By Rainer Siebold, David Dejour, Stefano Zaffagnini
This functional and tutorial guidebook, written by means of overseas specialists in anterior cruciate ligament (ACL) reconstruction, covers all not easy facets of ACL rupture within the acute and persistent surroundings. It covers the most recent, miraculous anatomical findings, therapy of partial ACL tears, a number of concepts for unmarried- and double-bundle ACL reconstruction, and complicated ACL revision surgical procedure. vital surgical steps are essentially defined with assistance from instructive, top quality images. very important suggestions, tips, and pitfalls are highlighted and intra- and postoperative problems, rehabilitation, and prevention of re-rupture are mentioned. All authors are well-liked and skilled ACL surgeons.
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Extra info for Anterior Cruciate Ligament Reconstruction: A Practical Surgical Guide
The best individual landmark for orientation is the ACL stump itself. Other important landmarks are the anterior horn of the lateral meniscus, the transverse (intermeniscal) ligament, the medial and lateral tibial spine, and the posterior horn of the lateral meniscus. These landmarks are especially important in revision surgery when ACL remnants are lacking. In acute ACL ruptures, the “C”-shaped tibial insertion of the ACL was carefully dissected with a small shaver. Arthroscopic pictures were taken to demonstrate the tibial ACL anatomy with associated landmarks (Figs.
As the knee flexes, the AM bundle moves posteriorly behind the PL bundle and begins to spiral around it. Clearly, the lengths of the two bundles change with varying degrees of knee flexion, meaning that they are not isometric. The AM bundle lengthens and tightens in flexion, while the PL bundle shortens and becomes slack in flexion. In extension, the AM bundle is slack and the PL bundle tight. Thus, the AM bundle represents the main restraint against anterior translation of the tibia [1, 4, 14].
J Bone Joint Surg Am 69(2):243–247 31. Siebold R, Ellert T, Metz S et al (2008) Tibial insertions of the anteromedial and posterolateral bundles of the anterior cruciate ligament: morphometry, arthroscopic landmarks, and orientation model for bone tunnel placement. Arthroscopy 24(2):154–161 32. Śmigielski R (2012) The ribbon concept of the anterior cruciate ligament. Presentation at ACL Study Group meeting. Jackson Hole, Wyoming 33. Starman JS, Vanbeek C, Armfield DR et al (2007) Assessment of normal ACL double bundle anatomy in standard viewing planes by magnetic resonance imaging.
Anterior Cruciate Ligament Reconstruction: A Practical Surgical Guide by Rainer Siebold, David Dejour, Stefano Zaffagnini