Combined Anterolateral and Posterolateral Knee Reconstruction Using a Single Continuous Iliotibial-Band Graft

Christoph Hellmund; Hanno Steinke; Pierre Hepp; Firas Souleimann; Jeanette Henkelmann; Ralf Henkelmann

DOI: https://doi.org/10.70885/hmsj.2026.03.001

Abstract

In 61% of multiligament knee injuries (MLKIs), the posterolateral corner (PLC) is involved. These patients frequently require anterior cruciate ligament (ACL) and/or posterior cruciate ligament (PCL) reconstruction in addition to lateral stabilization. Consequently, two or more tendon grafts are often necessary to achieve adequate knee reconstruction. The aim of this study was to describe a surgical technique for combined anterolateral and posterolateral reconstruction without the need for additional autologous tendon harvesting. This technique utilizes a continuous iliotibial band (ITB) autograft. The novel surgical technique was performed on eight cadaveric specimens that had not undergone any previous knee surgery. A long, continuous ITB graft is harvested using a double-bladed scalpel. Distally, it remains attached to Gerdy's tubercle. It is then routed through the periarticular tissue and secured dorsocranially to the lateral femoral epicondyle, creating a lateral extra-articular tenodesis. The remaining graft is then shuttled towards the anterior fibular head and passed through a previously drilled fibular tunnel. After exiting the fibular tunnel dorsally, the graft is shuttled towards the femoral insertion of the popliteal tendon and secured. This cadaveric study illustrates that a continuous iliotibial band autograft can be utilized to perform a combined anterolateral and posterolateral reconstruction, with the graft sequentially following the trajectory of a Lemaire’s lateral extra-articular tenodesis and Arciero’s posterolateral reconstruction technique. This technique may present a useful alternative in cases of complex lateral multiligament knee injuries.Keywords: Multiligament knee injury, Knee dislocation, Anterolateral ligament, Posterolateral reconstruction, Arciero, Lemaire, Iliotibial bandhttps://doi.org/10.70885/hmsj.2026.03.001

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