, Johnson M, Chronik B, Getgood A (2014) A cadaveric study of the anterolateral ligament: re-introducing the lateral capsular ligament. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-014-3117-z Caterine S, Litchfield R, Johnson M, Chronik B, Getgood A (2014) A cadaveric study of the anterolateral ligament: re-introducing the lateral capsular ligament. Knee Surg Sports Traumatol Arthrosc. doi:10.​1007/​s00167-014-3117-z
5.
go back to reference Chambat P, Guier C, Sonnery-Cottet B, Fayard JM, Thaunat M (2013) The evolution of ACL reconstruction over the last fifty years. Int Orthop 37:181–186PubMedCentralCrossRefPubMed Chambat P, Guier C, Sonnery-Cottet B, Fayard JM, Thaunat M (2013) The evolution of ACL reconstruction over the last fifty years. Int Orthop 37:181–186PubMedCentralCrossRefPubMed
6.
go back to reference Claes S, Luyckx T, Vereecke E, Bellemans J (2014) The Segond fracture: a bony injury of the anterolateral ligament of the knee. Arthroscopy 30:1475–1482CrossRefPubMed Claes S, Luyckx T, Vereecke E, Bellemans J (2014) The Segond fracture: a bony injury of the anterolateral ligament of the knee. Arthroscopy 30:1475–1482CrossRefPubMed
8.
go back to reference Colombet PD (2011) Navigated intra-articular ACL reconstruction with additional extra-articular tenodesis using the same hamstring graft. Knee Surg Sports Traumatol Arthrosc 19:384–389CrossRefPubMed Colombet PD (2011) Navigated intra-articular ACL reconstruction with additional extra-articular tenodesis using the same hamstring graft. Knee Surg Sports Traumatol Arthrosc 19:384–389CrossRefPubMed
9.
go back to reference Dodds AL, Halewood C, Gupte CM, Williams A, Amis AA (2014) The anterolateral ligament: anatomy, length changes and association with the Segond fracture. Bone Joint J 96-B:325–331CrossRefPubMed Dodds AL, Halewood C, Gupte CM, Williams A, Amis AA (2014) The anterolateral ligament: anatomy, length changes and association with the Segond fracture. Bone Joint J 96-B:325–331CrossRefPubMed
10.
go back to reference Galway R, Beaupré A, MacIntosh DL (1972) A clinical sign of symptomatic cruciate insufficiency. J Bone Joint Surg Br 54-B:763–764 Galway R, Beaupré A, MacIntosh DL (1972) A clinical sign of symptomatic cruciate insufficiency. J Bone Joint Surg Br 54-B:763–764
11.
go back to reference Goldman AB, Pavlov H, Rubenstein D (1988) The Segond fracture of the proximal tibia: a small avulsion that reflects major ligamentous damage. AJR Am J Roentgenol 151:1163–1167CrossRefPubMed Goldman AB, Pavlov H, Rubenstein D (1988) The Segond fracture of the proximal tibia: a small avulsion that reflects major ligamentous damage. AJR Am J Roentgenol 151:1163–1167CrossRefPubMed
12.
go back to reference Helito CP, Demange MK, Bonadio MB, Tirico LE, Gobbi RG, Pecora JR, Camanho GL (2014) Radiographic landmarks for locating the femoral origin and tibial insertion of the knee anterolateral ligament. Am J Sports Med 42:2356–2362CrossRefPubMed Helito CP, Demange MK, Bonadio MB, Tirico LE, Gobbi RG, Pecora JR, Camanho GL (2014) Radiographic landmarks for locating the femoral origin and tibial insertion of the knee anterolateral ligament. Am J Sports Med 42:2356–2362CrossRefPubMed
13.
go back to reference Helito C, Demange M, Bonadio M, Tirico L, Gobbi R, Pecora J, Camanho G (2013) Anatomy and histology of the knee anterolateral ligament. Orthop J Sports Med 1:7CrossRef Helito C, Demange M, Bonadio M, Tirico L, Gobbi R, Pecora J, Camanho G (2013) Anatomy and histology of the knee anterolateral ligament. Orthop J Sports Med 1:7CrossRef
14.
go back to reference Hughston JC, Andrews JR, Cross MJ, Moschi A (1976) Classification of knee ligament instabilities. Part II. The lateral compartment. J Bone Joint Surg Am 58:173–179PubMed Hughston JC, Andrews JR, Cross MJ, Moschi A (1976) Classification of knee ligament instabilities. Part II. The lateral compartment. J Bone Joint Surg Am 58:173–179PubMed
16.
go back to reference Ireland J, Trickey EL (1980) Macintosh tenodesis for anterolateral instability of the knee. J Bone Joint Surg Br 62:340–345PubMed Ireland J, Trickey EL (1980) Macintosh tenodesis for anterolateral instability of the knee. J Bone Joint Surg Br 62:340–345PubMed
17.
go back to reference Kennedy MI, Claes S, Fuso FA, Williams BT, Goldsmith MT, Turnbull TL, Wijdicks CA, LaPrade RF (2015) The anterolateral ligament: an anatomic, radiographic, and biomechanical analysis. Am J Sports Med. doi:10.1177/0363546515578253 PubMed Kennedy MI, Claes S, Fuso FA, Williams BT, Goldsmith MT, Turnbull TL, Wijdicks CA, LaPrade RF (2015) The anterolateral ligament: an anatomic, radiographic, and biomechanical analysis. Am J Sports Med. doi:10.​1177/​0363546515578253​ PubMed
18.
go back to reference Kittl C, Halewood C, Stephen JM, Gupte CM, Weiler A, Williams A, Amis AA (2015) Length change patterns in the lateral extra-articular structures of the knee and related reconstructions. Am J Sports Med 43:354–362CrossRefPubMed Kittl C, Halewood C, Stephen JM, Gupte CM, Weiler A, Williams A, Amis AA (2015) Length change patterns in the lateral extra-articular structures of the knee and related reconstructions. Am J Sports Med 43:354–362CrossRefPubMed
19.
go back to reference LaPrade RF, Gilbert TJ, Bollom TS, Wentorf F, Chaljub G (2000) The magnetic resonance imaging appearance of individual structures of the posterolateral knee. A prospective study of normal knees and knees with surgically verified grade III injuries. Am J Sports Med 28:191–199PubMed LaPrade RF, Gilbert TJ, Bollom TS, Wentorf F, Chaljub G (2000) The magnetic resonance imaging appearance of individual structures of the posterolateral knee. A prospective study of normal knees and knees with surgically verified grade III injuries. Am J Sports Med 28:191–199PubMed
20.
go back to reference Last RJ (1948) Some anatomical details of the knee joint. J Bone Joint Surg Br 30B:683–688PubMed Last RJ (1948) Some anatomical details of the knee joint. J Bone Joint Surg Br 30B:683–688PubMed
21.
go back to reference Leiter JR, Gourlay R, McRae S, de Korompay N, MacDonald PB (2014) Long-term follow-up of ACL reconstruction with hamstring autograft. Knee Surg Sports Traumatol Arthrosc 22:1061–1069CrossRefPubMed Leiter JR, Gourlay R, McRae S, de Korompay N, MacDonald PB (2014) Long-term follow-up of ACL reconstruction with hamstring autograft. Knee Surg Sports Traumatol Arthrosc 22:1061–1069CrossRefPubMed
22.
go back to reference Lemaire M (1967) Rupture ancienne du ligament croisé antérieur du genou; fréquence, clinique, traitement (46 cas). J Chir 83:311–320 Lemaire M (1967) Rupture ancienne du ligament croisé antérieur du genou; fréquence, clinique, traitement (46 cas). J Chir 83:311–320
23.
go back to reference Logan JS, Elliot RR, Wilson AJ (2011) A new technique for hamstring donor site blockade in anterior cruciate ligament reconstruction. Ann R Coll Surg Engl 93:326PubMedCentralCrossRefPubMed Logan JS, Elliot RR, Wilson AJ (2011) A new technique for hamstring donor site blockade in anterior cruciate ligament reconstruction. Ann R Coll Surg Engl 93:326PubMedCentralCrossRefPubMed
24.
go back to reference Logan JS, Elliot RR, Wilson AJ (2012) TransLateral ACL reconstruction: a technique for anatomic anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 20:1289–1292CrossRefPubMed Logan JS, Elliot RR, Wilson AJ (2012) TransLateral ACL reconstruction: a technique for anatomic anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 20:1289–1292CrossRefPubMed
25.
go back to reference MacIntosh DL, Darby TA (1976) Lateral substitution reconstruction. J Bone Joint Surg Br 58-B:142 MacIntosh DL, Darby TA (1976) Lateral substitution reconstruction. J Bone Joint Surg Br 58-B:142
26.
go back to reference McCulloch PC, Lattermann C, Boland AL, Bach BR Jr (2007) An illustrated history of anterior cruciate ligament surgery. J Knee Surg 20:95–104PubMed McCulloch PC, Lattermann C, Boland AL, Bach BR Jr (2007) An illustrated history of anterior cruciate ligament surgery. J Knee Surg 20:95–104PubMed
27.
go back to reference Neyret P, Palomo JR, Donell ST, Dejour H (1994) Extra-articular tenodesis for anterior cruciate ligament rupture in amateur skiers. Br J Sports Med 28:31–34PubMedCentralCrossRefPubMed Neyret P, Palomo JR, Donell ST, Dejour H (1994) Extra-articular tenodesis for anterior cruciate ligament rupture in amateur skiers. Br J Sports Med 28:31–34PubMedCentralCrossRefPubMed
28.
go back to reference Parsons EM, Gee AO, Spiekerman C, Cavanagh PR (2015) The biomechanical function of the anterolateral ligament of the knee. Am J Sports Med 43:669–674CrossRefPubMed Parsons EM, Gee AO, Spiekerman C, Cavanagh PR (2015) The biomechanical function of the anterolateral ligament of the knee. Am J Sports Med 43:669–674CrossRefPubMed
29.
go back to reference Pomajzl R, Maerz T, Shams C, Guettler J, Bicos J (2015) A review of the anterolateral ligament of the knee: current knowledge regarding its incidence, anatomy, biomechanics, and surgical dissection. Arthroscopy 31:583–591CrossRefPubMed Pomajzl R, Maerz T, Shams C, Guettler J, Bicos J (2015) A review of the anterolateral ligament of the knee: current knowledge regarding its incidence, anatomy, biomechanics, and surgical dissection. Arthroscopy 31:583–591CrossRefPubMed
30.
go back to reference Rezansoff AJ, Caterine S, Spencer L, Tran MN, Litchfield RB, Getgood AM (2014) Radiographic landmarks for surgical reconstruction of the anterolateral ligament of the knee. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-014-3126-y PubMed Rezansoff AJ, Caterine S, Spencer L, Tran MN, Litchfield RB, Getgood AM (2014) Radiographic landmarks for surgical reconstruction of the anterolateral ligament of the knee. Knee Surg Sports Traumatol Arthrosc. doi:10.​1007/​s00167-014-3126-y PubMed
31.
go back to reference Sanchez AR, Sugalski MT, LaPrade RF (2006) Anatomy and biomechanics of the lateral side of the knee. Sports Med Arthrosc 14:2–11CrossRefPubMed Sanchez AR, Sugalski MT, LaPrade RF (2006) Anatomy and biomechanics of the lateral side of the knee. Sports Med Arthrosc 14:2–11CrossRefPubMed
32.
go back to reference Segond P (1879) Recherches cliniques et expérimentales sur les épanchements sanguins du genou par entorse. Progres Med 7:297–341 Segond P (1879) Recherches cliniques et expérimentales sur les épanchements sanguins du genou par entorse. Progres Med 7:297–341
33.
go back to reference Sonnery-Cottet B, Thaunat M, Freychet B, Pupim BH, Murphy CG, Claes S (2015) Outcome of a combined anterior cruciate ligament and anterolateral ligament reconstruction technique with a minimum 2-year follow-up. Am J Sports Med. doi:10.1177/0363546515571571 Sonnery-Cottet B, Thaunat M, Freychet B, Pupim BH, Murphy CG, Claes S (2015) Outcome of a combined anterior cruciate ligament and anterolateral ligament reconstruction technique with a minimum 2-year follow-up. Am J Sports Med. doi:10.​1177/​0363546515571571​
34.
go back to reference Strum GM, Fox JM, Ferkel RD, Dorey FH, Del PW, Friedman MJ, Snyder SJ, Markolf K (1989) Intraarticular versus intraarticular and extraarticular reconstruction for chronic anterior cruciate ligament instability. Clin Orthop Relat Res 245:188–198PubMed Strum GM, Fox JM, Ferkel RD, Dorey FH, Del PW, Friedman MJ, Snyder SJ, Markolf K (1989) Intraarticular versus intraarticular and extraarticular reconstruction for chronic anterior cruciate ligament instability. Clin Orthop Relat Res 245:188–198PubMed
35.
go back to reference Terry GC, Hughston JC, Norwood LA (1986) The anatomy of the iliopatellar band and iliotibial tract. Am J Sports Med 14:39–45CrossRefPubMed Terry GC, Hughston JC, Norwood LA (1986) The anatomy of the iliopatellar band and iliotibial tract. Am J Sports Med 14:39–45CrossRefPubMed
36.
go back to reference Terry GC, Norwood LA, Hughston JC, Caldwell KM (1993) How iliotibial tract injuries of the knee combine with acute anterior cruciate ligament tears to influence abnormal anterior tibial displacement. Am J Sports Med 21:55–60CrossRefPubMed Terry GC, Norwood LA, Hughston JC, Caldwell KM (1993) How iliotibial tract injuries of the knee combine with acute anterior cruciate ligament tears to influence abnormal anterior tibial displacement. Am J Sports Med 21:55–60CrossRefPubMed
37.
go back to reference Trojani C, Beaufils P, Burdin G, Bussiere C, Chassaing V, Djian P, Dubrana F, Ehkirch FP, Franceschi JP, Hulet C, Jouve F, Potel JF, Sbihi A, Neyret P, Colombet P (2012) Revision ACL reconstruction: influence of a lateral tenodesis. Knee Surg Sports Traumatol Arthrosc 20:1565–1570CrossRefPubMed Trojani C, Beaufils P, Burdin G, Bussiere C, Chassaing V, Djian P, Dubrana F, Ehkirch FP, Franceschi JP, Hulet C, Jouve F, Potel JF, Sbihi A, Neyret P, Colombet P (2012) Revision ACL reconstruction: influence of a lateral tenodesis. Knee Surg Sports Traumatol Arthrosc 20:1565–1570CrossRefPubMed
38.
go back to reference Vadala AP, Iorio R, De CA, Bonifazi A, Iorio C, Gatti A, Rossi C, Ferretti A (2013) An extra-articular procedure improves the clinical outcome in anterior cruciate ligament reconstruction with hamstrings in female athletes. Int Orthop 37:187–192PubMedCentralCrossRefPubMed Vadala AP, Iorio R, De CA, Bonifazi A, Iorio C, Gatti A, Rossi C, Ferretti A (2013) An extra-articular procedure improves the clinical outcome in anterior cruciate ligament reconstruction with hamstrings in female athletes. Int Orthop 37:187–192PubMedCentralCrossRefPubMed
39.
go back to reference Vincent JP, Magnussen RA, Gezmez F, Uguen A, Jacobi M, Weppe F, Al-Saati MF, Lustig S, Demey G, Servien E, Neyret P (2012) The anterolateral ligament of the human knee: an anatomic and histologic study. Knee Surg Sports Traumatol Arthrosc 20:147–152CrossRefPubMed Vincent JP, Magnussen RA, Gezmez F, Uguen A, Jacobi M, Weppe F, Al-Saati MF, Lustig S, Demey G, Servien E, Neyret P (2012) The anterolateral ligament of the human knee: an anatomic and histologic study. Knee Surg Sports Traumatol Arthrosc 20:147–152CrossRefPubMed
40.
go back to reference Wilson AJ, Yasen SK, Nancoo T, Stannard R, Smith JO, Logan JS (2013) Anatomic all-inside anterior cruciate ligament reconstruction using the translateral technique. Arthrosc Tech 2:e99–e104PubMedCentralCrossRefPubMed Wilson AJ, Yasen SK, Nancoo T, Stannard R, Smith JO, Logan JS (2013) Anatomic all-inside anterior cruciate ligament reconstruction using the translateral technique. Arthrosc Tech 2:e99–e104PubMedCentralCrossRefPubMed
41.
go back to reference Zaffagnini S, Marcacci M, Lo PM, Giordano G, Iacono F, Neri MP (2006) Prospective and randomized evaluation of ACL reconstruction with three techniques: a clinical and radiographic evaluation at 5 years follow-up. Knee Surg Sports Traumatol Arthrosc 14:1060–1069CrossRefPubMed Zaffagnini S, Marcacci M, Lo PM, Giordano G, Iacono F, Neri MP (2006) Prospective and randomized evaluation of ACL reconstruction with three techniques: a clinical and radiographic evaluation at 5 years follow-up. Knee Surg Sports Traumatol Arthrosc 14:1060–1069CrossRefPubMed
42.
go back to reference Zens M, Feucht M, Ruhhammer J, Bernstein A, Mayr H, Sudkamp N, Woias P, Niemeyer P (2015) Mechanical tensile properties of the anterolateral ligament. J Exp Orthop 2:7PubMedCentralCrossRef Zens M, Feucht M, Ruhhammer J, Bernstein A, Mayr H, Sudkamp N, Woias P, Niemeyer P (2015) Mechanical tensile properties of the anterolateral ligament. J Exp Orthop 2:7PubMedCentralCrossRef
Metadata
Title
Combined anterolateral ligament and anatomic anterior cruciate ligament reconstruction of the knee
Authors
James O. Smith
Sam K. Yasen
Breck Lord
Adrian J. Wilson
Publication date
01-11-2015
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 11/2015
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-015-3783-5

Other articles of this Issue 11/2015

Knee Surgery, Sports Traumatology, Arthroscopy 11/2015 Go to the issue