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Review
. 2023 Apr 1;10(1):36.
doi: 10.1186/s40634-023-00599-8.

The 25-year experience of over-the-top ACL reconstruction plus extra-articular lateral tenodesis with hamstring tendon grafts: the story so far

Stefano Zaffagnini  1 , Gian Andrea Lucidi  1 , Luca Macchiarola  2 , Piero Agostinone  3 , Maria Pia Neri  1 , Maurilio Marcacci  4 , Alberto Grassi  1
Affiliations
Review

The 25-year experience of over-the-top ACL reconstruction plus extra-articular lateral tenodesis with hamstring tendon grafts: the story so far

Stefano Zaffagnini et al. J Exp Orthop. .

Abstract

This article presents with an evidence based approach, the kinematical rationale, biological evidence and the long term results of the "Over-The-Top" anterior cruciate ligament reconstruction with lateral plasty technique. This surgery was developed more than 25 years ago at the Rizzoli Institute by professor Marcacci and Zaffagnini and it is still widely performed in many orthopedic center worldwide.

Keywords: ACL; Anterior Cruciate Ligament; Lateral Pasty; Over-the-Top; Pivot shift.

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Conflict of interest statement

SZ is a consultant surgeon for Smith and Nephew and DePuy Synthes.

Figures

Fig. 1
Fig. 1
Surgical technique reconstruction for ACL and lateral plasty described by Zarins and Carter Rowe
Fig. 2
Fig. 2
3D-CT of the tibial insertion of a human ACL
Fig. 3
Fig. 3
3D- CT of the intercondylar groove. The ACL (orange) is composed of a multitude of fibers. The stars indicate the direct fibers, directed in the “Over the top” position
Fig. 4
Fig. 4
Technical tips for over-the-top and lateral plasty ACL reconstruction
Fig. 5
Fig. 5
Technical tips for over-the-top and lateral plasty ACL reconstruction
Fig. 6
Fig. 6
MRI of hamstring ACL graft that was harvested preserving the distal portion 1, 6, and 12 months after surgery
Fig. 7
Fig. 7
a-b Survival curve of ACL over the top and lateral plasty ACL reconstruction at 10 years (a); 10 year KOOS Subscale of Over-the-top (blue) and MOON ACL Registry (orange) (b)
See this image and copyright information in PMC

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