Anterolateral Rotary Instability of the Knee Joint:Results after Stabilization by Extraarticular Transposition of the Lateral Part of the Patellar Ligament. A Preliminary Report

Biomechanical Results of Lateral Extra-articular Tenodesis Procedures of the Knee: A Systematic Review

“…In addition, the grafts were fixed to ensure that the anterior bundle was taut in flexion and the posterior bundle was taut in extension (Fig 9). 1982 Benum 30 The lateral one-third of the patellar tendon was harvested proximally with a patellar bone block, passed deep to the FCL, and fixed with a staple within a bony groove deep to the femoral origin of the FCL with the knee flexed to 45 and held in external rotation (Fig 10). 1983 Müller 34 A strip of iliotibial band was detached proximally and fixed with 2 cancellous screws to a point anterior to the junction of the femoral shaft and lateral femoral condyle with the knee held in external rotation ( Fig 11).…”

“…However, several LET techniques exhibited a significant degree of uniformity, with the extra-articular graft generally attaching distally at the Gerdy tubercle and traveling proximally and posterolaterally toward the lateral femoral condyle. 20,[26][27][28][29][30][31][32][33][34][35] Table 1 and …”

Anterolateral rotatory instability of the knee: Cadaver study of extraarticular patellar-tendon transposition

“…However, this unnatural motion pattern of the knee will interfere with the normal "screw home" mechanism. Many of the extraarticular reconstruction procedures whose purpose is to eliminate or reduce anterolateral rotatory instability recommend fixing the tibia in an externally rotated position (Losee et al 1978, Benum 1982, Andrews et al 1985. This change in normal knee kinematics may subsequently result in the articular surfaces being subjected to higher than normal loads with abnormal contact locations, with the possibility of associated functional abnormalities and predisposition to knee arthrosis.…”

“…The rationale for the transposition of the lateral one third of the patellar tendon is to prevent anterolateral rotatory instability using material with sufficient mechanical strength, thereby reducing the risk that the graft will stretch out. Short-and medium-term follow-ups have shown that anterolateral rotatory instability is indeed prevented and does not appear to return with time (Benum 1982 and1986). The fact that one third of the patellar tendon is known to be stronger than the normal anterior ligament (Noyes et al 1983) and that the Benum procedure leads to forces close to normal under the same joint load states suggest that the technique may be a good choice if an extraarticular reconstruction is preferred as a sole procedure for the correction of anterolateral rotatory instability.…”

Extraarticular transposition of the patellar tendon for anterolateral instability of the knee:Poor results in 52 patients after 5-14-year follow-up

“…Antemlateral rotatory instability is the main cause of pain and discomfort in patients in the early period after an isolated rupture of the anterior cruciate ligament. To prevent this instability, Benum (1982) reported a method using transposition of the lateral one third of the patellar tendon, with a patellar bone block to the lateral femoral condyle. This ligament was felt to have sufficient strength to prevent the stretching observed with other extraarticular procedures (Noyes et al 1983b, Bray et al 1988, Dahlstedt et al 1988, Reid et al 1992.…”