Name: Anterolateral Ligament Reconstruction
Uploaded: 2015-05-05T00:00:00Z
Channel: Arthrex

<p>The anterolateral ligament (ALL) is reconstructed using a 4.75 mm BioComposite™ SwiveLock<sup>®</sup> suture anchor in the femur and a 7 mm SwiveLock suture anchor in the tibia. A gracilis tendon autograft is used in the ALL reconstruction. The graft should be isometric and is placed on the femur at 8 mm proximal and 4.3 mm posterior to the lateral epicondyle. On the tibia, the anatomic point is halfway between the Gerdy’s tubercle and fibular head.</p>

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AN1-00067-EN | D | Anterolateral Ligament Reconstruction

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A general overview including the relevant steps of an Arthrex surgical technique. These animations always include a voice-over explaining the process.

Eine allgemeine Übersicht, einschließlich der relevanten Schritte einer Arthrex Operationsanleitung. Diese Animationen enthalten immer Voice-Overs, die den Prozess erklären.

Operationstechnik-Animationen

Surgical Technique Animations

Visão geral incluindo as etapas relevantes de uma técnica cirúrgica Arthrex. Essas animações sempre incluem uma narração explicando o processo.

Animações de técnicas cirúrgicas

Descripción general que incluye los pasos relevantes de una técnica quirúrgica de Arthrex. Estas animaciones siempre incluyen una voz en off que explica el proceso.

Animaciones de técnicas quirúrgicas

Anterolateral Ligament Reconstruction

The tibial stab incision is made halfway between Gerdy's tubercle and the center of the fibular head. The femoral stab incision is made slightly proximal and posterior to the lateral epicondyle. The anterolateral ligament will run obliquely to the anterolateral tibia. Drill a 2.4 pin, eight millimeters proximal and 4.3mm posterior to the lateral femoral condyle. Aim slightly proximal and anterior to avoid ACL tunnel convergence. After the pin is drilled, split the iliotibial band around it to facilitate the introduction of the swivel lock. Drill a second 2.4mm guide. Pin 22mm posterior to gerdy's tubercle and ten millimeters distal to the joint line. This should be the approximate midpoint between Gerdy's tubercle and the center of the fibular head. Isometry can be tested by wrapping a piece of FiberWire around the pins and moving the leg through the range of motion. When the knee moves from extension to flexion, the FiberWire should be isometric or become slightly shorter by no more than five millimeters as it moves to 90 degrees of flexion. If it becomes shorter by more than five millimeters, adjust the femoral pin over. Drill the femoral guide pin with a 4.5mm cannulated. Drill to a depth of 20mm. Load the whip stitched sutures of the gracilis graft through the peak eyelet of the 4.75mm SwiveLock anchor, insert the SwiveLock into the drilled hole, ensure the eyelet is fully seated, so that the threads of the SwiveLock anchor have started to touch the bone. Hold the paddle of the SwiveLock and turn the knob to insert the anchor. The SwiveLock sutures can be removed. Shaverdrill the tibia guide pin with a seven millimeters cannulated. Drill to a depth of 20mm. Use a hemostat to dissect underneath the iliotibial band to create a plane from the femoral incision to the tibial incision, place a passing suture from distal to proximal with the hemostat. Use the passing suture to pass the graft to the tibial side. Whip stitch approximately 20mm of graft that will be placed in the tibia. Place the seven millimeter 4K tendinosis SwiveLock anchor over the graft. Push the forked end into the tunnel and adjust tension by pulling on the graft. It is important not to over constrain the anterolateral ligament. Fix the anchor with the knee in extension and neutral rotation. Once the anchor is in place, the sutures can be removed. Cut the end of the graft exiting the tibial socket.