Rotatory instability of the knee represents the main reason for failure and poor clinical outcomes regarding anterior cruciate ligament(ACL)reconstruction techniques.It is now clear that the anterolateral complex(ALC)...Rotatory instability of the knee represents the main reason for failure and poor clinical outcomes regarding anterior cruciate ligament(ACL)reconstruction techniques.It is now clear that the anterolateral complex(ALC)of the knee possesses a fundamental role,in association with the ACL,in controlling internal rotation.Over the past decade,ever since the anterolateral ligament has been identified and described as a distinct structure,there has been a renewed interest in the scientific community about the whole ALC:Lateral extra-articular tenodesis have made a comeback in association with ACL reconstructions to improve functional outcomes,reducing the risks of graft failure and associated injuries.Modern ACL reconstruction surgery must therefore investigate residual instability and proceed,when necessary,to extra-articular techniques,whether functional tenodesis or anatomical reconstruction.This review aims to investigate the latest anatomical and histological descriptions,and the role in rotational control and knee biomechanics of the ALC and its components.The diagnostic tools for its identification,different reconstruction techniques,and possible surgical indications are described..In addition,clinical and functional results available in the literature are reported.展开更多
Primary total knee arthroplasty(TKA)is a widespread procedure to address end stage osteoarthritis with good results,clinical outcomes,and long-term survivorship.Although it is frequently performed in elderly,an increa...Primary total knee arthroplasty(TKA)is a widespread procedure to address end stage osteoarthritis with good results,clinical outcomes,and long-term survivorship.Although it is frequently performed in elderly,an increased demand in young and active people is expected in the next years.However,a considerable dissatisfaction rate has been reported by highly demanding patients due to the intrinsic limitations provided by the TKA.Bicruciate-retaining(BCR)TKA was developed to mimic knee biomechanics,through anterior cruciate ligament preservation.First-generation BCR TKA has not gained popularity due to its being a challenging technique and having poor survival outcomes.Thanks to implant design improvement and surgeon-friendly instrumentation,secondgeneration BCR TKA has seen renewed interest.This review will focus on surgical indications,kinematical basis,clinical results and latest developments of secondgeneration BCR TKA.展开更多
文摘Rotatory instability of the knee represents the main reason for failure and poor clinical outcomes regarding anterior cruciate ligament(ACL)reconstruction techniques.It is now clear that the anterolateral complex(ALC)of the knee possesses a fundamental role,in association with the ACL,in controlling internal rotation.Over the past decade,ever since the anterolateral ligament has been identified and described as a distinct structure,there has been a renewed interest in the scientific community about the whole ALC:Lateral extra-articular tenodesis have made a comeback in association with ACL reconstructions to improve functional outcomes,reducing the risks of graft failure and associated injuries.Modern ACL reconstruction surgery must therefore investigate residual instability and proceed,when necessary,to extra-articular techniques,whether functional tenodesis or anatomical reconstruction.This review aims to investigate the latest anatomical and histological descriptions,and the role in rotational control and knee biomechanics of the ALC and its components.The diagnostic tools for its identification,different reconstruction techniques,and possible surgical indications are described..In addition,clinical and functional results available in the literature are reported.
文摘Primary total knee arthroplasty(TKA)is a widespread procedure to address end stage osteoarthritis with good results,clinical outcomes,and long-term survivorship.Although it is frequently performed in elderly,an increased demand in young and active people is expected in the next years.However,a considerable dissatisfaction rate has been reported by highly demanding patients due to the intrinsic limitations provided by the TKA.Bicruciate-retaining(BCR)TKA was developed to mimic knee biomechanics,through anterior cruciate ligament preservation.First-generation BCR TKA has not gained popularity due to its being a challenging technique and having poor survival outcomes.Thanks to implant design improvement and surgeon-friendly instrumentation,secondgeneration BCR TKA has seen renewed interest.This review will focus on surgical indications,kinematical basis,clinical results and latest developments of secondgeneration BCR TKA.
