Combined Anterior Cruciate Ligament and Anterolateral Ligament Reconstruction Using a Single Achilles Tendon Allograft: A Technical Note

Abstract

Clinical outcomes after anterior cruciate ligament reconstruction (ACLR) have improved remarkably. However, residual rotational instability of the knee joint remains a major concern. The anterolateral ligament (ALL) has recently gained interest as a secondary stabilizer of knee joint rotatory instability, and this has led to the attempt of ALL reconstruction (ALLR) in combination with ACLR to restore rotational stability in patients with anterior cruciate ligament (ACL) injury. Although several techniques for ALLR have recently been introduced, the ideal graft type and surgical technique for combined ACLR and ALLR are yet to be established. This technical note therefore aimed at introducing a novel surgical procedure involving the use of a single Achilles tendon allograft as a relatively simple and minimally invasive procedure for combined ALL and ACL reconstruction.

Comparison of Clinical and Radiographic Outcomes According to the Presence or Absence of a Posterior Draw Force during Graft Fixation in Anterior Cruciate Ligament Reconstruction

“…If patients opted for an allograft, the allogenous tibialis anterior tendon was used for the ACL reconstruction. A mixed graft was used when the diameter of the harvested autograft was too small for application [23,24].…”

Achilles Allograft Fiber Track Graft Preparation Technique for Anterior Cruciate Ligament Reconstruction

“… 9 , 10 , 11 The Achilles tendon provides several advantages, such as sufficient graft length, sufficient graft width, a bone block, and the ability to use the excess allograft tendon for additional ligament reconstruction. 12 , 13 , 14 Additionally, it can be used to combat rotatory instability, which is a common cause of primary reconstruction failure. 15 …”