Minimally Invasive Modified Ellison Procedure for Anterolateral Ligament Reconstruction With Biocomposite Knotless Anchor.

D'Ambrosi, Riccardo; Marchetti, Pietro; Skopljak, Edna; Valli, Federico; Nuara, Alessandro; Ursino, Nicola · Arthrosc Tech · 2025

case_report · Level V

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Abstract

In recent years, anterolateral ligament repair and lateral extra-articular tenodesis have gained prominence as adjuncts to anterior cruciate ligament reconstruction (ACLR). This renewed focus is driven by increasing reports of failure rates exceeding 20% in high-risk groups undergoing standalone ACLR. Despite advancements in surgical techniques, equipment, and postoperative rehabilitation for ACLR, unresolved rotational instability and the persistence of the pivot-shift phenomenon remain significant challenges after ACLR. However, concerns linger regarding potential complications associated with these procedures, including overconstraint of the lateral compartment, stiffness, infections, tunnel convergence, and other intra- and postoperative issues linked to extended surgical times and additional interventions. The aim of this surgical Technical Note is to present a minimally invasive, modified Ellison procedure, employing a biocomposite knotless suture anchor for tibial fixationoffering a potentially effective and less-invasive approach to address these challenges.