Combined ACL and Anterolateral Ligament Reconstruction Using an Adjustable-Loop Fixation Device: Surgical Technique

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Ligament Reconstruction

Background:

• Combined anterior cruciate ligament (ACL) and anterolateral ligament (ALL) reconstruction techniques lack a clear superiority.
• Existing methods carry reported risks that this study aims to mitigate.

Purpose of the Study:

• To present a novel surgical technique for combined ACL and ALL reconstruction.
• To theoretically reduce risks associated with current ACL and ALL reconstruction procedures.

Main Methods:

• Utilized hamstring tendon autografts for both ACL and ALL reconstruction.
• Employed a single, outside-in femoral tunnel with a short socket.
• Fixed the ACL with an adjustable-loop button and performed tibial fixation with bioabsorbable screws through small incisions.

Main Results:

• A case of a professional soccer player with acute ACL tear successfully underwent the combined ACL and ALL reconstruction.
• The procedure demonstrated outcomes comparable to traditional methods, with the adjustable-loop button proving a viable fixation option.
• The technique is well-established for ACL augmentation, potentially reducing failure rates in specific risk groups.

Conclusions:

• The presented technique offers theoretical advantages including improved healing, reduced risk of lateral collateral ligament injury, and avoidance of injury to specific nerves and vessels.
• Adjustable-loop cortical buttons may decrease complications like screw migration and implant removal.
• The use of small incisions enhances aesthetic results and reduces postoperative pain, offering theoretical benefits.