Komplexe Rekonstruktionen des vorderen Kreuzbands (VKB+X)

The increasing understanding of associated pathologies and combined (rotational) instabilities has led to the fact that anterior cruciate ligament (ACL) reconstructions are often not performed as isolated procedures. In addition to common meniscal lesions, ruptures of the (posterolateral) meniscal root and medial meniscal ramp, as well as associated anterolateral or anteromedial rotational instabilities, have been increasingly studied in recent years. The former can be well diagnosed with magnetic resonance imaging (MRI) and arthroscopy, whereas rotational instabilities require dedicated clinical examination. An accurate diagnosis of associated pathologies is the basis for making treatment decisions and the potential long-term success of an ACL reconstruction. This article specifically addresses anteromedial and anterolateral rotational instabilities as well as posterolateral root lesions and ramp lesions.