Rotational Knee Instability in ACL-Deficient Knees: Role of the Anterolateral Ligament and Iliotibial Band as Defined by Tibiofemoral Compartment Translations and Rotations

Conclusions: With ACL sectioning, a positive pivot-shift anterior subluxation occurred even with intact ALL and ITB structures, which indicates that the latter are not primary restraints but function together as anterolateral secondary restraints. With ACL deficiency, concurrent loss of the ALL and ITB resulted in conversion in a majority of knees (71%) to a Grade-3 pivot-shift subluxation, along with major increases of internal rotation in select knees. Clinical Relevance: With ACL rupture, major increases in rotational instability are not adequately resisted by native ALL or ITB structures. Therefore, anatomic ALL or ITB surgical reconstruction would not block a positive pivot shift. The potential protective effects of ACL graft-unloading from these structures require further study.
Source: JBJS - Category: Orthopaedics Authors: Tags: Basic Science, Sports Medicine Scientific Articles Source Type: research