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Ligaments

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Book cover Surgical Atlas of Sports Orthopaedics and Sports Traumatology

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Abstract

Rupture of the anterior cruciate ligament with subjective and objective instability. Persistent subjective and objective instability after primary conservative treatment.

Specific indications for anatomic single bundle technique: small femoral or tibial insertion zone (length < 14 mm), narrow notch (< 12 mm), open growth plates, marked bone bruise of the lateral femoral condyle, multi-ligament injuries.

Anatomic double-bundle technique: reconstruction of the anteromedial and posterolateral bundles with 2 autologous hamstring tendon grafts which are placed into two separate femoral and tibial tunnels (4-tunnels technique) at the anatomical insertion area for each bundle.

Anatomic single bundle technique: Reconstruction of the ruptured cruciate ligament with a hamstring tendon graft which is passed through a single femoral and tibial tunnels drilled at the center between the insertion foot print of the anteromedial and posterolateral bundles.

Symptom specific history: time and mechanism of injury, subjective instability, pain, functional demands.

Symptom specific examination: Assessment of the range of motion (Extension deficit), anterior drawer test, Lachlan test, pivot shift test, exclusion of associated instability and concomitant meniscal lesions.

  • X-ray of the knee joint in three views (AP, lateral, tangential patella) to exclude osseous lesions.

  • Long leg standing AP view if there is marked malalignment.

  • MRI to assess the ACL and verify other intraarticular lesions.

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References

References to Chapter 15.1

  • Brucker PU, Lorenz S, Imhoff AB (2006) Aperture Fixation in Arthroscopic Anterior Cruciate Ligament Double‐Bundle Reconstruction. Arthroscopy 22:1250e.1–1250e.6

    Article  Google Scholar 

  • Lorenz S, Anetzberger H, Spang JT, Imhoff AB (2007) Double‐Bundle Technique – Anatomic Reconstruction of the Anterior Cruciate Ligament. Oper Orthop Traumatol 19:473–488

    Article  PubMed  Google Scholar 

  • Lubowitz JH (2009) Anteromedial Portal Technique for Anterior Cruciate Ligament Femoral Socket: Pitfalls and Solutions. Arthroscopy 25:95–101

    Article  PubMed  Google Scholar 

  • Martins CA, Kropf EJ, Shen W, van Eck CF, Fu FH (2008) The Concept of Anatomic Anterior Cruciate Ligament Reconstruction. Oper Tech Sports Med 16:104–115

    Article  Google Scholar 

References to Chapter 15.2

  • George MS, Dunn WR, Spindler KP (2006) Current Concepts Review: Revision Anterior Cruciate Ligament Reconstruction. Am J Sports Med 34:2026–2037

    Article  PubMed  Google Scholar 

  • Kamath GV, Redfern JC, Greis PE, Burks RT (2011) Revision Anterior Cruciate Ligament Reconstruction. Am J Sports Med 39:199–217

    Article  PubMed  Google Scholar 

  • Said HG, Baloch K, Green M (2006) A New Technique for Femoral and Tibial Tunnel Bone Grafting Using the OATS Harvester in Revision Anterior Cruciate Ligament Reconstruction. Arthroscopy 22(7):796e1–796e3

    Article  Google Scholar 

  • Zantop T, Petersen W (2011) Arthroskopische Auffüllung von fehlplatzierten und erweiterten Bohrkanälen mit Beckenkammspongiosa bei Rezidivinstabilität nach Ersatzplastik des vorderen Kreuzbandes. Oper Orthop Traumatol 23:337–350

    Article  PubMed  CAS  Google Scholar 

References to Chapter 15.3

  • Lafrance RM, Giordano B, Goldblatt J, Voloshin I, Maloney M (2010) Pediatric tibial eminence fractures: evaluation and management. J Am Acad Orthop Surg 18:395–405

    PubMed  Google Scholar 

  • Lubowitz JH, Elson WS, Guttmann D (2005) Part II: arthroscopic treatment of tibial plateau fractures: intercondylar eminence avulsion fractures. Arthroscopy 21:86–92

    Article  PubMed  Google Scholar 

  • Meyers MH, McKeever FM (1959) Fractures of the intercondylar eminence of the tibia. J Bone Joint Surg Am 41:209–220

    PubMed  Google Scholar 

  • Sommerfeldt DW (2008) Die arthroskopisch assistierte Refixation bei knöchernen Ausrissen des vorderen Kreuzbands im Kindes‐ und Jugendalter. Oper Orthop Traumatol 20:310–320

    Article  PubMed  Google Scholar 

References to Chapter 15.4

  • Amis AA, Gupte CM, Bull AMJ, Edwards A (2006) Anatomy of the posterior cruciate ligament and the meniscofemoral ligaments. Knee Surg Sports Traumatol Arthrosc 14:257–263

    Article  PubMed  CAS  Google Scholar 

  • Jacobsen K (1976) Stress radiographical measurement of the anteroposterior, medial and lateral stability of the knee joint. Acta Orthop Scand 3:335–340

    Article  Google Scholar 

  • Jung TM, Strobel MJ, Weiler A (2006) Diagnostik und Therapie von Verletzungen des hinteren Kreuzbandes. Unfallchirurg 109:41–60

    Article  PubMed  CAS  Google Scholar 

  • Petersen W, Zantop T (2006) Biomechanik des hinteren Kreuzbandes und der hinteren Instabilität. Arthroskopie 19:207–214

    Article  Google Scholar 

References to Chapter 15.5

  • LaPrade RF, Johansen S, Wentorf FA, Engebretsen L, Esterberg JL, Tso A (2004) An analysis of an anatomical posterolateral knee reconstruction: an in vitro biomechanical study and development of a surgical technique. Am J Sports Med 32:1405–1414

    Article  PubMed  Google Scholar 

  • Moorman CT, LaPrade RF (2005) Anatomy and biomechanics of the posterolateral corner of the knee. J Knee Surg 18:137–145

    Article  PubMed  Google Scholar 

  • Ranawat A, Baker CL, Henry S, Harner CD (2008) Posterolateral corner injury: evaluation and management. J Am Acad Orthop Surg 16:506–518

    PubMed  Google Scholar 

  • Zantop T, Petersen W (2010) Posterolaterale Rekonstruktion des Kniegelenks nach Larson. Oper Orthop Traumatol 22:373–386

    Article  PubMed  Google Scholar 

References to Chapter 15.6

  • Borden PF, Kantaras AT, Caborn DNM (2002) Medial collateral ligament reconstruction with allograft using a double‐bundle technique. Arthroscopy 18(4):E19

    Article  PubMed  Google Scholar 

  • Kim SJ, Lee DH, Kim TH, Choi NH (2008) Concomitant reconstruction of the medial collateral and posterior oblique ligaments for medial instability of the knee. J Bone Joint Surg [Br] 90‐B:1323–1327

    Article  Google Scholar 

  • LaPrade RF, Engebretsen AH, Ly TV et al (2007) The anatomy of the medial part of the knee. J Bone Joint Surg [Am] 89:2000–2010

    Article  Google Scholar 

  • Lind M, Jakobsen BW, Lund B et al (2009) Anatomical reconstruction of the medial collateral ligament and posteromedial corner of the knee in patients with chronic medial collateral ligament instability. Am J Sports Med 37(6):1116–1122

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Trauma and Reconstructive Surgery, Eberhard-Karls University, Tübingen BG Trauma Center, Schnarrenberg-Str.  95, 72076, Tübingen, Germany

    Stefan Döbele Dr. med.

  2. Department of Orthopaedic Sports Medicine, Hospital Rechts der Isar, Technische Universität München, Ismaninger Street 22, 81675, Munich, Germany

    Matthias J. Feucht Dr. med. & Stefan Hinterwimmer Prof. Dr. med.

  3. Department of Trauma and Reconstructive Surgery, Murnau BG Trauma Center, Prof.-Küntscher-Str. 8, 82418, Murnau, Germany

    Gebhart Meidinger Dr. med.

Authors
  1. Matthias J. Feucht Dr. med.
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  2. Stefan Hinterwimmer Prof. Dr. med.
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  3. Stefan Döbele Dr. med.
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  4. Gebhart Meidinger Dr. med.
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Editor information

Editors and Affiliations

  1. Dept. of Orthopaedic Sports Medicine, Hospital Rechts der Isar, Munich, Germany

    Andreas B. Imhoff

  2. Dept. of Orthopaedic Sports Medicine, Hospital Rechts der Isar, München, Germany

    Matthias J. Feucht

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Feucht, M.J., Hinterwimmer, S., Döbele, S., Meidinger, G. (2015). Ligaments. In: Imhoff, A., Feucht, M. (eds) Surgical Atlas of Sports Orthopaedics and Sports Traumatology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-43776-6_15

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  • DOI: https://doi.org/10.1007/978-3-662-43776-6_15

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-43775-9

  • Online ISBN: 978-3-662-43776-6

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