Please login to view this media
- Talk
- 15/09/2021
- Canada
J. Édouard Samson Award Presentation Overview: Anterolateral Augmentation of ACL Reconstruction
Description
In this presentation, Alan Getgood, a consultant knee surgeon at the Farley Kennedy Sports Medicine Clinic in London, discusses his research on anterolateral augmentation in ACL (anterior cruciate ligament) reconstruction that earned recognition from the Canadian Orthopedic Foundation via the Sampson Award. He details the prevalence of ACL injuries among young, active patients, citing over 250,000 reconstructions performed annually in North America, and critiques the perceived high rates of surgical satisfaction and return to sport, which a closer examination of data may contradict.
He describes the problems associated with ACL injuries, particularly persistent rotatory laxity, which correlates with inferior clinical outcomes. To address these issues, he explores the anatomy and biomechanical implications of the anterolateral ligament (ALL), initially identified in a cadaveric study. Getgood focuses on how the ALL relates to controlling rotational laxity, referencing historical work and the debate surrounding its classification as a ligament versus an accessory structure.
Getgood shares findings from his cadaveric studies showing that while the ALL exists, its impact on knee stability may hinge more on the broader anterolateral complex. He presents the results of biomechanical studies indicating that lateral extra-articular tenodesis may provide improved rotational control compared to ALL reconstruction.
Furthermore, he emphasizes the importance of a multicenter randomized clinical trial focused on high-risk patients under age 25, showing that adding lateral tenodesis significantly reduces rates of graft failure and persistent rotatory laxity, although it does not appear to significantly affect patient-reported outcomes or the timing of return to sport.
Concluding, Getgood reviews how this research reshapes approaches to ACL reconstruction, advocating for the inclusion of lateral tenodesis in specific high-risk patients. He acknowledges the contributions of his research collaborators and highlights the broader implications of his findings for the treatment of ACL injuries.