Anterolateral Complex Reconstruction: Who, When, and How?

Anterior translation and rotatory laxity of the knee joint is the result of an anterior cruciate ligament (ACL) rupture. The goal of ACL reconstruction is to restore normal knee biomechanics. Abnormal knee kinematics have been thought to be one of the primary factors in the progression toward osteoarthritis after ACL reconstruction. It has been demonstrated that even with a well-performed single or double bundle ACL reconstruction rotatory laxity can persist. This persistent rotatory laxity is one of the reasons to the recent international focus on the stabilizing role of the anterolateral complex in the knee. In this article, we discuss the indications and different available techniques to reconstruct the anterolateral complex.