Different anterolateral procedures have variable impact on knee kinematics and stability when performed in combination with anterior cruciate ligament reconstruction

ObjectiveThe optimal anterolateral procedure to control rotational laxity of the knee is still unknown. The objective was compare ability five procedures performed in combination with anterior cruciate ligament reconstruction (ACLR) restore native kinematics setting a deficient (ACL) and structures.MethodsA controlled laboratory study using 10 fresh-frozen cadaveric whole lower limbs intact iliotibial band. Kinematics from 0° 90° flexion were recorded motion analysis three-dimensional (3D) optoelectronic system, allowing assessment internal rotation (IR) anteroposterior (AP) tibial translation at 30° flexion. Joint centres bony landmarks calculated 3D bone models obtained CT scans. Intact assessed initially, followed by sequential section ACL structures (anterolateral ligament, capsule Kaplan fibres). After ACLR, consecutively on same knee: ALLR, modified Ellison, deep Lemaire, superficial Lemaire MacIntosh. last three randomised. For each procedure, graft fixed neutral tension 20 N.ResultsIsolated ACLR did not normal overall combined plus anterolateral-deficient knee, leaving residual (p=0.034). Only ALLR (p=0.661) Ellison (p=0.641) restored IR state. Superficial MacIntosh tenodeses overconstrained IR, leading shifted different compared condition (p=0.004, p=0.001 p=0.045, respectively). Compared state, addition an induce any additional AP (all p>0.05), except for (p=0.032).ConclusionIn biomechanical vitro setting, comparison revealed that either or knee. achieved excellent but change kinematics.Level evidenceThe level-of-evidence statement does apply this experiments study. structures. A N. Isolated (p=0.032). In kinematics.