Although ACL reconstructions provide satisfactory clinical results nowadays, regardless of the type of graft or the surgical technique used (out-in vs in-out or single- vs double-bundle), the residual rotatory instability which is often detected at clinical follow-ups is still a matter of concern among surgeons. In this paper we try to analyze all the aspects which might contribute to this phenomenon by summarizing the biomechanical functions of the two bundles of the ACL, and by evaluating all the other factors strictly related to the rotatory instability of a reconstructed knee, such as the anatomical positioning of the single- or double-bundle new ACL, or the importance of a valid lateral compartment (LCL, ALTFL). Clinical, biomechanical and cadaver studies are discussed in order to contribute to better understanding of the origin of post-operative residual rotatory instability.
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http://dx.doi.org/10.1007/s10195-013-0254-y | DOI Listing |
Am J Sports Med
January 2025
Bond Institute of Health and Sport, Robina, Australia.
Background: Current research focused on clinical outcomes suggests that lateral extra-articular procedures (LEAPs) can reduce rotational instability and graft failure rates in primary anterior cruciate ligament reconstructions (ACLRs). Limited studies have investigated the functional outcomes after LEAPs, including patient-reported outcome measures, sports participation, and physical performance.
Purpose: To conduct a systematic literature review and meta-analysis to determine whether the addition of a LEAP to an ACLR results in superior functional and clinical outcomes as compared with an isolated ACLR.
J Spine Surg
December 2024
Department of Neurosurgery, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
Atlantoaxial rotatory subluxation (AARS) in the adult population is primarily trauma-induced. Conservative and surgical treatments have both been used successfully in treating AARS. In cases where AARS cannot be reduced by conservative measures, open reduction and fusion is the conventional treatment approach.
View Article and Find Full Text PDFOrthop J Sports Med
January 2025
Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Background: The aim of surgical treatment for posterolateral rotatory instability (PLRI) of the elbow is to restore the integrity of the lateral ulnar collateral ligament (LUCL), with ligamentous reconstruction being the preferred option for recurrent symptomatic PLRI. However, there is no clinical evidence demonstrating the superiority of reconstruction versus repair. Treatment options currently depend on the cause of the LUCL injury and surgeon preference.
View Article and Find Full Text PDFBiomedicines
November 2024
Clinic for Trauma and Reconstructive Surgery, University Hospital Heidelberg, 69118 Heidelberg, Germany.
: The elbow joint is stabilized by complex interactions between bony structures and soft tissues, notably the lateral and medial collateral ligaments. Posterolateral rotatory instability (PLRI), a form of elbow instability, is challenging to diagnose due to overlapping symptoms with other conditions. The radiocapitellar line (RCL) is a radiographic tool for assessing humeroradial alignment and elbow stability, but its diagnostic accuracy remains debated.
View Article and Find Full Text PDFAm J Sports Med
January 2025
Department of Orthopedics and Rehabilitation, University of Vermont, Burlington, Vermont, USA.
Background: A lateral extra-articular tenodesis (LET) is increasingly being utilized to augment an anterior cruciate ligament reconstruction because it has been shown to reduce the risk of postreconstruction graft failure or recurrent rotatory instability. Various femoral fixation techniques are available, including the use of an interference screw, staple, or suture anchor.
Purpose: To determine and compare the biomechanical properties of an LET graft when using an interference screw, staple, or suture anchor for the femoral fixation for a modified Lemaire LET.
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