SomEtimES a WinnEr iS a DrEamEr Who jUSt Won’t QUit

HISTORY The optimal ACL reconstruction is still a highly demanding clinical issue in orthopaedic research. In vitro and in vivo studies highlight that pure single bundle ACL surgery is not completely able to functionally restore knee rotational stability patterns. In the past few decades, several surgical reconstructions, combining intraand extra-articular procedures, have been proposed with the aim of improving the control of both knee translational and rotational laxities. In the 1960s and 1970s before arthroscopic techniques were introduced fascia lata fixed with two staples to achieve a bony anchoring at the femoral and tibial attachment (Figure 1 and 2). In the end, the idea of this modificationof the lateral tenodesis is to provide enough tissue for the extra-articular graft to withstand loading during cutting movements of the leg on the field and a bony anchoring to avoid slackening of the graft over time. Through a lateral approach one prepares a 10 to 13 mm wide strip at the posterior section of the Iliotibial (IT) Band. With a fascia cutter one is able to extend the fascia strip subcutaneously up to around 40 cm length. This long fascia lata strand remains inserted at the tibia. The sling is pulled underneath the proximal part of the lateral collateral (LC) ligament and with an osteotome, a bone flake is taken at the lateral margin of the – Written by Marc Martens, Qatar thE EXtra-articUlar latEral tEnoDESiS For an acl-DEFiciEnt KnEE SomEtimES a WinnEr iS a DrEamEr Who jUSt Won’t QUit