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lateral tenodesis

Darren L Johnson, Jacob B Stirton
As the overall incidence of anterior cruciate ligament (ACL) ruptures continues to rise, the failure rates in reconstructive surgery remain relatively stable. Despite advances in our understanding of graft selection, anatomic reconstruction, addressing concomitant injuries, and the importance of rehabilitation, we continue to see failure rates in primary ACL reconstructions of up to 15%. Thus as the number of primary ACL reconstructions rises, so too does the number of revision ACL surgeries. This rising need for revision ACL reconstructions presents an even more daunting task because failure rates of up to 25% have been reported...
December 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
M Wurm, E Herbst, P Forkel, A B Imhoff, M Herbort
OBJECTIVE: Treatment of persistent anterolateral knee instability. INDICATIONS: Subjective/objective (rotational) instability of the knee after anatomic anterior cruciate ligament (ACL) reconstruction. ACL re-rupture including special demands (e.g., high-performance athletes, hyperlaxity) RELATIVE CONTRAINDICATIONS: Osteoarthritis, additional instability of the knee, which should be treated independently; non-anatomic ACL reconstruction with persisting instability should be treated first with anatomic ACL reconstruction...
November 26, 2018: Operative Orthopädie und Traumatologie
Andrea Redler, Raffaele Iorio, Edoardo Monaco, Francesco Puglia, Megan R Wolf, Daniele Mazza, Andrea Ferretti
PURPOSE: To present the mid- to long-term clinical and radiographic outcomes of a series of patients who underwent revision anterior cruciate ligament (ACL) reconstruction with doubled gracilis and semitendinosus (DGST) autograft and a lateral extra-articular tenodesis (LET). METHODS: Patients who underwent revision ACL reconstruction with DGST and LET by a single surgeon between January 1997 and December 2013 were included. Revision was indicated by ACL failure noted on magnetic resonance imaging, persistent clinical instability, or laxity on clinical exam...
October 3, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Adnan Saithna, Mathieu Thaunat, Jean Romain Delaloye, Hervé Ouanezar, Jean Marie Fayard, Bertrand Sonnery-Cottet
Background: Clinical results of combined anterior cruciate ligament (ACL) and anterolateral ligament (ALL) reconstruction have demonstrated a significant reduction in ACL graft rupture rates and improved rates of return to sports compared with isolated ACL reconstruction1 . This finding is supported by laboratory studies that have demonstrated that combined ACL reconstruction and lateral extra-articular tenodesis procedures protect the ACL graft by load-sharing with it and by more reliably restoring normal knee kinematics compared with isolated ACL reconstruction...
March 28, 2018: JBJS essential surgical techniques
Mattia Alessio-Mazzola, Matteo Formica, Antonio Russo, Francesca Sanguineti, Andrea Giorgio Capello, Stefano Lovisolo, Lamberto Felli
We report the functional outcome after combined anterior cruciate ligament (ACL) reconstruction and lateral extra-articular tenodesis (LET) for ACL re-rupture and high-grade pivot shift in professional soccer players. For this retrospective review, the medical records of 24 professional soccer players were analyzed. The mean age at surgery was 23.8 ± 4.2 years and the mean follow-up was 42.2 ± 16.9 months. Pre- and postoperative assessment included the KT-1000 Lachman test, pivot shift test, International Knee Documentation Committee (IKDC) subjective knee evaluation, Tegner activity scale (TAS), and Lysholm score...
September 18, 2018: Journal of Knee Surgery
Tommaso Roberti di Sarsina, Luca Macchiarola, Cecilia Signorelli, Alberto Grassi, Federico Raggi, Giulio Maria Marcheggiani Muccioli, Stefano Zaffagnini
PURPOSE: The aim of this study was to follow up, clinically and radiographically, skeletally immature patients who underwent ACL reconstruction with an all-epiphyseal "over-the-top" technique. METHODS: Twenty athletes aged between 8 and 13 years were enrolled and retrospectively evaluated. The subjects underwent surgical ACL reconstruction between 2009 and 2013. The surgical technique consisted of a single-bundle all-epiphyseal ACL reconstruction with an extra-articular lateral tenodesis...
September 12, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Frank R Noyes, Lauren E Huser, John West, Darin Jurgensmeier, James Walsh, Martin S Levy
PURPOSE: To determine the effect of 2 extra-articular reconstructions on pivot-shift rotational stability and tibial internal rotation as a basis for clinical recommendations. METHODS: A robotic simulator tested 15 cadaver knees. Group 1 (anterior cruciate ligament [ACL] cut) underwent ACL bone-patellar tendon-bone reconstruction followed by sectioning the anterolateral structures and an extra-articular, manual-tension iliotibial band (ITB) tenodesis. Group 2 (ACL intact) tested the rotational stabilizing effect of a low-tension ITB tenodesis before and after sectioning the anterolateral ligament/ITB structures...
September 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Eivind Inderhaug, Joanna M Stephen, Andy Williams, Andrew A Amis
BACKGROUND: Anterolateral complex injuries are becoming more recognized. While these are known to affect tibiofemoral mechanics, it is not known how they affect patellofemoral joint behavior. PURPOSE: To determine the effect of (1) sectioning the anterolateral complex and (2) performing a MacIntosh tenodesis under various conditions on patellofemoral contact mechanics and kinematics. STUDY DESIGN: Controlled laboratory study. METHODS: Eight fresh-frozen cadaveric knees were tested in a customized rig, with the femur fixed and tibia free to move, with optical tracking to record patellar kinematics and with thin pressure sensors to record patellofemoral contact pressures at 0°, 30°, 60°, and 90° of knee flexion...
October 2018: American Journal of Sports Medicine
Krzysztof Hermanowicz, Adrian Góralczyk, Konrad Malinowski, Piotr Jancewicz
The injuries of the posterolateral corner (PLC) of the knee often remain misdiagnosed. Because most structures in this anatomical region have low potential to heal, the posterolateral rotational instability results in a deterioration in patient quality of life, impaired biomechanics of the knee, and increased tension on other ligaments and the meniscus. Many open and a few arthroscopic techniques have been developed to repair or reconstruct the damaged structures of the PLC. Creating an additional midlateral arthroscopic portal on the lateral side of the knee was the key to developing the technique to recreate a static stabilizer against external rotational instability of the PLC by fixing the popliteus tendon as a native, vascularized material to the tibia...
June 2018: Arthroscopy Techniques
Yongxing Cao, Yuan Hong, Yang Xu, Yuan Zhu, Xiangyang Xu
BACKGROUND: A key point to surgical treatment of chronic lateral ankle instability is choosing a suitable surgical procedure. The purpose of this meta-analysis was to compare different surgical techniques for management of chronic lateral ankle instability. METHODS: We searched the Cochrane Library, MEDLINE, and EMBASE. All identified randomized and quasi-randomized controlled trials of operative treatment for chronic lateral ankle instability were included. Two review authors independently extracted data from each study and assessed risk of bias...
June 25, 2018: Journal of Orthopaedic Surgery and Research
Brian Forsythe, William A Zuke, Richard N Puzzitiello, Anthony A Romeo
There are many methods for long head of the biceps tendon (LHBT) tenodesis, but a consensus on a superior method has yet to be met. In this article, we introduce a method for arthroscopic suprapectoral biceps tenodesis using a tenodesis screw in the bicipital tunnel. The intra-articular portion of the biceps tendon is transected. The subdeltoid space is then viewed via a lateral portal, and the tendon is mobilized from the bicipital tunnel. The tendon is retrieved through the anterior portal, and 5 whipstitch passes and a second distal stitch are placed...
May 2018: Arthroscopy Techniques
Hae Yoon Jung, Jieun Lee, Hyung Ik Shin
STUDY DESIGN: Cross-sectional. OBJECTIVES: To investigate the natural course of passive tenodesis grip in individuals with spinal cord injury (SCI) with no experience of tenodesis splint application and the related factors for success of the grip. SETTING: Community-dwelling persons with chronic SCI in South Korea. METHODS: Individuals with cervical SCI with preserved wrist extensor power, but completely paralyzed fingers and thumbs, were recruited...
September 2018: Spinal Cord
Emily J Curry, Catherine Logan, Kaytelin Suslavich, Kaitlyn Whitlock, Eric Berkson, Elizabeth Matzkin
Identifying patient factors influencing operational throughput time is becoming more imperative due to an increasing focus on value and cost savings in healthcare. The primary objective of this study was to determine patient factors influencing throughput time for primary rotator cuff repairs. Demographic information, medical history and operative reports of 318 patients from one ambulatory care center were retrospectively reviewed. Operating room set up, incision to closure and recovery room time were collected from anesthesia records...
March 29, 2018: Orthopedic Reviews
Pejma Shazadeh Safavi, Cory F Janney, Kenrick Lam, Daniel R Kunzler, Vinod Panchbhavi
In this case report, we present a unique case of idiopathic peroneal tenosynovitis in an otherwise healthy patient, presenting with a three-month history of pain over the lateral aspect of the right foot. Imaging revealed that fluid distention and synovial thickening distend the common peroneal tendon sheath and peroneus longus and brevis tendon sheaths. The patient was managed operatively with excision of the peroneus longus tendon, a side-to-side tenodesis, and Bröstrom-Gould lateral ankle ligament repair...
February 26, 2018: Curēus
Jun Wan, Can Zhang, Hong-Bo He
BACKGROUND: Resection of proximal fibular osteosarcoma involving the posteromedial aspect of the fibula is challenging. Reconstruction using a gastrocnemius flap may result in significant lateral instability and abnormal knee movement. Furthermore, postoperative gait may be disturbed by foot drop resulting from scarification of the common peroneal nerve. METHODS: Between January 2011 and December 2013, five patients with proximal fibular osteosarcoma were treated via the double-approach procedure using en bloc resection without a gastrocnemius flap...
March 27, 2018: World Journal of Surgical Oncology
Volker Musahl, Elmar Herbst, Jeremy M Burnham, Freddie H Fu
The anterolateral structures of the knee have recently garnered considerable interest regarding their role in rotatory knee instability related to anterior cruciate ligament tears. Isolated anterior cruciate ligament reconstruction may not always restore rotatory stability of the knee. In these patients, additional procedures, such as lateral reconstruction or tenodesis, may be indicated. The anatomy of the anterolateral structures of the knee has been well described. Histologic and anatomic studies have reported conflicting findings regarding the presence of a discrete ligament...
April 15, 2018: Journal of the American Academy of Orthopaedic Surgeons
Andrew S Neviaser, Diana C Patterson, Paul J Cagle, Bradford O Parsons, Evan L Flatow
BACKGROUND: Biceps tenodesis reduces the incidence of Popeye deformity occurring with tenotomy, but pain may occur with tenodesis superior to or within the bicipital groove. Arthroscopic suprapectoral tenodesis is an attractive alternative. The purpose of this study was to establish landmarks for arthroscopic suprapectoral tenodesis and determine the appropriate fixation point to optimize muscle tension. METHODS: Twelve fresh cadaveric shoulders were dissected. Urethane polymer was injected into the axillary artery...
July 2018: Journal of Shoulder and Elbow Surgery
Thomas Amouyel, Yves-Pierre Le Moulec, Nicolas Tarissi, Mo Saffarini, Olivier Courage
Arthroscopic repair of the long head of the biceps (LHB) is performed to treat various biceps pathologies yet the choice between tenotomy or tenodesis remains controversial. Although tenotomy is simpler and quicker, tenodesis results in fewer complications, and there are several techniques available using various fixation devices and sites. This Technical Note describes an all-arthroscopic, suprapectoral tenodesis technique using a bioresorbable interference screw, without motorized devices to create the humeral tunnel in the bicipital groove...
October 2017: Arthroscopy Techniques
Jesús Vilá-Rico, Josep María Cabestany-Castellà, Bernat Cabestany-Perich, César Núñez-Samper, Cristina Ojeda-Thies
BACKGROUND: Anatomic graft reconstruction of the anterior talo-fibular ligament is an alternative for patients who are bad candidates for standard procedures such as a Broström-Gould reconstruction (high-demand athletes, obesity, hyperlaxity or collagen disorders, capsular insufficiency or talar avulsions). The purpose of this study is to describe an all-inside arthroscopic technique for ATFL reconstruction, and the results in a series of patients with chronic ankle instability. METHODS: We reviewed patients with chronic ATFL ruptures treated with an all-inside arthroscopic allograft reconstruction of the ATFL, with a minimum 2-year follow-up...
December 23, 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Alexander E Weber, William Zuke, Erik N Mayer, Brian Forsythe, Alan Getgood, Nikhil N Verma, Bernard R Bach, Asheesh Bedi, Brian J Cole
BACKGROUND: There has been an increasing interest in lateral-based soft tissue reconstructive techniques as augments to anterior cruciate ligament reconstruction (ACLR). The objective of these procedures is to minimize anterolateral rotational instability of the knee after surgery. Despite the relatively rapid increase in surgical application of these techniques, many clinical questions remain. PURPOSE: To provide a comprehensive update on the current state of these lateral-based augmentation procedures by reviewing the origins of the surgical techniques, the biomechanical data to support their use, and the clinical results to date...
February 1, 2018: American Journal of Sports Medicine
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