Editorial Commentary: Anterolateral Ligament Augmentation for the Anterior Cruciate Ligament-Deficient Knee Debate-The Proof Is in the Pudding.

Abstract

The highly debatable and contentious anterolateral ligament (ALL) and its use as an augmentation for the anterior cruciate ligament (ACL)-deficient knee during ACL reconstruction continue to flourish in the literature, but the proof will be in the clinical outcome. Despite the ALL controversy, what clearly stands out from authors on either side of the debate is that there is much more going on than just the ACL in the ACL-deficient knee. Techniques of ALL augmentation or lateral extra-articular tenodesis continue to show promise that the lateral soft-tissue structures may provide the answer for the residual pivot and for better outcomes, higher return-to-sport rates, and lower rupture rates. Many authors and researchers believe that this may be a critical adjunct in high-risk situations during ACL reconstruction. But the proof of the pudding will be in the eating.