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Infographic| Volume 38, ISSUE 9, P2600-2601, September 2022

Combined Anterior Cruciate Ligament and Lateral Extra-Articular Reconstruction

DOI:https://doi.org/10.1016/j.arthro.2022.07.001
Combined Anterior Cruciate Ligament and Lateral Extra-Articular Reconstruction
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      Abstract

      The anterolateral complex (ALC) of the knee has received renewed research interest because of the potential role of this anatomic region in anterior cruciate ligament (ACL) tear biomechanics and surgical treatment outcomes. The primary structures of the ALC include the iliotibial band deep (Kaplan) fibers, the anterolateral ligament (ALL), and the capsulo-osseous layer (COL) of the iliotibial band, although there remains disagreement on the precise anatomic locations and biomechanical relevance of these structures. Sectioning studies in the ACL-deficient knee have revealed a contribution of the ALC in restraining tibial internal rotation and anterior translation. Biomechanical studies have revealed a potential role for lateral extra-articular reconstruction as an augmentation to ACL reconstruction in knees with combined ACL and ALC sectioning. Clinical studies have reported a reduced ACL reconstruction failure rate with both ALL reconstruction and lateral extra-articular tenodesis procedures.
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      Article info

      Publication history

      Accepted: July 1, 2022
      Received: March 24, 2022

      Footnotes

      The authors report the following potential conflicts of interest or sources of funding: A.G.G. is on the editorial or governing board of Arthroscopy; is Infographics Editor for Arthroscopy; is a paid consultant for Smith & Nephew; and paid presenter or speaker for Smith & Nephew and Ossur. J.C. is a paid consultant for Arthrex, ConMed Linvatec, Ossur, and Smith & Nephew and is a board or committee member of American Orthopaedic Society for Sports Medicine, Arthroscopy Association of North America, and International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine. R.F.L. is a consultant for Arthrex, Ossur, and Smith & Nephew; receives royalties from Arthrex, Ossur, Smith & Nephew, and Elsevier; and is on the editorial board of American Journal of Sports Medicine, Knee Surgery Sports Traumatology Arthroscopy, Journal of Experimental Orthopaedics, Journal of Orthopaedic and Sports Physical Therapy, and Operative Techniques in Sports Medicine. Full ICMJE author disclosure forms are available for this article online, as supplementary material.

      Identification

      DOI: https://doi.org/10.1016/j.arthro.2022.07.001

      Copyright

      © 2022 by the Arthroscopy Association of North America

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