Arthroscopic ACL reconstruction with extra-articular anterolateral augmentation

Background: many techniques developed to overcome internal rotation instability associated with some cases of ACL injury , like changing techniques of tunneling from transtibial to more anatomical techniques, then double bundle reconstruction, recently the concept of adding the anterolateral reconstruction has been developed .Purpose: to evaluate the knee functional outcome following combined ACL and ALL reconstruction using central strip of the iliotibial band for ALL reconstruction. Study Design: case seriesMethods: From October 2020 to July 2021, 30 patients with ACL tear associated with high grade pivoting underwent combined ACL and ALL reconstruction. Hamstring graft was used for the ACL that was fixed by adjustable loop on the femoral side and biodegradable interference screw on the tibial side and iliotibial band slip used for the ALL reconstruction. The follow up on regular basis for one year postoperative for the last case.Results: the IKDC objective score was markedly improved from D in all case prop. to A to B with special concern to (Lachman test, anterior drawer test and the pivot shift test), IKDC subjective form mean score improved from 27.5 pre op. to 85 ,the lyshlom score pre operative was poor for all cases that improved to excellent to good.Conclusion: It was found that this technique provide good reasonable solution for the internal rotation instability that is found in those patients with high grade pivot shift , with simple technique , easy learning curve, short time, good functional results