Internal Bracing in Multiple-Ligament Knee Reconstruction

  • Nicholas A. Trasolini
  • Adam Lindsay
  • Joseph Cooper
  • George F. “Rick” HatchIIIEmail author


The multiple-ligament injured knee is a complex environment of three-dimensional instability. In many cases, conventional techniques suffice for restoring function and decreasing pain in this patient population. However, in cases of extreme instability, high energy trauma, high demand patients, or revision, conventional reconstruction techniques may be insufficient. An emerging technique, commonly referred to as “internal bracing” or “suture tape augmentation,” has great potential to improve stability and restore function in these cases. In this chapter, we will explore the historical roots of this technique. We will then discuss the biomechanical theory and available clinical data. Finally, we will present two case examples and describe the senior author’s preferred surgical technique.


Internal bracing Suture augmentation Suture reinforcement Suture tape augmentation Ligament Anterior cruciate ligament Posterior cruciate ligament Lateral collateral ligament Medial collateral ligament Knee dislocation Surgical techniques 


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Nicholas A. Trasolini
    • 1
  • Adam Lindsay
    • 1
  • Joseph Cooper
    • 1
  • George F. “Rick” HatchIII
    • 1
    Email author
  1. 1.Department of Orthopaedic Surgery, Keck Medical CenterUniversity of Southern CaliforniaLos AngelesUSA

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