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Anterolateral Complex Reconstruction: Another Fad or Method to Improve ACL Outcomes?
Ryan Wood1, Jacquelyn Marsh2, Alan Getgood1
1The Fowler Kennedy Sport Medicine Clinic.
Techniques in Orthopaedics (Rockville, Md.)
|December 14, 2018
Summary
Anterolateral rotational laxity after anterior cruciate ligament reconstruction (ACLR) is a concern. Adjunctive techniques like lateral extra-articular tenodesis may improve knee stability and reduce graft failure, but economic impacts require further study.
Area of Science:
- Orthopedic surgery
- Sports medicine
- Biomechanics
Background:
- Anterolateral rotational laxity is a common issue post-anterior cruciate ligament reconstruction (ACLR).
- This laxity can increase the risk of graft failure.
- There is growing interest in addressing the anterolateral complex to improve outcomes.
Purpose of the Study:
- To evaluate the role of adjunctive techniques in managing anterolateral rotational laxity after ACLR.
- To explore if these techniques can restore normal knee kinematics and reduce graft failure rates.
- To consider the economic implications of additional surgical procedures.
Main Methods:
- Review of current literature on anterolateral complex reconstruction and lateral extra-articular tenodesis.
- Analysis of biomechanical principles related to knee kinematics.
- Consideration of historical data from modified ACLR techniques.
Main Results:
- Adjunctive techniques show potential to restore knee kinematics.
- Improved biomechanics do not always translate to superior clinical outcomes, as seen with previous ACLR modifications.
- Additional procedures introduce further costs.
Conclusions:
- Lateral extra-articular tenodesis and anterolateral ligament reconstruction may help control anterolateral rotational laxity.
- Clinical efficacy and long-term benefits need robust validation.
- Economic analysis is crucial to determine the cost-effectiveness of these advanced ACLR strategies.
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