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Anterior Cruciate Ligament Tear: Rationale and Indications for Anatomic ACL Reconstruction

  • Bart Muller
  • Shugo Maeda
  • Yoshimasa Fujimaki
  • Paulo H. Araujo
  • Freddie H. FuEmail author
Chapter
  • 1.9k Downloads

Abstract

Reconstruction of the anterior cruciate ligament (ACL) is one of the most frequently performed operations in orthopaedic sports medicine [17]. Traditionally, treatment for complete ACL tears has long been a conventional single-bundle (SB) reconstruction [13, 19]. Short-term results for SB reconstructions have been relatively good, with improvement in subjective knee instability and the ability to return to sports [25]. However, in a subset of patients, subjective knee instability persists, and they remain unable to return to prior activity. With SB reconstruction, good to excellent results are only achieved in 60 % of patients and less than 50 % returns to playing sport at their preinjury level [5, 7]. Moreover, long-term results suggest that the rate in which osteoarthritic (OA) changes occur is not reduced by SB reconstruction as compared to nonoperated knees [10, 15, 26]. Multiple studies have shown that the native biomechanical properties of the knee cannot be fully restored by nonanatomic SB reconstruction [8, 40] and that this may be a cause of cartilage thinning [3, 37].

Keywords

Anterior Cruciate Ligament Anterior Cruciate Ligament Reconstruction Femoral Tunnel Native Anterior Cruciate Ligament Double Bundle 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Supplementary material

Video 3

Anatomic ACL reconstruction: (3-1) Anatomic single bundle ACL reconstruction, (3-2) Anatomic double bundle ACL reconstruction (WMV 790522 kb)

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Copyright information

© Springer-Verlag London 2013

Authors and Affiliations

  • Bart Muller
    • 1
    • 2
  • Shugo Maeda
    • 1
    • 3
  • Yoshimasa Fujimaki
    • 1
    • 4
  • Paulo H. Araujo
    • 1
  • Freddie H. Fu
    • 5
    Email author
  1. 1.Department of Orthopaedic SurgeryUniversity of PittsburghPittsburghUSA
  2. 2.Department of Orthopaedic SurgeryUniversity of AmsterdamAmsterdamThe Netherlands
  3. 3.Department of Orthopaedic SurgeryHirosaki University Graduate School of MedicineHirosaki, AomoriJapan
  4. 4.Department of Orthopaedic SurgeryShowa University School of MedicineShinagawa-kuJapan
  5. 5.Department of Orthopaedic SurgeryUniversity of Pittsburgh Medical CenterPittsburghUSA

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