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. 2019 Jul 18;8(8):e821-e825.
doi: 10.1016/j.eats.2019.03.020. eCollection 2019 Aug.

Lateral Extra-articular Tenodesis With Proximal Staple Fixation

Adam Kwapisz  1 , Scott Mollison  1 , Sheila McRae  1 , Peter MacDonald  1
Affiliations

Lateral Extra-articular Tenodesis With Proximal Staple Fixation

Adam Kwapisz et al. Arthrosc Tech. .

Abstract

A technique for lateral extra-articular tenodesis using proximal staple fixation is described as an adjunct to anterior cruciate ligament (ACL) reconstruction. Lateral extra-articular tenodesis has been used in an effort to decrease failure rates in ACL-deficient patients with ligamentous laxity, prior failed ACL surgery, or grade 3 pivot-shift findings. Numerous surgeons have described combining ACL reconstruction with extra-articular surgery. The approach described in this article is easy and cost-effective. Moreover, because this technique uses a staple instead of a SwiveLock (Arthrex, Naples, FL) or other suture anchor, it limits the chance of conflicting with the tunnels for the ACL because there is no need to drill or punch additional tunnels.

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Figures

Fig 1
Fig 1
Lateral view of the right knee. The skin incision is marked along the iliotibial band. (F, femur; FH, fibular head; I, marked incision; P, patella; TT, tibial tubercle.)
Fig 2
Fig 2
Lateral view of the right knee after the iliotibial band strip (ITBS) has been harvested. (P, patella; TT, tibial tubercle.)
Fig 3
Fig 3
Lateral view of the right knee after the incision has been made and the iliotibial band (ITB) has been dissected. The arrow is pointing in the direction in which the double blade (DB) will be used. (F, femur; FH, femoral head; P, patella; TT, tibial tubercle.)
Fig 4
Fig 4
Lateral view of the right knee after the lateral collateral ligament (LCL, dotted lines) has been isolated, and a tunnel beneath is prepared to pass the iliotibial band strip (ITBS). (F, femur; FH, femoral head; TT, tibial tubercle.)
Fig 5
Fig 5
Lateral view of the right knee after the iliotibial band (ITB) has been harvested. The arrow is pointing to the laser mark indicating the correct length of the tissue strip (dotted lines). (DB, double blade; F, femur; P, patella; TT, tibial tubercle.)
Fig 6
Fig 6
Lateral view of the right knee after the iliotibial band strip (ITBS) has been passed under the lateral collateral ligament (LCL, dotted lines). (FH, femoral head.)
Fig 7
Fig 7
Lateral view of the right knee after the iliotibial band strip (ITBS) has been fixed with a staple (S). The dotted lines indicate the lateral collateral ligament (LCL).
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References

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