Download PDF
J Knee Surg 2014; 27(05): 353-358
DOI: 10.1055/s-0034-1382786
Special Focus Section
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Combined Anterior Cruciate Ligament and Posterolateral Reconstruction of the Knee Using Allograft Tissue in Chronic Knee Injuries

Gregory C. Fanelli
1   Department of Orthopaedics, Geisinger Health System, Danville, Pennsylvania
,
David G. Fanelli
1   Department of Orthopaedics, Geisinger Health System, Danville, Pennsylvania
,
Craig J. Edson
1   Department of Orthopaedics, Geisinger Health System, Danville, Pennsylvania
,
Matthew G. Fanelli
2   Penn State Hershey, College of Medicine, Hershey, Pennsylvania
› Author Affiliations
Further Information

Publication History

17 April 2014

08 May 2014

Publication Date:
20 June 2014 (online)

    Permissions and Reprints

Abstract

Combined anterior cruciate ligament (ACL) and posterolateral injury of the knee can result in significant functional instability for the affected individual. Both components of the instability must be treated to maximize the probability of success for the surgical procedure. Higher failure rates of the ACL reconstruction have been reported when the posterolateral instability has been left untreated. The purpose of this article is to describe our surgical technique, and present the results of 34 chronic combined ACL posterolateral reconstructions in 34 knees using allograft tissue, and evaluating these patient outcomes with KT 1000 knee ligament arthrometer, Lysholm, Tegner, and Hospital for Special Surgery knee ligament rating scales. In addition, observations regarding patient demographics with combined ACL posterolateral instability, postoperative range of motion loss, postinjury degenerative joint disease, infection rate, return to function, and the use of radiated and nonirradiated allograft tissues will be presented.

Keywords

anterior cruciate ligament - posterolateral instability - combined ACL posterolateral instability - allograft - mechanical graft tensioning
 

  • References

  • 1 Bonanzinga T, Zaffagnini S, Grassi A, Marcheggiani Muccioli GM, Neri MP, Marcacci M. Management of combined anterior cruciate ligament-posterolateral corner tears: a systematic review. Am J Sports Med 2013;
    PubMedSearch in Google Scholar
  • 2 Lee SH, Jung YB, Jung HJ, Song KS, Ko YB. Combined reconstruction for posterolateral rotatory instability with anterior cruciate ligament injuries of the knee. Knee Surg Sports Traumatol Arthrosc 2010; 18 (9) 1219-1225
    CrossrefPubMedSearch in Google Scholar
  • 3 LaPrade RF, Resig S, Wentorf F, Lewis JL. The effects of grade III posterolateral knee complex injuries on anterior cruciate ligament graft force. A biomechanical analysis. Am J Sports Med 1999; 27 (4) 469-475
    PubMedSearch in Google Scholar
  • 4 Ross G, DeConciliis GP, Choi K, Scheller AD. Evaluation and treatment of acute posterolateral corner/anterior cruciate ligament injuries of the knee. J Bone Joint Surg Am 2004; 86-A (Suppl. 02) 2-7
    PubMedSearch in Google Scholar
  • 5 Daniel DM, Akeson W, O'Conner J , eds. Knee Ligaments: Structure, Function, Injury, and Repair. New York: Raven; 1990: 421-447
  • 6 Tegner Y, Lysholm J. Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res 1985; (198) 43-49
    PubMedSearch in Google Scholar
  • 7 Windsor RE, Insall JN, Warren RF, Wickiewicz TL. The hospital for special surgery knee ligament rating form. Am J Knee Surg 1988; 1: 140-145
    PubMedSearch in Google Scholar
  • 8 Fanelli GC. Rationale and Surgical Technique for PCL and Multiple Knee Ligament Reconstruction. 3rd ed. Warsaw, IN: Biomet Sports Medicine; 2012
    Search in Google Scholar
  • 9 Fanelli GC. Surgical treatment of combined PCL ACL medial and lateral side injuries (global laxity): acute and chronic. In: Fanelli GC. , ed. The Multiple Ligament Injured Knee: A Practical Guide to Management. 2nd ed. New York, NY: Springer-Verlag; 2013: 281-301
    CrossrefSearch in Google Scholar
  • 10 Fanelli GC. Mechanical graft tensioning in multiple ligament knee surgery. In: . Fanelli GC, , ed. The Multiple Ligament Injured Knee: A Practical Guide to Management. 2nd ed. New York, NY: Springer-Verlag; 2013: 323-330
    CrossrefSearch in Google Scholar
  • 11 Fanelli GC, Edson CJ, Maish DR. Revision anterior cruciate ligament reconstruction: associated patholaxity, tibiofemoral malalignment, rehabilitation, and results. Am J Knee Surg 2001; 14 (3) 201-204
    PubMedSearch in Google Scholar
  • 12 Fanelli GC, Larson RV. Practical management of posterolateral instability of the knee. Arthroscopy 2002; 18 (2) (Suppl. 01) 1-8
    CrossrefPubMedSearch in Google Scholar
  • 13 Fanelli GC. Surgical reconstruction for acute posterolateral injury of the knee. J Knee Surg 2005; 18 (2) 157-162
    Thieme ConnectPubMedSearch in Google Scholar
  • 14 Fanelli GC. Surgical treatment of lateral posterolateral instability of the knee using biceps tendon procedures. Sports Med Arthrosc 2006; 14 (1) 37-43
    CrossrefPubMedSearch in Google Scholar
  • 15 Fanelli GC, Tomaszewski DJ. Allograft use in the treatment of the multiple ligament injured knee. Sports Med Arthrosc 2007; 15 (3) 139-148
    CrossrefPubMedSearch in Google Scholar
  • 16 Edson CJ, Fanelli GC, Beck JD. Rehabilitation after multiple-ligament reconstruction of the knee. Sports Med Arthrosc 2011; 19 (2) 162-166
    CrossrefPubMedSearch in Google Scholar
  • 17 Edson CJ, Fanelli GC. Postoperative rehabilitation of the multiple ligament injured knee. In: Fanelli GC, , ed. The Multiple Ligament Injured Knee: A Practical Guide to Management. 2nd ed. New York, NY: Springer-Verlag; 2013: 437-442
    CrossrefSearch in Google Scholar