Extra-articular lateral reconstruction technique.
This article describes an anterolateral reconstruction procedure that, when used in combination with an intra-articular anterior cruciate ligament (ACL) reconstruction, restores rotary and anterior knee stability. We believe that failing to recognize lateral instabilities and to perform an extra-articular reconstruction is an under-recognized cause of failure of ACL reconstruction. We also describe the indications, medical histories, and physical examination tests used to determine when an anterolateral reconstruction is needed. One should suspect a compromise of the lateral structures when presented with a failed ACL reconstruction in which the tunnels, the graft, and the rehabilitation all seem to have been done properly, or when a prior lateral procedure has been attempted and failed. In our experience, if a second ACL reconstruction is undertaken without the benefit of a lateral reconstruction, it may fail as well.
McGuire
D A
DA
Private Practice, Anchorage, Alaska, USA.
Wolchok
J C
JC
D016118:Anterior Cruciate Ligament / Q000601:surgery*; D005081:Exercise Therapy; D006801:Humans; D007593:Joint Instability / Q000503:physiopathology / Q000534:rehabilitation / Q000601:surgery*; D007719:Knee Joint; D019637:Orthopedic Procedures; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures / Q000379:methods*; D012086:Reoperation; D013536:Suture Techniques; D013710:Tendons / Q000637:transplantation*; D014184:Transplantation, Homologous