Anatomic anterior cruciate ligament (ACL) reconstruction: a global perspective. Part 1

Abstract

These data summarize the results of five panels on anatomic ACL reconstruction. The most popular graft choice among surgeons for primary ACL reconstructions is hamstring tendon autograft, with allograft being used most frequently employed in revision cases. Nearly half of the surgeons surveyed performed both single- and double-bundle ACL reconstructions depending on certain criteria. Regardless of the technique regularly employed, there was unanimous support among surgeons for the use of "anatomic" reconstructions using bony and soft tissue remnant landmarks.

Updates in biological therapies for knee injuries: anterior cruciate ligament

“…Knee stability and cartilage incident forces are displayed in distinctive ways related to anatomical and nonanatomical ACL reconstruction. As already stated, given the better understanding of ACL anatomy, there has been a transition from the so-called isometric reconstruction to anatomic reconstruction of the ACL [4,5]. Allegedly, some studies pointed out that anatomical tunnel placement results in superior biological healing, biomechanical properties, knee stability, and even a protective cartilage effect, as compared with a nonanatomic reconstruction [45][46][47][48][49].…”

“…ACLR is a common orthopedic procedure. There have been many advances in ACLR techniques in the last few years, in part because of a better understanding of the ligament anatomy and a transition from the so-called isometric reconstruction to anatomic reconstruction of the ACL [4,5]. Despite these advances, ACLR is not a universally successful procedure and has actual failure rates around 8 % [5].…”

Validity of Single Leg Hop Test in Comparison of Lysholm Score after ACL Reconstruction through Anteromedial Portal Technique by Using Hamstring Tendon

“…[10,11] However, as of late, there have been reports of no difference in outcome measures between the two techniques particularly when the reconstruction is ‗‗anatomic''. [12,13] Patient satisfaction after -anatomic‖ Reconstruction of the anterior cruciate ligament has not been well studied. [14] Over the past 20 years, focus on patient-reported outcomes rather than clinician-based measures has increased due to the superior validity of the former.…”

Graft tensioning in anterior cruciate ligament reconstruction

“…The graft is then prepared and a tibial and femoral tunnel established to insert the graft. Once inserted, the graft is tensioned and fixed at the femur and tibia relevant to the surgical method chosen (Andersson, Samuelsson, & Karlsson, 2009;Arciero et al, 1996;Beynnon, Johnson, Abate, Fleming, & Nichols, 2005;Chalmers et al, 2013;Middleton et al, 2014;van Eck et al, 2010;Voigt, Schönaich, & Lill, 2006) (Fitzgerald et al, 2000;Kessler et al, 2008;Meuffels et al, 2009;Meunier et al, 2007;Moksnes & Risberg, 2009). In contrast, some literature reports that conservatively managed ACL injuries present with increased joint laxity, a greater risk of meniscal damage post injury and reduced long-term activity levels (Meuffels et al, 2009;Mihelic, Jurdana, Jotanovic, Madjarevic, & Tudor, 2011;Strehl & Eggli, 2007) while surgically managed patients subjectively perceive a better outcome and maintain higher levels of sports participation (Fink, Hoser, Hackl, Navarro, & Benedetto, 2001).…”

“…An arthroscopic approach to ACL reconstruction is universally accepted as the primary method due to the reduction in surgical trauma and post-operative morbidity, greater visualisation and superior accuracy for tunnel placement (Chalmers et al, 2013;Dandy, 1982;Martins et al, 2008;Middleton et al, 2014;Raab, Fischer, Smith, Markman, & Steubs, 1993;van Eck et al, 2010;Woo et al, 2006). Initially, in the mid 1980's, a 2-incision technique was preferred where the tibial and femoral tunnels were drilled independently via separate incisions.…”