2021 Annual Meeting Knee Access Pass-Questions and Answers: ACL Beyond the Ligament

Video Transcription

One question, it seems from some of the articles that we've seen today that some people are indicating lateral sided reconstructions for every single case.  I would like to run through the panel and see what your indications are, when do you use it, and when do you think it's appropriate in the revision setting?  Thanks for the question. I think the indications previously when we first started exploring this were controversial, but now we have a number of comparative studies,  and you also heard today that there was quite a bit of agreement between us in terms of the indications, which previously might not have been the case.  But to summarize my slide, the comparative studies  demonstrate significant advantages in patients who are young, participating in pivoting sports, those with hyperlaxity, chronic injuries, undergoing revision ACL reconstruction,  and then we've heard today in elite athletes too.  All right. Yeah, I completely agree, and I think it is interesting that everyone seems to be on the same page now with this. I think the one thing that teaching residence fellows  is just saying that this decision's not made in a vacuum, and you've got to look at the patient as a whole. And the other big thing is the contraindication,  is if you have a soft patient or a patient that can't deal with pain, this hurts, it absolutely adds morbidity, they don't move their knee,  they get stiff, and you've made them worse. So I think it's something that's important to consider when considering all of these factors as well.  So I do it in most of my revisions now. I haven't started doing it in a lot of my primaries, but as more and more evidence keeps coming out,  I'll probably start adding it more to the high-risk athletes. Alex, do you change your indications based on your graft? You know, I really don't. It's a great point.  I would echo what the other panelists have said so far.  For me, it's largely BTB in this patient population with the occasional quad with a bone block. You know, I think in the Fiseal techniques, I'll use quad all soft tissue.  But if the athletes fall into these categories of high risk, then I think adding the lateral extra-articular tenodesis is my preferred technique. Well, that was a great session.  I'd like to introduce Dr. Brian Cole, and he's going to introduce Dr. Rick Rear. Thank you.

Video Summary

In this video, the panel discusses the use of lateral sided reconstructions in knee surgeries. They agree that there are certain indications for this technique, including young patients, those participating in pivoting sports, patients with hyperlaxity or chronic injuries, those undergoing revision ACL reconstruction, and elite athletes. However, they caution that this decision should not be made in isolation, and the patient's overall condition must be considered. They also mention that the procedure may not be suitable for patients who cannot tolerate pain, as it can lead to complications. The panelists also discuss their preferred grafts for the procedure. The video ends with Dr. Brian Cole introducing Dr. Rick Rear.

Asset Caption

Volker Musahl, MD; Alan Getgood, MD, FRCS (Tr&Orth); Robert Duerr, MD; Kyle Borque, MD; Adnan Saithna, MD, FRCS; Alexander Weber, MD; Richard K.N. Ryu, MD

Keywords

lateral sided reconstructions

knee surgeries

indications

patient's overall condition

complications