Indications and Methods for Additional Anterolateral Procedures during an Anterior Cruciate Ligament Reconstruction
10.4055/jkoa.2025.60.2.82
- Author:
Bon-ki KOO
1
;
Sang Hak LEE
Author Information
1. Department of Orthopedic Surgery, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Korea
- Publication Type:Symposium
- From:The Journal of the Korean Orthopaedic Association
2025;60(2):82-90
- CountryRepublic of Korea
- Language:English
-
Abstract:
The surgical reconstruction of the anterior cruciate ligament (ACL) has shown continuous advances, but concerns persist regarding its instability, the occurrence of post-traumatic osteoarthritis, and the high frequency of re-ruptures. Despite the lack of consensus regarding the precise structure of the anterolateral ligament (ALL) complex, this structure is anatomically present, and it can be damaged concurrently with the ACL, providing resistance to rotational instability. The debate regarding the timing and necessity of additional surgeries during ACL reconstruction is ongoing. Some authors advocate for concurrent procedures because of various risk factors, despite the widely varying opinions on this issue. Common adjunctive surgical techniques include ALL reconstruction and lateral extra-articular tenodesis. These procedures typically use various grafts and generally produce favorable clinical outcomes. Nevertheless, additional surgeries should be considered in certain cases because standard ACL reconstruction techniques may not be suitable for all patients. These cases include revision reconstructions, patients under 20 years old with high activity levels, those experiencing significant rotational instability, and individuals with specific anatomical risk factors. In such cases, procedures targeting the ALL complex may offer added benefits.
