The concept of individualized anatomic anterior cruciate ligament (ACL) reconstruction

Hofbauer, Marcus; Muller, Bart; Murawski, Christopher D.; Eck, Carola F. van; Fu, Freddie H.

doi:10.1007/s00167-013-2562-4

Cited by 70 publications

(89 citation statements)

References 36 publications

(41 reference statements)

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“…A thorough history should be obtained, with a special emphasis on activity level, mechanism of injury, and antecedent symptoms. 50 The reason for failure of the primary reconstruction surgery must be determined in order to avoid the same outcome with revision surgery. 20 The patient should also be queried for information regarding previous joint injuries, history of coagulation disorders, osteoporosis risk factors, and any history of generalized ligamentous laxity or connective tissue disorders.…”

Section: Technical Considerations For Revision Acl Reconstruction Surmentioning

confidence: 99%

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Technical Considerations in Revision Anterior Cruciate Ligament Reconstruction for Operative Techniques in Orthopaedics

Burnham

Herbst

Pauyo

et al. 2017

Operative Techniques in Orthopaedics

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As the incidence of anterior cruciate ligament (ACL) reconstruction continues to increase, the rate of revision surgery continues to climb. Revision surgery has inherent challenges that must be addressed in order to achieve successful results. The cause of the primary ACL reconstruction failure should be determined, and careful preoperative planning should be performed to address the cause(s) of failure. Each patient undergoing revision surgery should undergo a thorough history and physical examination, receive full length alignment radiographs, lateral radiographs, 45-degree flexion weight-bearing postero-anterior radiographs, and patellofemoral radiographs. 3-dimensional computed topography (CT) scan should be performed to assess tunnel position and widening. Magnetic resonance imaging (MRI) should be used to assess for intra-articular soft tissue pathology. Meniscal tears, meniscal deficiency, anterolateral capsule injuries, bony morphology, age, activity level, connective tissue diseases, infection, graft choice, and tunnel position can all impact the success of ACL reconstruction surgery. Meniscal lesions should be repaired, and in cases of persistent rotatory instability, extra-articular procedures may be indicated. Furthermore, osteotomies may be needed to correct malalignment or excess posterior tibial slope. Depending on the placement and condition of the original femoral and tibial tunnels, revision surgery may be performed in a single procedure or in a staged manner. In most cases, the surgery can be performed in one procedure. Regardless, the surgeon must communicate with the patient openly regarding the implications of revision ACL surgery and the treatment plan should be developed in a shared fashion between the surgeon and the patient.

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Section: Technical Considerations For Revision Acl Reconstruction Surmentioning

confidence: 99%

“…The stability of the injured knee should be evaluated in the context of the uninjured knee, with the goal of surgery to restore the native stability. 50 …”

Section: Technical Considerations For Revision Acl Reconstruction Surmentioning

confidence: 99%

Technical Considerations in Revision Anterior Cruciate Ligament Reconstruction for Operative Techniques in Orthopaedics

Burnham

Herbst

Pauyo

et al. 2017

Operative Techniques in Orthopaedics

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“…Drilling both tunnels independently, either by outside-in or anteromedial technique, best ensures that this goal is achieved. However, individualizing ACL surgery refers not only to graft placement at the center of the native insertion site, but also to the selection of graft type, size, and surgical technique given the patient's intraoperative measurements-the area and shape of the footprint, bone morphology (that is, the morphology of the intercondylar notch) [1,4]. The concept of individualized anatomic ACL surgery continues with a rehabilitation protocol tailored to the patient and a proper clearance for returning to sports.…”

Section: Where Do We Need To Go?mentioning

confidence: 99%

CORR Insights®: Does Anteromedial Portal Drilling Improve Footprint Placement in Anterior Cruciate Ligament Reconstruction?

2016

Clinical Orthopaedics &Amp; Related Research

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“…Suboptimal outcome data and observed degenerative knee joint alterations in long-term follow-up studies [5,22,26,37] are primarily responsible for a re-evaluation of surgical technique that leads to major technical modifications. For example, the implementation of anatomical individualized ACL reconstruction [3,14,15,29,31,44], using different…”

Section: Introductionmentioning

confidence: 99%

Tibial ACL insertion site length: correlation between preoperative MRI and intra-operative measurements

Widhalm

Sürer

Kurapati

et al. 2014

Knee Surg Sports Traumatol Arthrosc

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The concept of individualized anatomic anterior cruciate ligament (ACL) reconstruction

Abstract: V.

Cited by 70 publications

References 36 publications

Technical Considerations in Revision Anterior Cruciate Ligament Reconstruction for Operative Techniques in Orthopaedics

Technical Considerations in Revision Anterior Cruciate Ligament Reconstruction for Operative Techniques in Orthopaedics

CORR Insights®: Does Anteromedial Portal Drilling Improve Footprint Placement in Anterior Cruciate Ligament Reconstruction?

Tibial ACL insertion site length: correlation between preoperative MRI and intra-operative measurements

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