Extra-Articular Lateral Tenodesis for Anterior Cruciate Ligament Deficient Knee: A Case Report

Diego García-Germán,Samuel González,Ricardo Rodríguez-Arozena,Pablo Menéndez,Pablo De La Cuadra

doi:10.1155/2013/648908

Abstract

We present the case of an extra-articular lateral tenodesis for an anterior cruciate ligament (ACL) deficient knee. A 46-year-old male patient sustained an ACL graft rupture after a motorcycle accident. He complained of rotational instability and giving-way episodes. His previous graft was fixed by an intra-articular femoral staple that was not possible to remove at the time of the ACL revision. A modified Lemaire procedure was then performed. He gained rotational stability and was able to resume his sporting activities. We believe that isolated extra-articular reconstructions may still have a role in selected indications including moderate-demand patients complaining of rotational instability after ACL graft failure.

Highlights

anterior cruciate ligament (ACL) revision can be a demanding procedure
Rotational instability has been related to the injury and loss of function of the anterolateral structures [2, 3] with the anterolateral ligament receiving increasing interest in recent times [4, 5]
We present the case of an extra-articular lateral tenodesis for an ACL deficient knee with excellent outcome and full patient satisfaction

Summary

Introduction

ACL revision can be a demanding procedure. Hardware from previous surgeries, tunnel widening, and incorrect tunnel placement, as well as associated injuries, increase complication rates and worse results should be expected compared to primary reconstruction. Extra-articular tenodesis were designed to limit internal tibial rotation in ACL deficient knees. They are nonanatomic, because they do not reproduce the anterolateral ligament anatomy, they are able to control the pivot shift [6,7,8]. Because they do not reproduce the anterolateral ligament anatomy, they are able to control the pivot shift [6,7,8] These techniques were widely abandoned with the introduction of arthroscopic procedures but have showed renewed interest lately in cases where rotational instability is an issue, such as in revision cases [9, 10]. We present the case of an extra-articular lateral tenodesis for an ACL deficient knee with excellent outcome and full patient satisfaction

Case Presentation

Discussion