Lemaire lateral extra-articular tenodesis for anterolateral rotational knee instability
Subscribe to get full access to this operation and the extensive Knee Surgery Atlas.
Learn the Lemaire lateral extra-articular tenodesis for anterolateral rotational knee instability surgical technique with step by step instructions on OrthOracle. Our e-learning platform contains high resolution images and a certified CME of the Lemaire lateral extra-articular tenodesis for anterolateral rotational knee instability surgical procedure.
The Anterolateral ligament(ALL) is described as a triangular structure in the anterolateral aspect of the knee and found deep to the iliotibial tract. It measures between 34 and 59 mm in length and is approximately 2mm thick in men and 1mm in women. Its origin is near the lateral epicondyle in the femur and its insertion is located between Gerdy’s tubercle and the fibula, with an extension toward the lateral meniscus.
Biomechanical studies have shown that the ALL is an important stabilizer during anterolateral tibial rotation and effects pivot shift in cases of ACL failure. The description of the anterolateral ligament (ALL) and its effect on controlling internal rotation has led to the development of ALL reconstruction. However, there is continued debate regarding the anatomy of the ALL and in particular the ideal femoral origin. This has led to some confusion over the best technique of reconstruction and consequently the generalisation of the results of the different techniques reported in the literature.
Historically, multiple extra-articular procedures were developed to reduce anterolateral rotational instability (ALRI), collectively referred to as lateral extra-articular tenodesis (LET) procedures. However, concerns regarding the nonanatomic nature of LET procedures and the potential for over-constraint led to a decrease in their popularity. Biomechanical studies have also shown that the IT band does play an important role in rotational stability of the knee and the donor morbidity of these procedures is unknown.
Cadaveric biomechanical studies have shown that the lateral Lemarie tenodesis in association with ACL reconstruction better restores the rotational stability to the knee compared to ACL reconstruction combined with ALL reconstruction. The Lemaire reconstruction is my preferred technique to address ALRI of the knee in addition to ACL reconstruction.
Author: Professor Martyn Snow FRCS(Tr & Orth)
Institution :The Royal Orthopaedic Hospital, Birmingham ,UK.
- Each operation and the questions associated become a named course in the CPD section
- The operative technique itself is read as a lesson as is any company implant information if this is being assessed.
- You’ll need to tick the box to confirm this has been done and can do this immediately if you have already read the op tech.
- The vast majority of operations have a 10-15 MCQ quiz covering all aspects of the decision making and the technique
- There are four possible answers of which one is correct (or on occasion more correct) than the others.
- There are additional quiz modules on the surgical steps, the implants and problem cases being added continually
- The course is completed once all the lessons are read and quizzes submitted and passed.
- On successful completion of each quiz you will receive validated CPD points that add to the certificate in your CPD folder.
- Your dashboard also will contain a record of the time you have spent logged onto and using the site.
- The timer suspends after 5 minutes though if there is no activity.
- When you restart you will resume at the same point in the module.
- Once you have completed each quiz you will need to feedback on the module first then click “submit” and your paper will be marked.
The pass mark is 75%.
- If you fall below this level you will be directed back to re-read the slides where you’ve tripped up.
- Once these have been read you can re-do just the questions you failed on.
- Once you have passed the quiz you can return at a future stage & resit .
- Operation Quiz – 1 CPD point
- Surgical steps Quiz – 1/4 CPD point
- Implants Quiz – 1/4 CPD point
- Problem case Quiz – 1/2 CPD point
One CPD point equates to one hour of academic activity
Welcome to the Professional Development question section. The objective of taking these tests is to demonstrate that you have understood all aspects of the assessment and management of patients requiring surgical intevention. On successful completion you will receive a certificate accredited by both the Royal College of Surgeons of both England and Edinburgh as well as the British Orthopaedic Association.
Our content is designed for both Surgeons in independent practice and Surgeons in training.