The anatomy of the anterior cruciate ligament and its relevance to the technique of reconstruction

Śmigıelski, Robert; Zdanowicz, Urszula; Drwięga, Michał; Ciszek, Bogdan; Williams, Andy

doi:10.1302/0301-620x.98b8.37117

Cited by 90 publications

(72 citation statements)

References 46 publications

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“…42 Following an extensive research on the anatomy of ACL in recent years, some researchers have introduced a flat ribbon concept of ACL anatomy and its relevance to the surgical technique of ACL reconstruction. 6,21 Oshima et al 43 found that the cross-sectional shape of the four-fold semitendinosus tendon graft was oval and proved the superiority of SBO technique over SBR technique. Nowadays, femoral oval The Journal of Knee Surgery tunnel technique has been gradually accepted in clinical practice and achieved a satisfactory function of the knee.…”

Section: Discussionmentioning

confidence: 99%

“…39 The anatomic landmarks for the ACL reconstruction have been investigated in recent years, proper placement of the graft was a critical factor for the ACL reconstruction, and anatomical reconstruction of the ACL was widely accepted. 6,10 Recently more studies have found that the traditional SB ACL reconstruction could neither restore full rotational stability nor biomechanical properties of the knee and researchers have been exploring ways to improve the surgi-cal technique. 22,40 The DB ACL reconstruction could effectively restore the rotational stability of the knee and reduce the forward instability.…”

Section: Discussionmentioning

confidence: 99%

“…[18][19][20] The detailed technique of ACL reconstruction in relation to its native anatomy, such as tunnel placement, is still a hot topic for debate. 6 Most recent studies 6,21,22 have introduced the flat ribbon concept of the femoral insertion of ACL and the concept has been gaining popularity. Based on these findings, researchers have attempted the femoral oval tunnel technique for ACL reconstruction to find a simple, safe, and effective surgical method.…”

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confidence: 99%

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Anatomical Anterior Cruciate Ligament Reconstruction with Hamstring Tendon Autografts: A Comparative Study of Three Different Techniques

et al. 2020

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The ideal procedure for anterior cruciate ligament (ACL) reconstruction is one that can achieve anatomical restoration for a better ACL function. This retrospective comparative study was conducted to evaluate the objective and subjective clinical results of the conventional single-bundle femoral round (SBR) tunnel technique, the single-bundle femoral oval (SBO) tunnel technique, and the double-bundle (DB) surgical technique for anatomical ACL reconstruction with hamstring tendon autografts. Patients who underwent the SBO, SBR, and DB ACL reconstructions from January 2016 to August 2017 were included in this study. A total of 163 patients underwent different surgical techniques; 41 patients underwent the SBO procedure, 78 patients received SBR, and the remaining 44 patients underwent the DB procedure. The Lachman's test, pivot-shift test, Lysholm's score, International Knee Documentation Committee (IKDC) score, and Tegner's score were compared among groups postoperatively. KT-1000 was used to measure the anterior laxity of the knee. Magnetic resonance imaging was used to compare the ACL graft maturity. Second-look arthroscopy was conducted to compare the graft status and synovial coverage. Significant differences among groups were found with respect to the Lysholm's score, Tegner's score, and IKDC score. Patients in the SBO and DB groups acquired higher functional scores than the SBR group. More patients with positive pivot-shift test were observed in the SBR group than other groups at 12- and 24-month postoperative follow-ups. The postoperative KT-1000 was better in the SBO and DB groups than in the SBR group. The mean signal/noise quotient (SNQ) of the SBO group was 2.70 ± 0.92, significantly lower than 3.58 ± 1.21 of the SBR group. Despite a higher proportion of patients with grade B or C synovial coverage and partial graft injury found in the SBR group, there were no significant differences among the groups. The SBO and DB technique achieved better clinical results than the SBR technique. The SBO technique was indeed an ideal surgical procedure for ACL reconstruction provided that the shortcoming of DB technique must be taken into account. This is a Level III, retrospective comparative study.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Anatomical Anterior Cruciate Ligament Reconstruction with Hamstring Tendon Autografts: A Comparative Study of Three Different Techniques

et al. 2020

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“…Stability of the knee joint is achieved by cooperation of static and dynamic stabilisers such as ligaments and muscles. There is disagreement among orthopaedic society about the number, location or structure of knee ligaments with new concepts being developed [13,14] and old verified. It is widely accepted that the knee joint is one of the most complex joints of the human body.…”

Section: Anatomy and Biomechanics Of Knee Jointmentioning

confidence: 99%

Stress distribution in the knee joint in relation to tibiofemoral angle using the finite element method

Karpiński

Jaworski²,

Jonak

et al. 2019

MATEC Web Conf.

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The article presents the results of a preliminary study on the structural analysis of the knee joint, considering changes in the mechanical properties of the articular cartilage of the joint. Studies have been made due to the need to determine the tension distribution occurring in the cartilage of the human knee. This distribution could be the starting point for designing custom made human knee prosthesis. Basic anatomy, biomechanical analysis of the knee joint and articular cartilage was introduced. Based on a series of computed tomography [CT] scans, the 3D model of human knee joint was reverse-engineered, processed and exported to CAD software. The static mechanical analysis of the knee joint model was conducted using the finite element method [FEM], in three different values of tibiofemoral angle and with varying mechanical properties of the cartilage tissue. Main conclusions of the study are: the capability to absorb loads by articular cartilage of the knee joint is preliminary determined as decreasing with increasing degenerations of the cartilage and with age of a patient. Without further information on changes of cartilage’s mechanical parameters in time it is hard to determine the nature of relation between mentioned capability and these parameters.

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“…been investigated and the findings have resulted in modifications in the techniques of reconstruction following rupture. 4 The injury is usually due to a pivoting movement, which provokes both the ligament rupture and shear forces across the articular surface, with cartilage and menisci lesions often associated with acute ACL ruptures. 5 The goals of ACL reconstruction are the restoration of normal knee anatomy and function, reestablishment of biological and biomechanical homeostasis, and prevention of osteoarthritis (OA).…”

mentioning

confidence: 99%

Trends in Anterior Cruciate Ligament Reconstruction in the Last Decade: A Web-Based Analysis

Yücens

Aydemir

2018

J Knee Surg

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Anterior cruciate ligament (ACL) injury is known to be one of the most common knee joint injuries. ACL reconstruction can be similar to the native ACL in respect of graft morphology, tension, position, and orientation. ACL reconstruction can be applied with different surgery techniques, graft and fixation devices, and rehabilitation as ACL reconstruction is just as important as surgery. Although commonly known as a sports injury, ACL injuries are increasingly seen in the general population. The aim of this study was to investigate the trends in ACL injury treatment in the last decade especially the graft choice. The abstracts of a total of 2,622 papers which stated ACL in the title were investigated through a search on the Web of Knowledge. Main topics were created as the ACL reconstruction theme. ACL reconstruction was examined in the abstracts with graft choice as the main theme followed by single bundle, double bundle, sports, rehabilitation, revision, complication, skeletally immature, biomechanics and kinematics, fixation devices, meniscus, anesthesia and pain, tunnel, cell, and intra-articular injection. Of the total 2,622 documents, 2,129 were original articles and 181 were reviews. Most of the documents, 436 in number (16.6%), were published in the , followed by the, , at 264. Of the total documents published, 36.3% were from the United States followed by 8.5% from Japan. The author with the most publications was F.H. Fu with 94 publications followed by B.R. Bach with 41 publications. The hamstring graft was most used at 187 single use and comprising 52% of the total graft combinations. Most papers were published in 2016. In 2012, single and double bundle grafts were determined to a total of 23. The most common title investigated in papers was biomechanics and kinematics with a total of 241 publications followed by rehabilitation at 208. Throughout the years of the study period, the most common graft choice was hamstring autograft. Biomechanics and kinematics was the most common title investigated as biomechanics and rehabilitation are known to be just as important as surgery for a successful outcome and patient satisfaction.

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The anatomy of the anterior cruciate ligament and its relevance to the technique of reconstruction

Cited by 90 publications

References 46 publications

Anatomical Anterior Cruciate Ligament Reconstruction with Hamstring Tendon Autografts: A Comparative Study of Three Different Techniques

Anatomical Anterior Cruciate Ligament Reconstruction with Hamstring Tendon Autografts: A Comparative Study of Three Different Techniques

Stress distribution in the knee joint in relation to tibiofemoral angle using the finite element method

Trends in Anterior Cruciate Ligament Reconstruction in the Last Decade: A Web-Based Analysis

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