Abstract
Purpose
In some complex cases, standard anterior cruciate ligament reconstruction is not enough and could lead to a new failure. Lateral extra-articular reconstruction should be added. We describe a new mini-invasive technique using the same hamstring graft for intra-articular reconstruction and lateral tenodesis, optimized with navigation.
Method
This arthroscopic technique is precisely described, different graft setting are possible, four strands graft inside the joint and two strands for the tenodesis or two strands graft for all the whole graft. As the lateral tenodesis is not anatomic, tunnel placement could be tricky. The use of navigation system is a real advantage for this technique with optimal tunnels placement.
Results
No results are given.
Conclusion
This technique is comparable to others reported previously, showing a clinical advantage and no increasing of osteoarthritis. The use of the same graft avoids collateral damages, and navigation improves the graft placement.
Similar content being viewed by others
References
Amis AA, Scammell BE (1993) Biomechanics of intra-articular and extra-articular reconstruction of the anterior cruciate ligament. J Bone Joint Surg Br 5:812–817
Bach BR Jr, Tradonsky S, Bojchuk J, Levy ME, Bush-Joseph CA, Khan NH (1998) Arthroscopically assisted anterior cruciate ligament reconstruction using patellar tendon autograft five- to nine-year follow-up evaluation. Am J Sports Med 1:20–29
Bignozzi S, Zaffagnini S, Lopomo N, Martelli S, Iacono F, Marcacci M (2009) Does a lateral plasty control coupled translation during antero-posterior stress in single-bundle ACL reconstruction? An in vivo study. Knee Surg Sports Traumatol Arthrosc 1:65–70
Carson WG Jr (1988) The role of lateral extra-articular procedures for anterolateral rotatory instability. Clin Sports Med 4:751–772
Colombet P, Robinson JR (2008) Computer navigation ACL reconstruction. In: Fu FH, Cohen SB (eds) Computer navigation ACL reconstruction. SLACK incorporated, Thorofare, pp 361–374
Colombet PD, Robinson JR (2008) Computer-assisted, anatomic, double-bundle anterior cruciate ligament reconstruction. Arthroscopy 10:1152–1160
Denti M, Lo Vetere D, Bait C, Schonhuber H, Melegati G, Volpi P (2008) Revision anterior cruciate ligament reconstruction: causes of failure, surgical technique, and clinical results. Am J Sports Med 10:1896–1902
Draganich LF, Reider B, Ling M, Samuelson M (1990) An in vitro study of an intraarticular and extraarticular reconstruction in the anterior cruciate ligament deficient knee. Am J Sports Med 3:262–266
Engebretsen L, Lew WD, Lewis JL, Hunter RE (1990) The effect of an iliotibial tenodesis on intraarticular graft forces and knee joint motion. Am J Sports Med 2:169–176
Ferretti A, Conteduca F, Monaco E, De Carli A, D’Arrigo C (2006) Revision anterior cruciate ligament reconstruction with doubled semitendinosus and gracilis tendons and lateral extra-articular reconstruction. J Bone Joint Surg Am 11:2373–2379
Ferretti A, Conteduca F, Monaco E, De Carli A, D’Arrigo C (2007) Revision anterior cruciate ligament reconstruction with doubled semitendinosus and gracilis tendons and lateral extra-articular reconstruction. Surgical technique. J Bone Joint Surg Am 196–213
Harner CD, Giffin JR, Dunteman RC, Annunziata CC, Friedman MJ (2001) Evaluation and treatment of recurrent instability after anterior cruciate ligament reconstruction. Instr Course Lect 463–474
Harter RA, Osternig LR, Singer KM, James SL, Larson RL, Jones DC (1988) Long-term evaluation of knee stability and function following surgical reconstruction for anterior cruciate ligament insufficiency. Am J Sports Med 5:434–443
Krackow KA, Brooks RL (1983) Optimization of knee ligament position for lateral extraarticular reconstruction. Am J Sports Med 5:293–302
Kurosawa H, Yasuda K, Yamakoshi K, Kamiya A, Kaneda K (1991) An experimental evaluation of isometric placement for extraarticular reconstructions of the anterior cruciate ligament. Am J Sports Med 4:384–388
Lebel B, Hulet C, Galaud B, Burdin G, Locker B, Vielpeau C (2008) Arthroscopic reconstruction of the anterior cruciate ligament using bone-patellar tendon-bone autograft: a minimum 10-year follow-up. Am J Sports Med 7:1275–1282
Marcacci M, Zaffagnini S, Giordano G, Iacono F, Presti ML (2009) Anterior cruciate ligament reconstruction associated with extra-articular tenodesis: a prospective clinical and radiographic evaluation with 10- to 13-year follow-up. Am J Sports Med 4:707–714
Monaco E, Labianca L, Conteduca F, De Carli A, Ferretti A (2007) Double bundle or single bundle plus extraarticular tenodesis in ACL reconstruction? A CAOS study. Knee Surg Sports Traumatol Arthrosc 10:1168–1174
Wroble RR, Grood ES, Cummings JS, Henderson JM, Noyes FR (1993) The role of the lateral extraarticular restraints in the anterior cruciate ligament-deficient knee. Am J Sports Med 2:257–262
Zaffagnini S, Marcacci M, Lo Presti M, Giordano G, Iacono F, Neri MP (2006) Prospective and randomized evaluation of ACL reconstruction with three techniques: a clinical and radiographic evaluation at 5 years follow-up. Knee Surg Sports Traumatol Arthrosc 11:1060–1069
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Colombet, P.D. Navigated intra-articular ACL reconstruction with additional extra-articular tenodesis using the same hamstring graft. Knee Surg Sports Traumatol Arthrosc 19, 384–389 (2011). https://doi.org/10.1007/s00167-010-1223-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00167-010-1223-0