Review of evolution of tunnel position in anterior cruciate ligament reconstruction

Rayan, Faizal; Nanjayan, Shashi Kumar; Quah, Conal; Ramoutar, Darryl; Konan, Sujith; Haddad, Fares S.

doi:10.5312/wjo.v6.i2.252

Cited by 105 publications

(107 citation statements)

References 67 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In addition, other structures of the anterolateral corner, such as the iliotibial tractus with its connecting Kaplan fibers, the lateral retinaculum and the lateral capsule, are suggested to influence pivot-rotational stability [57] . Additionally, it is currently being discussed whether the ALL becomes insufficient over time in cases of chronic 86 February 18, 2016|Volume 7|Issue 2| WJO|www.wjgnet.com [40] . Increased contact stress after an anterior cruciate ligament rupture in the posterior lateral compartment during pivot shifting (green area) and in the posterior medial compartment during Lachman testing (violet area) -modified from Imhauser et al [41] .…”

Section: Lateral Collateral Ligamentmentioning

confidence: 99%

Section: Tunnel Positioning and Effects On Biomechanicsmentioning

confidence: 99%

“…Nevertheless, the introduction of the anteromedial portal technique allowed "independent" drilling of femoral ACL tunnels and, thus, a method to reliably and visually address the native tibial and femoral ACL footprints [84,85] . Hence, novel anteromedial portal "anatomical" singleand double-bundle ACL reconstruction techniques have been clinically introduced and biomechanically evaluated [21,[86][87][88][89] . Correlating to the results of the biomechanical mismatch studies [8,16] , both anatomic double-bundle and anatomic single-bundle ACL reconstruction techniques resulted in superior kinematics compared to transtibial ("high-AM") femoral tunnel drilling for ACL reconstruction [21,89,90] .…”

mentioning

confidence: 99%

See 2 more Smart Citations

Biomechanics of the anterior cruciate ligament: Physiology, rupture and reconstruction techniques

Domnick

Raschke

Herbort

2016

WJO

View full text Add to dashboard Cite

ligament (ACL) on kinematics and clinical outcomes have been investigated in many biomechanical and clinical studies over the last several decades. The knee is a complex joint with shifting contact points, pressures and axes that are affected when a ligament is injured. The ACL, as one of the intra-articular ligaments, has a strong influence on the resulting kinematics. Often, other meniscal or ligamentous injuries accompany ACL ruptures and further deteriorate the resulting kinematics and clinical outcomes. Knowing the surgical options, anatomic relations and current evidence to restore ACL function and considering the influence of concomitant injuries on resulting kinematics to restore full function can together help to achieve an optimal outcome. Conflict-of-interest statement:There are no conflicts of interest to declare. Open-Access:This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/ licenses/by-nc/4.0/ [1] . The ACL is a central ligament of the knee. The main functional role of the ACL is to provide stability against anterior tibial translation (ATT) and internal rotation. An acute ACL rupture is a common orthopedic trauma, with an estimated incidence of 78 per 100000 persons and a mean age of 32 years in Sweden and an estimated incidence of up to 84 per 100000 persons in the United States [2,3] . A common and frequent injury mechanism is noncontact combined valgus-and internal-rotation trauma [2,4] . Therefore, ACL injuries are often associated with other ligamentous injuries, such as a (partial) rupture of the medial collateral ligament (MCL) or the menisci. In addition, compression of the lateral condyle with a bone bruise or chondral lesion is often associated with the injury due to the valgus trauma. Persistent instability of the knee may be associated with long-term degenerative lesions. Surgical treatment of the ACL in the context of other injured structures and reconstruction of the intact joint kinematics are suggested to be the keys to a good clinical outcome [5,6] . ANATOMYThe ACL has its origin at the medial area of the lateral femoral condyle and inserts into the center of the eminentia of the tibia plateau next to the anterior horn of the lateral meniscus. The structure of the ACL has been described as two functional bundles: The anteromedial (AM) and the posterolateral (PL) bundle [7] . These two bundles have been associated with different roles in anteroposterior and complex-rotational stabilization of the joint [8][9][10] . The femoral origin was described as oval shaped with a longitudinal diameter of 18 mm and a width of approximately 11 mm [11,12] . ...

show abstract

Section: Lateral Collateral Ligamentmentioning

confidence: 99%

Section: Tunnel Positioning and Effects On Biomechanicsmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Biomechanics of the anterior cruciate ligament: Physiology, rupture and reconstruction techniques

Domnick

Raschke

Herbort

2016

WJO

View full text Add to dashboard Cite

show abstract

“…Rayan, Kaseta, revealed the importance of tunnel placement [8][9][10][11]. These studies focused on the anteroposterior position of femoral tunnel.…”

Section: Discussionmentioning

confidence: 99%

Untitled

2016

MOJOR

View full text Add to dashboard Cite

Submit Manuscript | http://medcraveonline.com IntroductionArthroscopic Anterior Cruciate Ligament (ACL) reconstruction is one of the most commonly procedure which are done by orthopedic surgeons, ACL is one of the most commonly disrupted ligaments in the knee injuries and is a common cause of knee instability [1][2][3].This ligament consists of two functional fiber components. These are named by the site which they attach on the tibia, the anteromedial and posterolateral bundle. With knee extension, the posterolateral one is tight and the anteromedial bundle is relaxed. Since ACL deficient knee causes limitation to activity because of symptomatic instability and high prevalence of knee osteoarthritis, the most common method of treatment in these injuries is an ACL reconstruction [4,5]. In some literature the estimated failure rate after this surgery reports approximately 10%.The probable problems of the arthroscopic reconstruction procedure included graft failure, femoral and tibial tunnel mismatch, interference screw fixation divergence, and posterior cortex destruction, graft laceration by the screw threads and graft impingement by non-anatomic tunnel placement.Some literature has revealed that there is no significant difference in mid-terms follow-up results in functional and radiographic scores between one or two incision approach, but they didn't compare the placement of femoral tunnels. In the recent reports they showed that Anatomical ACL graft positioning seems to be an important factor for postoperative knee function and stability in ACL reconstruction [1,4].On the other hand, since the location of femoral tunnels for ACL replacement grafts remains a subject of debate [6] so, we conducted this study by the aim of knee stability evaluation and functional outcome following ACL reconstruction by two different femoral tunnel positions. Materials and MethodsIn this prospective experimental study, the patients were referred to 3 referral orthopedics and trauma centers because of ACL tear which need to surgery. Between January 2000 to July 2003, 472 documents of ACL tear which were reconstructed Materials and methods:In the current study, 472 patient s documents with ACL tear which were scheduled for reconstruction existed. By exclusion criteria, during the period January 2000 to July 2003, 159 total participants (147 men, 12women) were enrolled and were classified non-randomly in 2groups by the femoral tunnel position which all of them were operated arthroscopically assisted ACL reconstruction.Results: In our study 159 patients (147 male and 12 female) were participated. In the first group which femoral tunnel were placed at 11 o'clock position (right knee) and 1 o'clock (left knee), we found 28 cases with normal and 53 cases with varus and in the second group which femoral tunnel were placed at 10 o'clock position (right knee) and 2 o'clock position (left knee), we find 32 cases with normal and other 46 patients with varus mal alignment. Conclusion:We found no significant difference between the 10 and 11o'c...

show abstract

“…The anterior cruciate ligament (ACL) is the most commonly injured ligament of the knee and annually, approximately 400,000 ACL injuries occur, which necessitate surgical intervention [7]. Ligaments are dense, complex, tissues composed of collagens (type I, III, and V), elastin proteoglycans, water, and cells [8,9], and display a hierarchical structure composed of collagen molecules, fibrils, fibril bundles, and fascicles that are arranged parallel to the longitudinal axis of the ligament [10].…”

mentioning

confidence: 99%

Regenerative Engineering: Studies of the Rotator Cuff and other Musculoskeletal Soft Tissues

2016

View full text Add to dashboard Cite

Regenerative Engineering' is the integration of advanced materials science, stem cell science, physics, developmental biology and clinical translation to regenerate complex tissues and organ systems. Advanced biomaterial and stem cell science converge as mechanisms to guide regeneration and the development of prescribed cell lineages from undifferentiated stem cell populations. Studies in somite development and tissue specification have provided significant insight into pathways of biological regulation responsible for tissue determination, especially morphogen gradients, and paracrine and contact-dependent signaling. The understanding of developmental biology mechanisms are shifting the biomaterial design paradigm by the incorporation of molecules into scaffold design and biomaterial development that are specifically targeted to promote the regeneration of soft tissues. Our understanding allows the selective control of cell sensitivity, and a temporal and spatial arrangement to modulate the wound healing mechanism, and the development of cell phenotype leading to the patterning of distinct and multi-scale tissue systems.Building on the development of mechanically compliant novel biomaterials, the integration of spatiotemporal control of biological, chemical and mechanical cues helps to modulate the stem cell niche and direct the differentiation of stem cell lineages. We have developed advanced biomaterials and biomimetic scaffold designs that can recapitulate the native tissue structure and mechanical compliance of soft musculoskeletal tissues, such as woven scaffold systems for ACL regeneration, non-woven scaffolds for rotator cuff tendon augmentation, and porous elastomers for regeneration of muscle tissue. Studies have clearly demonstrated the modulation of stem cell response to bulk biomaterial properties, such as toughness and elasticity, and scaffold structure, such as nanoscale and microscale dimensions. The integration of biological cues inspired from our understanding of developmental biology, along with chemical, mechanical and electrical stimulation drives our development of novel biomaterials aimed at specifying the stem cell lineage within 3-dimensional (3D) tissue systems. This talk will cover the development of biological cues, advanced biomaterials, and scaffold

show abstract

Review of evolution of tunnel position in anterior cruciate ligament reconstruction

Cited by 105 publications

References 67 publications

Biomechanics of the anterior cruciate ligament: Physiology, rupture and reconstruction techniques

Biomechanics of the anterior cruciate ligament: Physiology, rupture and reconstruction techniques

Untitled

Regenerative Engineering: Studies of the Rotator Cuff and other Musculoskeletal Soft Tissues

Contact Info

Product

Resources

About