Lateral reinforcement in anterior cruciate ligament reconstruction

Lateral extra-articular procedures were popular in the treatment of anterior cruciate ligament injury in the nineteen seventies and eighties, but fell from favor due to poor results, concerns regarding biomechanics, and concurrent advances in intra-articular reconstruction. Persistent problems with rotational control in modern reconstructive techniques have lead to a resurgence of interest in the concept of lateral reinforcement. In this article, we examine the history of lateral extra-articular procedures, the reasons for renewed interest in the technique, recent research that lends support to lateral procedures and possible indications for selective use.