Anterolateral rotational laxity of the knee is a persistent problem following anterior cruciate ligament reconstruction (ACLR) that can lead to increased rates of graft failure. Renewed interest in the anterolateral complex of the knee has led to a resurgence in the use of adjunctive techniques such as lateral extra-articular tenodesis and anterolateral ligament reconstruction. Use of these techniques can restore normal knee kinematics and potentially thereby reduce the rate of graft failure. Historically, experience with modified ACLR techniques such as the double-bundle ACLR have shown that improved biomechanics is not always reflected in clinical outcome trials. Additional procedures also come with additional costs and further economic analysis needs to be performed to clarify whether these additional costs are offset by improved clinical and societal outcomes in the longer-term.
*The Fowler Kennedy Sport Medicine Clinic
†Faculty of Health Sciences, University of Western Ontario, London, ON, Canada
A.G. receives research funding from ISAKOS and Smith and Nephew Inc.
The authors declare that they have nothing to disclose.
For reprint requests, or additional information and guidance on the techniques described in the article, please contact Alan Getgood, MPhil, MD, FRCS (Tr&Orth) DipSEM, at or by mail at The Fowler Kennedy Sport Medicine Clinic, 3M Centre; University of Western Ontario, London, ON, Canada, N6A 3K7. You may inquire whether the author(s) will agree to phone conferences and/or visits regarding these techniques.