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Surgical Treatment of Combined ACL and Lateral Side Injuries: Acute and Chronic

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The Multiple Ligament Injured Knee

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Abstract

Management of the patient with combined ligamentous knee instability can be a challenging problem. Several studies have suggested that lateral/posterolateral knee instability accompanies anterior cruciate injury in 11–12.5% of patients. As approximately 100,000 anterior cruciate ligament (ACL) reconstructions are performed in the United States each year, this combined injury pattern is an entity that the orthopedic surgeon must be able to recognize and appropriately address.

The purpose of this chapter is to discuss the current state of combined anterior and lateral knee instability. It will begin with a review of the pertinent pathophysiology and biomechanics of the ACL and lateral knee ligaments to provide a framework for further discussion. A discussion of the clinical exam will follow and include the key features of the history, physical exam, imaging studies, and diagnostic arthroscopy that will enable the surgeon to appropriately evaluate these injuries and successfully move forward. Finally, the surgical options for combined anterior cruciate and lateral knee ligament injuries will be reviewed, with suggested treatment strategies and approaches for both the acutely and chronically injured patient.

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Authors and Affiliations

  1. Division of Sports Medicine, Department of Orthopaedics, John Dempsey Hospital, University of Connecticut Health Center, 263 Farmington Ave, Farmington, CT, 06030, USA

    Julienne Lippe M.D. & Robert A. Arciero M.D.

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  1. Julienne Lippe M.D.
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  2. Robert A. Arciero M.D.
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Correspondence to Robert A. Arciero M.D. .

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  1. GHS Orthopaedics, Woodbine Lane 115, Danville, 17822-5212, Pennsylvania, USA

    Gregory C. Fanelli

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Lippe, J., Arciero, R.A. (2013). Surgical Treatment of Combined ACL and Lateral Side Injuries: Acute and Chronic. In: Fanelli, G. (eds) The Multiple Ligament Injured Knee. Springer, New York, NY. https://doi.org/10.1007/978-0-387-49289-6_11

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