PMC5777553_01
Sagittal magnetic resonance imaging knee view showing the graft (neoligament) after an anterior cruciate ligament reconstruction. Despite the presence of artifacts from previous fixation with metal interference screws, it is possible to visualize the anterior cruciate ligament graft.
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PMC5777553_01_10.1177_2325967117751348-fig1.jpg
fig1-2325967117751348
It was noted that the first reconstruction was technically adequate, with an intact graft (Figure 1) and appropriate tunnel positioning (Figure 2).
Lateral radiographic knee view showing the anterior cruciate ligament tunnels and the metal screws used for graft fixation. The femoral tunnel was performed close to the anteromedial bundle position.
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PMC5777553_01_10.1177_2325967117751348-fig2.jpg
fig2-2325967117751348
It was noted that the first reconstruction was technically adequate, with an intact graft (Figure 1) and appropriate tunnel positioning (Figure 2).
Lateral view of the right knee showing the extra-articular reconstruction of the anterolateral ligament. The graft is already fixed into the femur and is going in an anteroinferior direction until its tibial insertion between the Gerdy tubercle and the fibular head.
10.1177_2325967117751348-fig3.jpg
PMC5777553_01_10.1177_2325967117751348-fig3.jpg
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ALL reconstruction, a lateral incision was made in line with the iliotibial band, and a femoral tunnel on the posterior border of the lateral epicondyle and a tibial tunnel between the Gerdy tubercle and the fibular head (7 mm distal to the lateral tibial plateau) were created with a 7-mm drill. An allograft semitendinosus tendon from our institution's tissue bank was used as a graft, and fixation was performed at 30  of flexion and neutral rotation with absorbable 7 x 25-mm interference screws (Smith & Nephew) (Figures 3 and 4).
Lateral view of the right knee showing the final appearance of the anterolateral ligament reconstruction, which is already fixed into the femur and tibia, passing under the iliotibial band to respect its anatomic path.
10.1177_2325967117751348-fig4.jpg
PMC5777553_01_10.1177_2325967117751348-fig4.jpg
fig4-2325967117751348
ALL reconstruction, a lateral incision was made in line with the iliotibial band, and a femoral tunnel on the posterior border of the lateral epicondyle and a tibial tunnel between the Gerdy tubercle and the fibular head (7 mm distal to the lateral tibial plateau) were created with a 7-mm drill. An allograft semitendinosus tendon from our institution's tissue bank was used as a graft, and fixation was performed at 30  of flexion and neutral rotation with absorbable 7 x 25-mm interference screws (Smith & Nephew) (Figures 3 and 4).