Anatomic reconstruction of the lateral capsular ligament (“one-loop plasty”) for anterolateral rotatory instability. A cadaveric study

Abstract

The aim of this study was to devise a method for lateral plasty to correct anterolateral rotatory instability (ALRI) responsible for the symptomatology elicited by the McIntosh pivot-shift test. We focused on the anatomy and function of the lateral capsular ligament (LCL). Using 50 cadaveric knees, we cut the LCL and the anterior cruciate ligament (obtaining a positive pivot-shift test result) and made a simple reconstruction of the LCL by looping a portion of fascia lata through a tunnel in the femur under the fibular collateral ligament, and inside a cortico-cancellous groove just medial to Gerdy's tuberculum on the tibia. The anatomic study let us understand the right points of fixation for a transplant both on the femur and on the tibia with a good isometry. After reconstruction, the pivot-shift test was negative. We think that this “loop-plasty” is a good solution for ALRI.