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“Over the Top” Single-Bundle ACL Reconstruction with Extra-articular Plasty

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Rotatory Knee Instability

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Abstract

Anterior cruciate ligament reconstruction is one of the most commonly performed surgeries worldwide, but there remains a lack of evidence about one technique being preferable to another. Professor Marcacci and his equipe developed in 1992 a surgical technique called “over the top” plus lateral plasty, using autologous ipsilateral gracilis and semitendinosus muscles tendons.

  • Only one tibial tunnel is required, reducing the risk of graft malplacement, making this technique suitable also for revision cases.

  • Cheap and reliable fixation devices (metal staples), reducing surgical time and allowing early rehabilitation.

  • The additional lateral plasty makes this technique reliable in addressing multidirectional laxities, not only anteroposterior but also rotational ones, making this technique comparable to a double-bundle one.

In this chapter, the “over the top” plus extraarticular plasty ACL reconstruction will be described, relating it to the current concepts of reconstruction and laxity assessment. The highly satisfactory results obtained over the time with the above-reported technique show that a combination of intra- and extra-articular procedures for ACL reconstruction is a valid surgical option in the ACL-deficient knee.

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Authors and Affiliations

  1. Clinica Ortopedica e Traumatologica II, Laboratorio di Biomeccanica ed Innovazione Tecnologica, Istituto Ortopedico Rizzoli, Via di Barbiano, 1/10, Bologna, 40136, Italy

    Stefano Zaffagnini, Tommaso Roberti Di Sarsina, Alberto Grassi, Giulio Maria Marcheggiani Muccioli, Federico Raggi, Tommaso Bonanzinga, Cecilia Signorelli & Maurilio Marcacci

Authors
  1. Stefano Zaffagnini
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  2. Tommaso Roberti Di Sarsina
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  3. Alberto Grassi
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  4. Giulio Maria Marcheggiani Muccioli
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  5. Federico Raggi
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  6. Tommaso Bonanzinga
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  7. Cecilia Signorelli
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  8. Maurilio Marcacci
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Corresponding author

Correspondence to Stefano Zaffagnini .

Editor information

Editors and Affiliations

  1. UPMC Center for Sports Medicine, Pittsburgh, Pennsylvania, USA

    Volker Musahl

  2. Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden

    Jón Karlsson

  3. Orthopaedic Surgery, Kobe University School of Medicine, Kobe, Japan

    Ryosuke Kuroda

  4. Istituto Ortopedico Rizzoli, University of Bologna, Bologna, Italy

    Stefano Zaffagnini

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Zaffagnini, S. et al. (2017). “Over the Top” Single-Bundle ACL Reconstruction with Extra-articular Plasty. In: Musahl, V., Karlsson, J., Kuroda, R., Zaffagnini, S. (eds) Rotatory Knee Instability. Springer, Cham. https://doi.org/10.1007/978-3-319-32070-0_28

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  • DOI: https://doi.org/10.1007/978-3-319-32070-0_28

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  • Online ISBN: 978-3-319-32070-0

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