Operative techniques in orthopedics »

  • ACL Reconstruction in Combination with an Extra-articular Tenodesis

    Posted 2017-03-07 00:00:00 dun: Mahammad A. Tafida

    Rotatory instability of the knee is very often associated with the antero-posterior laxity in the ACL deficient knee and it is most probably caused by lesions of the anterolateral structures such the capsule and the anterolateral ligament. If underdiagnosed or undertreated with isolated ACL reconstruction this residual instability may lead to re-injury of premature arthritis.This manuscript focuses on the role of lateral extra-articular tenodesis (LET) in re-establishing dynamic stability when performed together with ACL reconstruction; then it describes our preferred surgical technique, which always associates ACL and LET, and discusses it with other surgical options described in ...

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  • Anterolateral Complex Reconstruction – Who, When and How?

    Posted 2017-02-24 00:00:00 dun: Mahammad A. Tafida

    Anterior translation and rotatory laxity of the knee joint is the result of an anterior cruciate ligament (ACL) rupture. The goal of ACL reconstruction is to restore normal knee biomechanics. Abnormal knee kinematics have been thought to be one of the primary factors in the progression towards osteoarthritis after ACL reconstruction. It has been demonstrated that even with a well-performed single or double bundle ACL reconstruction rotatory laxity can persist. This persistent rotatory laxity is one of the reasons to the recent international focus on the stabilizing role of the anterolateral complex in the ...

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  • Biomechanical Role of Lateral Structures in Controlling Anterolateral Rotatory Laxity - The ITB

    Posted 2017-02-23 00:00:00 dun: Mahammad A. Tafida

    Recent research, focusing on rotatory knee laxity, has intrigued the whole orthopaedic knee community. First popularized by Hughston et al. peripheral knee injuries at the time of cruciate ligament rupture have regained more and more recognition, which has led to a better understanding of these injuries. Recent research has been focused on anterolateral rotatory instability, especially regarding which structures are responsible for the high-grade anterior subluxation of the lateral tibial plateau when ...

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  • Repair of the Anterolateral Structures in the Acutely Injured ACL

    Posted 2017-02-23 00:00:00 dun: Mahammad A. Tafida

    Repair of the acutely injured anterolateral complex is a surgical procedure justified by biomechanical studies, surgical findings and clinical results.In a lack of specific radiological protocols able to reliably detect such injuries, indications are still related to the degree of pivot test, as evaluated preoperatively under anesthesia (explosive pivot shift).Repair techniques, to be always performed along with an ACL reconstruction, are simple procedures strictly related to type of injury. In type I and II tears, when a clear stretching is encountered (limited to the anterolateral capsule and ligament or extended towards the posterolateral capsule) repair consists of retensioning the capsule by means of plicating it with simple ...

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  • Historical Overview of Lateral Tenodeses Procedures and State of the Art in 2016

    Posted 2017-02-23 00:00:00 dun: Mahammad A. Tafida

    Since the original descriptions of the lateral capsuloligamentous complex of the knee, this structure (also known as the anterolateral ligament (ALL)) has been known to be commonly injured at the time of anterior cruciate ligament (ACL) injury. Surgeons have sought to reconstruct the ALL in ACL deficient knees with the goal of restoring normal kinematics. Numerous surgical procedures have been developed over the past 50 years to correct the pathologic anterior and rotatory laxity seen with ACL ...

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