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C. BATAILLER, S. LUSTIG, D. WASCHER, E. SERVIEN, P. NEYRET
16
SURGICALTECHNIQUES
[10, 11]
Lateral extra-articular tenodesis
procedures
The extra-articular tenodesis has been
attempted historically as an isolated procedure,
without ACL reconstruction. These techniques
achieve a lateral reinforcement to control
rotational laxity, without reproduce the ALL
course.
Lemaire procedure
[12]
This technique uses a strip of ITB, measuring
18cm long and 10mm wide and left attached to
Gerdy’s tubercle. The graft is passed under the
FCL, through a femoral tunnel just above the
LFE and proximally to the FCL insertion, and
back under the FCL. It is fixed in tibial bone
tunnel through Gerdy’s tubercle, at 30° of
flexion with neutral rotation. Christel and Dijan
used a modified Lemaire procedure with single
bundle of graft (75mm long, 10mm wide),
Fig. 3:
Cadaveric dissection (a) and
line drawing (b) of a right knee
showing the superficial lateral
capsular structure (ALL), described
by Kennedy
(Photo: Courtesy of
T. Branch and T. Lording. Line drawing
from Kennedy and al. [8])
.
LCL or FCL, lateral or fibular collateral
ligament; ALL, anterolateral ligament.
Biceps
femoris
ALL
Femoral
attachment
FCL Femoral
attachment
Popliteus tendon
Lateral
gastrocnemius
Gerdy’s
Tubercle
ALL Tibial
attachment
Anterior arm of
biceps femoris
FCL attachment to
fibular head
a
b