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Indications for Ancillary Surgery in the ACL-Deficient Knee

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The ACL-Deficient Knee

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Abstract

Modern ACL reconstruction frequently provides a stable knee and allows a majority of athletes to return to sport. However, the incidences of failed surgery and progression of degenerative disease remain unacceptably high. Ancillary procedures including lateral extra-articular reconstruction, valgus-producing HTO, tibial deflexion osteotomy, and procedures related to meniscal preservation and restoration may provide routes for improving results. These procedures augment ACL reconstruction by decreasing stress on the intra-articular graft, improving stability by decreasing anterior tibial translation and/or the pivot shift, and decreasing stress on the articular cartilage by altering load transmission and/or decreasing shear stress due to abnormal joint kinematics. Further work, including development of new techniques and well-designed prospective studies evaluating results, is necessary to improve and verify the utility of these procedures.

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Authors and Affiliations

  1. Department of Orthopaedics, Brunei Ministry of Health, Bandar Seri Begawan, Brunei

    Biju Benjamin M.D.

  2. Department of Orthopaedic Surgery, The Ohio State University Medical Center, Columbus, OH, USA

    Robert A. Magnussen M.D.

  3. Department of Orthopaedic Surgery, Hôpital de la Croix-Rousse, Centre Albert Trillat, Lyon, France

    Philippe Neyret M.D.

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  1. Biju Benjamin M.D.
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  2. Robert A. Magnussen M.D.
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  3. Philippe Neyret M.D.
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Correspondence to Philippe Neyret M.D. .

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Editors and Affiliations

  1. Depto. Cirugia Ortopédica, Hospital Arnau de Vilanova, c/San Clemente 12, Valencia, 46015, Spain

    Vicente Sanchis-Alfonso

  2. , Orthopaedic Surgery, Hospital de Sant Pau, St Antoni m Claret 167, Barcelona, 08025, Spain

    Joan Carles Monllau

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Benjamin, B., Magnussen, R.A., Neyret, P. (2013). Indications for Ancillary Surgery in the ACL-Deficient Knee. In: Sanchis-Alfonso, V., Monllau, J. (eds) The ACL-Deficient Knee. Springer, London. https://doi.org/10.1007/978-1-4471-4270-6_13

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  • DOI: https://doi.org/10.1007/978-1-4471-4270-6_13

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