Anterior cruciate ligament reconstruction with anterolateral stabilization by a modified Lemaire technique in adolescent professional football player: a case report

  • Damir Hudetz St. Catherine Specialty Hospital, 49210 Zabok/10000 Zagreb, Croatia
  • Vilim Molnar St. Catherine Specialty Hospital
  • Zeljko Jelec St. Catherine Specialty Hospital, 49210 Zabok/10000 Zagreb, Croatia
  • Eduard Rod St. Catherine Specialty Hospital, 49210 Zabok/10000 Zagreb, Croatia
  • Vid Matisic St. Catherine Specialty Hospital, 49210 Zabok/10000 Zagreb, Croatia
  • Igor Boric St. Catherine Specialty Hospital, 49210 Zabok/10000 Zagreb, Croatia
  • Dragan Primorac St. Catherine Specialty Hospital, 49210 Zabok/10000 Zagreb, Croatia
Keywords: anterior cruciate ligament reconstruction, lateral extra-articular tenodesis, Lemaire procedure, professional football player

Abstract

Background: Anterior cruciate ligament (ACL) tear is one of the most common injuries in professional athletes. Additional procedures, such as anterolateral ligament reconstruction and lateral extra-articular tenodesis attempt to reduce rotational instability, the most common cause of re-injury in patients with a nonisolated ACL tear.

Case study: A 17-year-old professional football player suffered a right knee injury in a direct hit to the lateral side of the knee. Magnetic resonance imaging showed anterior cruciate ligament tear and lateral knee structures soft tissue contusion. Due to the injury of the lateral structures and the increased risk of ACL rerupture, it was decided to perform ACL reconstruction with additional anterolateral stabilization by a modified Lemaire technique without additional screw fixation in the area of the lateral femoral epicondyle, which could damage the epiphyseal plate and, concurrently, impair bone growth.

Conclusion: The addition of lateral extra-articular tenodesis by a modified Lemaire technique prevents rotational instability in a patient with expressed pivotshift before the surgery, without overconstraint of the knee and additional damage to the epiphyseal plate.

Downloads

Download data is not yet available.

References

Siegel L, Vandenakker-Albanese C, Siegel D. Anterior Cruciate Ligament Injuries. Clin J Sport Med. 2012;22:349–55.

Wiggins AJ, Grandhi RK, Schneider DK, Stanfield D, Webster KE, Myer GD. Risk of Secondary Injury in Younger Athletes After Anterior Cruciate Ligament Reconstruction. Am J Sports Med. 2016;44:1861–76.

Bernholt DL, Kennedy MI, Crawford MD, DePhillipo NN, LaPrade RF. Combined Anterior Cruciate Ligament Reconstruction and Lateral Extra-Articular Tenodesis. Arthrosc Tech. 2019;8:e855–9.

Geeslin AG, Moatshe G, Chahla J, Kruckeberg BM, Muckenhirn KJ, Dornan GJ, et al. Anterolateral Knee Extra-articular Stabilizers: A Robotic Study Comparing Anterolateral Ligament Reconstruction and Modified Lemaire Lateral Extra-articular Tenodesis. Am J Sports Med. 2018;46:607–16.

Collins MJ, Arns TA, Leroux T, Black A, Mascarenhas R, Bach BR, et al. Growth Abnormalities Following Anterior Cruciate Ligament Reconstruction in the Skeletally Immature Patient: A Systematic Review. Arthroscopy. 2016;32:1714–23.

Ćuti T, Antunović M, Marijanović I, Ivković A, Vukasović A, Matić I, et al. Capacity of muscle derived stem cells and pericytes to promote tendon graft integration and ligamentization following anterior cruciate ligament reconstruction. Int Orthop. 2017;41:1189–98.

Getgood A, Brown C, Lording T, Amis A, Claes S, Geeslin A, et al. The anterolateral complex of the knee: results from the International ALC Consensus Group Meeting. Knee Surgery, Sport Traumatol Arthrosc. 2019;27:166–76.

Joseph L, Demey G, Chamu T, Schmidt A, Germain A, van Rooij F, et al. Adding a modified Lemaire procedure to ACLR in knees with severe rotational knee instability does not compromise isokinetic muscle recovery at the time of return-to-play. J Exp Orthop. 2020;7:84.

Slette EL, Mikula JD, Schon JM, Marchetti DC, Kheir MM, Turnbull TL, et al. Biomechanical Results of Lateral Extra-articular Tenodesis Procedures of the Knee: A Systematic Review. Arthroscopy. 2016;32:2592–611.

Hewison CE, Tran MN, Kaniki N, Remtulla A, Bryant D, Getgood AM. Lateral Extra-articular Tenodesis Reduces Rotational Laxity When Combined with Anterior Cruciate Ligament Reconstruction: A Systematic Review of the Literature. Arthroscopy. 2015;31:2022–34.

Gupta A, Tejpal T, Shanmugaraj A, Horner NS, Gohal C, Khan M. Allepiphyseal anterior cruciate ligament reconstruction produces good functional outcomes and low complication rates in pediatric patients: a systematic review. Knee Surgery, Sport Traumatol Arthrosc. 2020;28:2444–52.

Published
2021-09-28
How to Cite
1.
Hudetz D, Molnar V, Jelec Z, Rod E, Matisic V, Boric I, Primorac D. Anterior cruciate ligament reconstruction with anterolateral stabilization by a modified Lemaire technique in adolescent professional football player: a case report. Acta Chir. Croat. [Internet]. 2021Sep.28 [cited 2021Oct.17];18(1):15-0. Available from: https://acc.hkd.com.hr/index.php/ACC/article/view/129
Section
Case Reports

Most read articles by the same author(s)