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Lateral extra articular tenodesis

Nicholas N DePhillipo, Mark E Cinque, Jorge Chahla, Andrew G Geeslin, Robert F LaPrade
PURPOSE: To perform a systematic review of the described anterolateral ligament (ALL) reconstruction techniques, biomechanical performance, and clinical outcomes of ALL reconstruction in the setting of concurrent anterior cruciate ligament (ACL) reconstruction. METHODS: A systematic review was performed according to PRISMA guidelines using the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, PubMed, MEDLINE, and Embase, from 1980 to present...
May 11, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
Andy Williams, Simon Ball, Jo Stephen, Nathan White, Mary Jones, Andrew Amis
PURPOSE: The purpose of this work was to develop the rationale for adding a lateral extra-articular tenodesis to an ACL reconstruction in a knee with an injury that included both the ACL and anterolateral structures, and to show the early clinical picture. METHODS: The paper includes a review of recent anatomical and biomechanical studies of the anterolateral aspect of the knee. It then provides a detailed description of a modified Lemaire tenodesis technique. A short-term clinical follow-up of a case and control group was performed, with two sequential groups of patients treated by isolated ACL reconstruction, and by combined ACL plus lateral tenodesis...
April 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Brian M Devitt, Nicolas Bouguennec, Kristoffer W Barfod, Tabitha Porter, Kate E Webster, Julian A Feller
PURPOSE: The role of lateral extra-articular tenodesis (LEAT) as an augment to primary anterior cruciate ligament reconstruction (ACLR) remains controversial. However, concerns exist regarding the risk of development of osteoarthritis due to over constraint of the knee. To systematically review the literature to analyse the long-term incidence of osteoarthritis in patients who had an LEAT performed in isolation or in combination with intra-articular ACLR for the treatment of ACL deficiency...
April 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Frank R Noyes
There remains controversy on the role of a concurrent lateral extra-articular procedure with anterior cruciate ligament (ACL) reconstruction. Previous biomechanical studies often are historical and inconclusive. Studies show the anterolateral ligament and iliotibial band are secondary restraints and, when injured in conjunction with the ACL, produce gross (Grade 3) pivot-shift subluxations. Recent robotic studies show a well-placed bone-patellar tendon-bone reconstruction does restore time-zero kinematics with a negative pivot-shift...
December 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Bart Vundelinckx, Benjamin Herman, Alan Getgood, Robert Litchfield
After anterior cruciate ligament (ACL) rupture, anteroposterior and rotational laxity in the knee causes instability, functional symptoms, and damage to other intra-articular structures. Surgical reconstruction aims to restore the stability in the knee, and to improve function and ability to participate in sports. It also protects cartilage and menisci from secondary injuries. Because of persistent rotational instability after ACL reconstruction, combined intra-articular and extra-articular procedures are more commonly performed...
January 2017: Clinics in Sports Medicine
Meghan J Price, Maria Tuca, Frank A Cordasco, Daniel W Green
PURPOSE OF REVIEW: As anterior cruciate ligament (ACL) injury is becoming increasingly prevalent in the population of active children and young adolescents, it is crucial to be aware of both the modifiable and nonmodifiable factors that place this population at increased ACL injury risk. Historically, there has not been a definitive consensus on all of these risk factors-particularly the nonmodifiable ones. RECENT FINDINGS: The present review has accumulated the most recent evidence for the nonmodifiable risk factors in ACL injury focusing particularly on female gender, generalized joint laxity, knee recurvatum, increased lateral tibial slope, decreased intercondylar notch width, structural lower extremity valgus, limb length discrepancy, family history, and history of contralateral knee ACL injury...
February 2017: Current Opinion in Pediatrics
S Zaffagnini, C Signorelli, T Bonanzinga, T Roberti Di Sarsina, A Grassi, A Budeyri, G M Marcheggiani Muccioli, F Raggi, L Bragonzoni, N Lopomo, M Marcacci
PURPOSE: The hypothesis was that an alteration of different surgical variables of ACL reconstruction would produce significant changes in post-operative static laxity of knee joint. METHODS: Joint laxity was acquired by a surgical navigation system for 17 patients just after graft fixation during single-bundle reconstruction with extra-articular lateral tenodesis. The analysed laxity parameters were: internal/external rotation at 30° (IE30) and 90° (IE90) of flexion, varus/valgus rotation at 0° (VV0) and 30° (VV30) of flexion and anterior/posterior displacement at 30° (AP30) and 90° (AP90) of flexion...
November 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Matteo Guzzini, Daniele Mazza, Mattia Fabbri, Riccardo Lanzetti, Andrea Redler, Carlo Iorio, Edoardo Monaco, Andrea Ferretti
PURPOSE: The growing popularity of elite soccer among female participants has led to increased incidents of anterior cruciate ligament (ACL) ruptures. Many authors underline a positive glide after ACL reconstruction (ACLR), especially in women. In fact, an isolated intra-articular ACLR may be inadequate to control rotational instability after a combined injury of the ACL and the peripheral structures of the knee. Extra-articular procedures are sometimes used in primary cases displaying excessive antero-lateral rotatory instability...
October 2016: International Orthopaedics
Erik L Slette, Jacob D Mikula, Jason M Schon, Daniel C Marchetti, Matthew M Kheir, Travis Lee Turnbull, Robert F LaPrade
PURPOSE: To systematically review and compare biomechanical results of lateral extra-articular tenodesis (LET) procedures. METHODS: A systematic review was performed using the PubMed, Medline, Embase, and Cochrane databases. The search terms included the following: extraarticular, anterolateral, iliotibial, tenodesis, plasty, augmentation, procedure, reconstruction, technique, biomechanics, kinematic, robot, cadaver, knee, lateral tenodesis, ACL, Marcacci, Lemaire, Losee, Macintosh, Ellison, Andrews, Hughston, and Muller...
December 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Mai Katakura, Hideyuki Koga, Kaori Nakamura, Ichiro Sekiya, Takeshi Muneta
PURPOSE: Several kinds of anterolateral ligament (ALL) reconstructions to augment intra-articular anterior cruciate ligament reconstruction to better control anterolateral rotational instability (ALRI) have been reported. However, the optimal femoral attachment site for ALL reconstruction is still unclear. The purpose of this study was to investigate the effects of different femoral attachment sites on the tension changes through knee motions in different situations in order to determine a recommended femoral attachment site for ALL reconstruction...
April 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Ata A Rahnemai-Azar, R Matthew Miller, Daniel Guenther, Freddie H Fu, Bryson P Lesniak, Volker Musahl, Richard E Debski
BACKGROUND: The role of the anterolateral capsule in knee stability has recently been advocated by studies reporting that a distinct ligament exists in this area. Defining the structural properties of the anterolateral capsule can provide insight into its contribution to joint stability. The structural properties of the iliotibial band also need to be determined, as it is a common graft used for extra-articular tenodesis. PURPOSE/HYPOTHESIS: The purpose of this study was to determine the structural properties of the anterolateral capsule and iliotibial band...
April 2016: American Journal of Sports Medicine
Guan-Yang Song, Lei Hong, Hui Zhang, Jin Zhang, Yue Li, Hua Feng
PURPOSE: To evaluate the clinical outcomes of combined lateral extra-articular tenodesis (LET) and intra-articular anterior cruciate ligament (ACL) reconstruction (ACLR) in addressing the high-grade pivot-shift phenomenon. METHODS: The PubMed/Medline database was searched for articles reporting clinical outcomes of combined LET and intra-articular ACLR in treating ACL injuries with high-grade pivot shift. High-grade pivot shift was defined as the presence of moderate to severe rotational instability shown by a grade II or III manual pivot shift preoperatively (grade 0, normal; grade I, glide; grade II, clunk; and grade III, locking, according to International Knee Documentation Committee [IKDC] form)...
May 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
James H Lubowitz
Knee lateral extra-articular tenodesis (LET) can be combined with anterior cruciate ligament (ACL) reconstruction with a goal of reducing anterolateral rotatory instability. Like double-bundle ACL reconstruction, LET combined with ACL reconstruction reduces pivot-shift, a subjective test, but results in no significant difference in clinical outcome.
October 2015: Arthroscopy: the Journal of Arthroscopic & related Surgery
Thomas Branch, Frédéric Lavoie, Christian Guier, Eric Branch, Timothy Lording, Shaun Stinton, Philippe Neyret
PURPOSE: The purpose of this study was to compare the biomechanical characteristics and patient outcomes after either isolated intraarticular ACL reconstruction or intraarticular reconstruction with lateral extra-articular tenodesis. In addition, we aimed to evaluate biomechanical parameters of the entire uninjured, contralateral knee as a baseline during the analysis. METHODS: Eighteen patients were evaluated at an average of 9.3 years after ACL reconstruction...
October 2015: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Christopher E Hewison, Michael N Tran, Nicole Kaniki, Alliya Remtulla, Dianne Bryant, Alan M Getgood
PURPOSE: To determine whether the addition of lateral extra-articular tenodesis (LET) to anterior cruciate ligament (ACL) reconstruction would provide greater control of rotational laxity and improved clinical outcomes compared with ACL reconstruction alone. METHODS: Two independent reviewers searched 9 databases for randomized and nonrandomized clinical studies comparing ACL reconstruction plus LET versus ACL reconstruction alone in a human adult population. All years and 5 languages were included...
October 2015: Arthroscopy: the Journal of Arthroscopic & related Surgery
Luke Spencer, Timothy A Burkhart, Michael N Tran, Alex James Rezansoff, Shaneel Deo, Scott Caterine, Alan M Getgood
BACKGROUND: Anatomic anterolateral ligament (ALL) reconstruction has been proposed to assist anterior cruciate ligament (ACL) reconstruction in controlling anterolateral rotational laxity of the knee. However, the biomechanical effects have not been reported. PURPOSE: (1) To investigate the effect of ALL transection on rotational knee kinematics and (2) to determine the effect on knee biomechanics of ALL reconstruction procedures compared with lateral extra-articular tenodesis (LET)...
September 2015: American Journal of Sports Medicine
Daniel Guenther, Chad Griffith, Bryson Lesniak, Nicola Lopomo, Alberto Grassi, Stefano Zaffagnini, Freddie H Fu, Volker Musahl
Recent publications have generated renewed interest in the anatomy of the anterolateral capsule. Knowledge of the biomechanical function of the anterolateral components is lacking. Further research is required to evaluate the influence of the anterolateral capsule on rotatory laxity of the knee. The role of surgical procedures, such as an extra-articular tenodesis or lateral plasty, has to be defined based on quantification of the injury. This article seeks to summarize the current literature and discusses the role of the anterolateral capsule and reconstructive techniques in combined ligamentous knee trauma...
October 2015: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Edoardo Monaco, Barbara Maestri, Fabio Conteduca, Daniele Mazza, Carlo Iorio, Andrea Ferretti
BACKGROUND: The pivot-shift test is considered a reliable examination to evaluate the results of anterior cruciate ligament (ACL) reconstruction, as it strongly correlates with patient satisfaction, giving-way episodes, and activity level. The addition of lateral tenodesis (LT) to current techniques of intra-articular reconstruction with a hamstring graft could potentially improve knee laxity in cases of severe rotational instability. PURPOSE: To biomechanically investigate the effect of intra- and extra-articular ACL reconstructions on knee laxity and the pivot-shift phenomenon...
July 2014: American Journal of Sports Medicine
Diego García-Germán, Pablo Menéndez, Samuel González, Pablo de la Cuadra, Ricardo Rodríguez-Arozena
We present the case of an extra-articular lateral tenodesis for an anterior cruciate ligament (ACL) deficient knee. A 46-year-old male patient sustained an ACL graft rupture after a motorcycle accident. He complained of rotational instability and giving-way episodes. His previous graft was fixed by an intra-articular femoral staple that was not possible to remove at the time of the ACL revision. A modified Lemaire procedure was then performed. He gained rotational stability and was able to resume his sporting activities...
2013: Case Reports in Orthopedics
Dominique Saragaglia, Alexis Pison, Ramsay Refaie
PURPOSE: The aim of this study was to assess the anatomical results, functional results and the incidence of arthritis of a mixed intra- and extra-articular hamstring tendon based reconstruction for anterior instability of the knee. METHODS: This retrospective study consists of 100 knees in 99 patients (22 female and 77 male) operated upon between November 2003 and March 2006. The average age was 29.7 ± 10.4 years and the average interval between injury and surgery was 26...
August 2013: International Orthopaedics
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