Related Experiment Video
Updated: Feb 16, 2026
Harvesting of Peroneus Longus Tendon Autograft
Published on: September 2, 2025
Minimally invasive anatomic reconstruction of the anterolateral ligament with ipsilateral gracilis tendon
Giovanni Felice Trinchese1, Francesco Oliva2, Nicola Maffulli3
1Department of Orthopaedics and Traumatology, "San Francesco d'Assisi" Hospital, Oliveto Citra (SA), Italy.
Background:
There has been much interest in understanding the anatomy and biomechanics of the anterolateral ligament (ALL). Several recon struction procedures have been proposed to correct rotatory instability after Anterior Cruciate Ligament (ACL) and anterolateral soft tissues injuries.
Methods:
We propose a new anatomic minimally invasive ALL reconstruction using the ipsilateral gracilis tendon. Through small skin incisions, the femoral attachment and the tibial insertion of the ALL can be identified, and half tunnels drilled. Then, the neo-ligament can be passed under the fascia lata into the tunnels. Fixation to the tibia is accomplished with a biotenodesis screw, and to the femur with a TightRope RT (Arthrex).
Conclusion:
This procedure allows to reconstruct in a minimally invasive fashion the ALL in selected patients with chronic anterolateral instability in ACL deficient knees.
Level Of Evidence:
V.
