Extra-articular reconstructive surgery for combined anterolateral-anteromedial rotatory instability

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomechanics

Background:

• Combined anterolateral-anteromedial rotatory knee instability presents complex surgical challenges.
• Extra-articular reconstructions offer an alternative to traditional intra-articular procedures for knee instability.

Purpose of the Study:

• To assess the efficacy of a specific extra-articular surgical technique for combined anterolateral-anteromedial rotatory knee instability.
• To compare the functional outcomes of this extra-articular reconstruction with established anterior cruciate ligament reconstruction methods.

Main Methods:

• Surgical extra-articular reconstruction involving anteromedial capsulorrhaphy, pes transfer, and iliotibial band rerouting with biceps advancement.
• Follow-up evaluations of 14 patients (12 male, 2 female) undergoing the procedure for combined rotatory knee instability.

Main Results:

• An 8-month average healing and rehabilitation period was required for patients to return to full activity.
• Twelve of 13 evaluated patients showed functional improvement, with one patient reinjuring the knee postoperatively.
• The functional outcomes favorably compared with reported results of anterior cruciate ligament reconstructions.

Conclusions:

• The described extra-articular reconstruction provides a technically simpler approach with favorable functional outcomes for combined anterolateral-anteromedial rotatory knee instability.
• Further long-term studies are necessary to definitively compare this extra-articular technique with combined extra-articular and intra-articular anterior cruciate ligament reconstructions.