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Chronic Anterior Cruciate Ligament Tear: Single-Bundle ACL Reconstruction: Anteromedial Portal Versus Transfemoral Outside-In Versus Transtibial Drilling Technique

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The ACL-Deficient Knee

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Abstract

Surgical procedures for reconstruction of a torn anterior cruciate ligament (ACL) have changed considerably over the last 30 years. They have evolved from open surgery to advanced all-inside endoscopic techniques. Arthroscopic transtibial ACL reconstructions have been largely used in recent decades. However, a trend toward more anatomic ACL reconstructions has started in recent years due to the high rates of persistent rotatory instability observed after vertically oriented graft. Placing a single femoral tunnel at the center of the anatomic insertions of the ACL may restore the rotational stability of the knee as well as a double-bundle technique. A thorough knowledge of the anatomical attachment sites of the ACL is required for precise anatomic ACL reconstruction.

This chapter focuses on the advantages as well as disadvantages of single-bundle ACL reconstruction when using either the transtibial or anatomic approach. The author’s preferred method and rationale for anatomic single-bundle ACL reconstruction are also presented.

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Author information

Authors and Affiliations

  1. Department of Orthopedic Surgery and Traumatology, Hospital de la Sta Creu i Sant Pau, C/ St AM Claret, 167, 08025, Barcelona, Spain

    Joan Carles Monllau M.D., Ph.D.

  2. ICATME (Catalan Institute of Traumatology and Sports Medicine), Hospital Universitari Dexeus. Universitat Autònoma de Barcelona, C/ Sabino Arana 5-19, 08028, Barcelona, Spain

    Joan Carles Monllau M.D., Ph.D., Xavier Pelfort, Pablo Eduardo Gelber, Marc Tey & Juan Erquicia

  3. Department of Orthopedic Surgery and Traumatology, Hospital del Mar. Universitat Autònoma de Barcelona, C/ Passeig Marítim 25-29, 08003, Barcelona, Spain

    Xavier Pelfort, Pablo Eduardo Gelber, Marc Tey & Juan Erquicia

  4. Department of Orthopaedic Surgery, Hospital Arnau de Vilanova, Valencia, Spain

    Vicente Sanchis-Alfonso M.D., Ph.D.

  5. Hospital 9 de Octubre, Valencia, Spain

    Vicente Sanchis-Alfonso M.D., Ph.D.

Authors
  1. Joan Carles Monllau M.D., Ph.D.
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  2. Xavier Pelfort
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  3. Pablo Eduardo Gelber
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  4. Marc Tey
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  6. Vicente Sanchis-Alfonso M.D., Ph.D.
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Correspondence to Joan Carles Monllau M.D., Ph.D. .

Editor information

Editors and Affiliations

  1. Depto. Cirugia Ortopédica, Hospital Arnau de Vilanova, c/San Clemente 12, Valencia, 46015, Spain

    Vicente Sanchis-Alfonso

  2. , Orthopaedic Surgery, Hospital de Sant Pau, St Antoni m Claret 167, Barcelona, 08025, Spain

    Joan Carles Monllau

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ACL reconstruction. The surgical technique (MP4 424462 kb)

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Monllau, J.C., Pelfort, X., Gelber, P.E., Tey, M., Erquicia, J., Sanchis-Alfonso, V. (2013). Chronic Anterior Cruciate Ligament Tear: Single-Bundle ACL Reconstruction: Anteromedial Portal Versus Transfemoral Outside-In Versus Transtibial Drilling Technique. In: Sanchis-Alfonso, V., Monllau, J. (eds) The ACL-Deficient Knee. Springer, London. https://doi.org/10.1007/978-1-4471-4270-6_20

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  • DOI: https://doi.org/10.1007/978-1-4471-4270-6_20

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