The “Minimizing Excessive Rotational Instability Technique” (MERI Technique): A Simple Lateral Tenodesis Reconstructing the Condylar Strap, the Distal Kaplan Fibers, and the Femoral Insertion of the Anterolateral Ligament to Control Internal Rotation

Abstract

The Minimizing Excessive Rotational Instability technique is a simple and minimally invasive lateral tenodesis designed to enhance internal rotation control during anterior cruciate ligament reconstruction by reconstructing the distal Kaplan fibers, the condylar strap, and the femoral insertion of the anterolateral ligament. Using a 1‐cm‐wide fascia lata strip, the procedure involves fixation with a single anchor at an isometric point proximal to the anterolateral ligament insertion, followed by a continuous locking suture and fascia lata closure on the anchor, which further reinforces rotational stability without excessive constraint. Although possibly biomechanically less restrictive than traditional lateral extra‐articular tenodesis, the Minimizing Excessive Rotational Instability technique strikes a balance between stability and flexibility, potentially reducing postoperative stiffness and morbidity. Its simplicity, cost‐effectiveness, and minimal invasiveness make it a valuable alternative for addressing anterolateral instability in select anterior cruciate ligament reconstruction patients.