The MacIntosh lateral substitution reconstruction for anterior cruciate deficiency

Abstract

Twenty-five patients who had anterior cruciate deficient knees treated by the MacIntosh reconstruction operation were reviewed after 5 years, with particular reference to any changes occurring over time. Subjectively, the knees were improved and the results were even better after 5 years than after one year. This was considered to be due to a decrease in the restriction of flexion, and to the psychological and functional adaptation to the injured knee. In the knees operated on, the anterolateral instability increased significantly during the follow up from one year (mean 1.9 mm) to 5 years (3.0 mm), but the numerical value was still as good as in the intact knees (3.5 mm).

Mechanical tensile properties of the anterolateral ligament

“…This ITB‐based approach is found in a similar manner in other techniques. Carson (1985), Österman et al 1993, Wolff et al (2005) approaches based on the semitendinosus tendon to address ALRI have also been discussed in literature (Ulmer et al 2006; Zantop and Petersen 2010).…”

Historia de la reparación del ligamento cruzado anterior

“…MacIntosh (138,149) , en el Toronto General Hospital, describió la reconstrucción intraarticular con una tira obtenida de la cintilla iliotibial, conocida como técnica MacIntosh-1, que Andrews y Sanders (144,145) modificaron, añadiendo su concepto de isometría, ganando mucha popularidad. La isometría pretendía mantener el injerto a la misma tensión en flexión y en extensión de la rodilla.…”

“…Amirault et al (138) y Ostermann et al (149) consideraron que las técnicas extraarticulares, como la de MacIntosh, eran la alternativa para prevenir un pivote central. Sin embargo, para Amis y Scammell (151) , en las roturas aisladas del LCA no están justificadas y, si se hace una técnica intraarticular correcta, es innecesario acompañarla de métodos extraarticulares.…”

Combined anterior cruciate ligament revision with reconstruction of the antero‐lateral ligament does not improve outcome at 2‐year follow‐up compared to isolated acl revision; a randomized controlled trial

“…There are several standardized extra-articular stabilizing surgical procedures on the anterolateral side of the knee, including lateral extra-articular tenodesis (LET). These were once the primary procedures for the treatment of ACL deficiency [ 4 , 5 ] and were later combined with intra-articular ACL reconstruction [ 6 , 7 ].…”