Graft choices for anterolateral ligament knee reconstruction surgery: Current concepts

Table 2 Lateral extraarticular tenodesis and anterolateral ligament reconstruction Techniques: Advantages and disadvantages[39,72,73]

Advantages	Disadvantages
1. Lateral extraarticular tenodesis
Improvement of rotational knee stability	Non-anatomic procedure
Reduction of ACL graft failure rate	Possible over-constraining
Reproducible, easy-to-learn technique	May add pain to postoperative rehabilitation
Inexpensive procedure, especially when using high-resistance suture	Muscle herniation, if ITB closure is not performed in proper way
No risk of tunnel coalition when fixed with sutures proximally
2. Anterolateral ligament reconstruction
Improvement of rotational knee stability	Need ability to identify anatomic landmarks
Reduction of ACL graft failure rate	Use of allograft or synthetic results in increased cost
Preserves iliotibial band	Use of autograft requires additional surgery for graft harvest and possible donor site morbidity
Avoids lateral collateral ligament attachment
Secure graft fixation allows for early motion and accelerated anterior cruciate ligament rehabilitation

ACL: Anterior cruciate ligament; ITB: Iliotibial band.