Intraarticular Versus Intraarticular and Extraarticular Reconstruction for Chronic Anterior Cruciate Ligament Instability

Strum, G M; Fox, James M.; Ferkel, Richard D.; Dorey, Fred; Pizzo, Wilson Del; Friedman, Marc J.; Snyder, Stephen J.; Markolf, Keith L.

doi:10.1097/00003086-198908000-00030

Cited by 100 publications

(93 citation statements)

References 32 publications

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“…The combined reconstructions did not provide additional stability. Similar clinical results were obtained where no demonstrable benefit with combined stabilization procedures for chronic ACL instability was found (Anderson et al, 2001;Strum et al, 1989).…”

Section: Introductionsupporting

confidence: 69%

Biomechanical evaluation of intra-articular and extra-articular procedures in anterior cruciate ligament reconstruction: A finite element analysis

Ramaniraka

Saunier

Siegrist

et al. 2007

Clinical Biomechanics

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Background. Intra-articular techniques (single and double bundles) are the most widely used procedures for the anterior cruciate ligament reconstruction. Lemaire introduced in 1967 the extra-articular techniques, and combined intra-articular and extra-articular reconstruction, to better restore the stability of the knee. However, the effectiveness of these procedures (intra-articular, extra-articular combined or not with intra-articular) seems to be controversial.Methods. In the present study, we developed numerical models of a knee joint to evaluate the effects of these different procedures on the kinematics and biomechanics of the knee during an internal rotation test. Six cases were simulated: intact anterior cruciate ligament, intra-articular reconstructed anterior cruciate ligament (single and double bundles), extra-articular reconstructed anterior cruciate ligament alone, and combination of extra-and intra-articular reconstructions. The loading condition was an internal tibial torque of 2 N m at 0°, 15°, 30°and 45°of knee flexion. Internal rotation of the tibia and forces within the grafts and the ligaments were calculated.Findings. This study showed that both single and double bundles intra-articular reconstructions restore similar internal rotation control and biomechanics of the soft structures as the intact anterior cruciate ligament situation. On the other hand, our results indicate that extra-articular reconstruction reduces appreciably the internal rotation and modifies the charges distribution in the soft structures when compared to the intact anterior cruciate ligament.Interpretation. The extra-articular procedure alters the kinematics of the knee, which might overconstraint the ligaments and the femorotibial joints, leading to the failure of the anterior cruciate ligament reconstruction.

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Section: Introductionsupporting

confidence: 69%

Biomechanical evaluation of intra-articular and extra-articular procedures in anterior cruciate ligament reconstruction: A finite element analysis

Ramaniraka

Saunier

Siegrist

et al. 2007

Clinical Biomechanics

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“…Many studies have already investigated the role of such extraarticular procedures. 5,6,[8][9][10]29,30 Anderson et al, 31 as well as Roth et al, 5 showed no improvement by the addition of an extra-articular procedure. Completely …”

Section: Figmentioning

confidence: 99%

“…1 Because of limitations of current intra-articular techniques and inability to fully restore normal knee kinematics, insufficient anterolateral structures may play a role in residual knee laxity. 1,3,4 The role of extra-articular procedures improving knee stability has been a matter of debate, especially with regard to the rotational component (glide), and although authors such as Roth et al, 5 Strum et al, 6 and Barrett et al 7 found no significant improvements with the use of extra-articular plasty, Lerat et al, 8 Noyes et al, 9 and Zaffagnini et al 10 found increased success rates with the addition of an extra-articular procedure.…”

mentioning

confidence: 99%

Percutaneous Reconstruction of the Anterolateral Ligament of the Knee With a Polyester Tape

Wagih¹,

Elguindy²

2016

Arthroscopy Techniques

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Recent advances in surgeons' understanding of the anatomic, biomechanical, and radiologic features of the anterolateral ligament (ALL) of the knee have led to an increased interest in reconstruction of this structure as part of the management of knee instability. Even without any technical flaws and proper positioning of the bone tunnels, there is a small subset of patients, approximately 7% of all patients, who experience some residual anterolateral rotational instability after anterior cruciate ligament reconstruction. For this reason, some researchers have turned again toward the anterolateral aspect of the knee and specifically the ALL. In this technical note, the surgical steps for percutaneous reconstruction of ALL of the knee using a polyester tape are described.

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“…Hace varias décadas se comenzó a utilizar la tenodesis extraarticular aislada (81)(82)(83)(84) , controlando de forma efectiva la inestabilidad rotacional pero ejerciendo solamente un moderado control sobre la inestabilidad anteroposterior con resultados pobres a largo plazo. Además, se observó un aumento de cambios degenerativos en el compartimento lateral de la rodilla (85,86) . Posteriormente, se pasó a la reconstrucción intraarticular transtibial del LCA mediante fascí-culo único, convirtiéndose en el gold estándar, con una orientación más vertical de la misma, mejorando en este caso la inestabilidad anteroposterior, pero con resultados pobres en el control de la inestabilidad rotacional (87,88) .…”

Section: Tratamientounclassified

Revisión sistemática: ligamento anterolateral de la rodilla

Cáceres¹,

Vázquez²,

Espejo-Reina³

et al. 2018

REACA

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Intraarticular Versus Intraarticular and Extraarticular Reconstruction for Chronic Anterior Cruciate Ligament Instability

Cited by 100 publications

References 32 publications

Biomechanical evaluation of intra-articular and extra-articular procedures in anterior cruciate ligament reconstruction: A finite element analysis

Biomechanical evaluation of intra-articular and extra-articular procedures in anterior cruciate ligament reconstruction: A finite element analysis

Percutaneous Reconstruction of the Anterolateral Ligament of the Knee With a Polyester Tape

Revisión sistemática: ligamento anterolateral de la rodilla

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