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Individualized Anatomical Anterior Cruciate Ligament Reconstruction
Anterior cruciate ligament (ACL) rupture is a common injury particularly among young active individuals. ACL injury leads to increased knee laxity and abnormal knee biomechanics that may prevent return to sports and predispose to early onset degenerative changes in the joint. Therefore, optimizing ACL injury treatment is of great interest to the sports medicine field. ACL reconstruction (ACLR) is considered the treatment of choice for most patients, especially in those involved in cutting and pivoting activities, often allowing them to return sports. (Source: Operative Techniques in Orthopaedics)
Source: Operative Techniques in Orthopaedics - January 31, 2017 Category: Orthopaedics Authors: Marcio Bottene Villa Albers, Daniel Guenther, Carola F. van Eck, Freddie H. Fu Source Type: research

Technical Considerations in Revision Anterior Cruciate Ligament Reconstruction for Operative Techniques in Orthopaedics
As the incidence of anterior cruciate ligament (ACL) reconstruction continues to increase, the rate of revision surgery continues to climb. Revision surgery has inherent challenges that must be addressed to achieve successful results. The cause of the primary ACL reconstruction failure should be determined and careful preoperative planning should be performed to address the cause(s) of failure. Each patient undergoing revision surgery should undergo a thorough history and physical examination, receive full-length alignment radiographs, lateral radiographs, 45 ° flexion weight-bearing posteroanterior radiographs, and patel...
Source: Operative Techniques in Orthopaedics - January 31, 2017 Category: Orthopaedics Authors: Jeremy M. Burnham, Elmar Herbst, Thierry Pauyo, Thomas Pfeiffer, Darren L. Johnson, Freddie H. Fu, Volker Musahl Source Type: research

Remnant Tissue –Preserving Technique for Anatomical Double-Bundle Anterior Cruciate Ligament Reconstruction
Preservation of the anterior cruciate ligament (ACL) remnant tissue has attracted notice in ACL reconstruction. Remnant preservation has been expected to have several potential advantages to improve postoperative knee stability such as enhanced graft coverage, accelerated cell repopulation, and revascularization. Recently, we have developed a new remnant-preserving technique for anatomical double-bundle ACL reconstruction using the semitendinosus tendon. The anterior laxity values and the results of the pivot-shift test were significantly better in the remnant tissue –preserving procedure than in the remnant tissue–res...
Source: Operative Techniques in Orthopaedics - January 31, 2017 Category: Orthopaedics Authors: Eiji Kondo, Kazunori Yasuda Source Type: research

Editorial - “Individualized Anatomic Anterior Cruciate Ligament Reconstruction”
Despite humans sharing 99.9% of DNA, differences in the remaining 0.1% provide us with the rich diversity we see between populations and between genders.1 Biological variability is inherent to mankind, and this is manifested through multiple aspects, including human anatomy itself. (Source: Operative Techniques in Orthopaedics)
Source: Operative Techniques in Orthopaedics - January 31, 2017 Category: Orthopaedics Authors: S. Irarr ázaval, R. Kuroda Source Type: research

BONY MORPHOLOGY: Comparative Anatomy and its Importance for the ACL
Bone morphology is related to static and dynamic parameters during anterior cruciate ligament (ACL) kinematics and can affect injury mechanism patterns, gait analysis, biomechanical properties and surgical references for ligament reconstructions. It does not only depend on mechanical factors but reflects a developmental program with many other factor involved, including nutrition and hormones, especially those involved in the calcium metabolism. While Wolff ′s Law continues to be a dominant paradigm in Orthopaedics, in the past 15 years enormous advances have been made that have improved our understanding of how individu...
Source: Operative Techniques in Orthopaedics - January 31, 2017 Category: Orthopaedics Authors: Sheila J. McNeill Ingham, Rogerio Teixeira de Carvalho, Rene J. Abdalla, Freddie H. Fu, C. Owen Lovejoy Source Type: research

Variations in Anterior Cruciate Ligament Anatomy
The aim of anterior cruciate ligament reconstruction is to restore native ligament anatomy to potentially restore function. Morphological measurements of the native anterior cruciate ligament are a valuable asset to effective surgical planning, influencing decisions such as graft choice and single- vs. double-bundle reconstruction. Several studies support the existence of high inter-individual morphological variabilities, an important factor that should be taken into account for each patient to ensure native ligament anatomy restoration and function. (Source: Operative Techniques in Orthopaedics)
Source: Operative Techniques in Orthopaedics - January 31, 2017 Category: Orthopaedics Authors: Sebasti án Irarrázaval Source Type: research

Matching the ACL Graft to the Patient
The aim of anterior cruciate ligament (ACL) reconstruction is to restore normal knee functioning. Key to successful ACL reconstruction is understanding how to match the ACL graft to the bone tunnel while taking into account inter-patient variances. Bone tunnel location and size should be determined according to the original ACL footprint anatomy of each patient. Therefore, appropriate assessments of individual anatomy should be obtained prior to surgery via imaging techniques. Additionally, graft type should be carefully selected after fully considering biomechanical properties, donor site morbidities, patient activities a...
Source: Operative Techniques in Orthopaedics - January 31, 2017 Category: Orthopaedics Authors: Yuichi Hoshino, Freddie H. Fu Source Type: research

Individualized Anatomic Anterior Cruciate Ligament Reconstruction
Anterior cruciate ligament (ACL) rupture is a common injury particularly among young active individuals. ACL injury leads to increased knee laxity and abnormal knee biomechanics that may prevent return to sports and predispose to early onset degenerative changes in the joint. Therefore, optimizing ACL injury treatment is of great interest to the sports medicine field. Anterior cruciate ligament reconstruction (ACLR) is considered the treatment of choice for the majority of the patients, especially in those involved in cutting and pivoting activities, often allowing them to return sports. (Source: Operative Techniques in Orthopaedics)
Source: Operative Techniques in Orthopaedics - January 31, 2017 Category: Orthopaedics Authors: Marcio Bottene Villa Albers, Daniel Guenther, Carola F. van Eck, Freddie H. Fu Source Type: research

The Influence of Intercondylar Notch Shape and Size on the Treatment Algorithm for Anatomic Anterior Cruciate Ligament Reconstruction
The intercondylar notch and anterior cruciate ligament (ACL) are closely related. Literature suggests that patients with a narrow intercondylar notch may be predisposed to ACL injury. However, the notch is also important during ACL reconstruction surgery. A narrow notch, or A-shaped notch may make it difficult to drill the femoral tunnel from the medial portal and may not be able to accommodate a double-bundle technique. However, if these considerations are taken into account, a narrow notch does not predispose to ACL graft rupture. (Source: Operative Techniques in Orthopaedics)
Source: Operative Techniques in Orthopaedics - January 31, 2017 Category: Orthopaedics Authors: Carola F. van Eck Source Type: research

Biological Augmentation of Anterior Cruciate Ligament Grafts
Anterior cruciate ligament (ACL) injury is a common sports injury. Generally, arthroscopic anterior cruciate ligament (ACL) reconstruction is performed because of the poor self-healing ability of the injured ACL. In the healing process after ACL reconstruction, tendon graft remodeling and incorporation at the tendon-bone junction are important factors for healing success. It is commonly accepted that the strength of the tendon graft attenuates immediately after ACL reconstruction and gradually increases thereafter. (Source: Operative Techniques in Orthopaedics)
Source: Operative Techniques in Orthopaedics - January 31, 2017 Category: Orthopaedics Authors: Koji Takayama, Ryosuke Kuroda Source Type: research

Intraoperative Landmarks for Tunnel Placement in Anatomic ACL Reconstruction
Anatomic anterior cruciate ligament (ACL) reconstruction, which stabilizes the knee without a loss of motion, requires graft placement within ACL attachment-area tunnels. Intraoperatively identifiable arthroscopic landmarks for the femoral attachment area include the resident ′s ridge, proximal cartilage margin, and posterior cartilage margin. In turn, tibial landmarks include the anterior ridge/Parson′s knob, intercondylar eminence, medial intercondylar ridge, and anterior horn of the lateral meniscus. (Source: Operative Techniques in Orthopaedics)
Source: Operative Techniques in Orthopaedics - January 31, 2017 Category: Orthopaedics Authors: Konsei Shino, Ryo Iuchi, Yuta Tachibana, Tomohiko Matsuo, Tomoki Ohori, Tatsuo Mae Source Type: research

Remnant tissue preserving technique for anatomic double-bundle ACL reconstructiont
Preservation of the anterior cruciate ligament (ACL) remnant tissue has attracted notice in ACL reconstruction. Remnant preservation has been expected to have several potential advantages to improve postoperative knee stability, such as enhanced graft coverage, accelerated cell repopulation and revascularization. Recently, we have developed a new remnant-preserving technique for anatomic double-bundle ACL reconstruction using the semitendinosus tendon. The anterior laxity values and the results of the pivot-shift test were significantly better in the remnant tissue –preserving procedure than in the remnant tissue–resec...
Source: Operative Techniques in Orthopaedics - January 31, 2017 Category: Orthopaedics Authors: Eiji Kondo, Kazunori Yasuda Source Type: research

Anatomic Double-bundle ACL Reconstruction:The Chinese Experience
The Double-bundle (DB) anterior cruciate ligament (ACL) reconstruction has evolved gradually and got nationwide attentions in China for 13 years. This review summarizes the experiences we have achieved since the DB ACL reconstruction was started in our country in 1998, regarding choice of grafts, surgical approach, bone tunnel placement, and fixation methods. A growing number of articles reveal that DB ACL reconstruction brings better clinical outcomes regarding the results of KT-1000, pivot shift, and Lachman test, IKDC outcomes, and complications. (Source: Operative Techniques in Orthopaedics)
Source: Operative Techniques in Orthopaedics - January 31, 2017 Category: Orthopaedics Authors: Wei Lu, Juan Wang, Rui Wang, Biao Chen, Weimin Zhu, Freddie H. Fu Source Type: research

Technical Considerations in Revision Anterior Cruciate Ligament (ACL) Reconstruction for Operative Techniques in Orthopaedics
As the incidence of anterior cruciate ligament (ACL) reconstruction continues to increase, the rate of revision surgery continues to climb. Revision surgery has inherent challenges that must be addressed in order to achieve successful results. The cause of the primary ACL reconstruction failure should be determined, and careful preoperative planning should be performed to address the cause(s) of failure. Each patient undergoing revision surgery should undergo a thorough history and physical examination, receive full length alignment radiographs, lateral radiographs, 45-degree flexion weight-bearing postero-anterior radiogr...
Source: Operative Techniques in Orthopaedics - January 31, 2017 Category: Orthopaedics Authors: Jeremy M. Burnham, Elmar Herbst, Thierry Pauyo, Thomas Pfeiffer, Darren L. Johnson, Freddie H. Fu, Volker Musahl Source Type: research

Future Perspectives of Anterior Cruciate Ligament Reconstruction
Reconstruction of the Anterior Cruciate Ligament (ACL) is a common procedure of orthopaedic surgery. The challenges of recreating normal knee function after an injury to the ACL have led to excessive research and continuous innovation of the surgical techniques for ACL reconstruction. Recently, focus has been turned towards the anatomic ACL reconstruction, which is one of the most intriguing approaches regarding the surgical technique. Furthermore, exploration of basic anatomy of the knee has led to further insight in concepts of tunnel placement, graft options and treatment strategies. (Source: Operative Techniques in Orthopaedics)
Source: Operative Techniques in Orthopaedics - January 31, 2017 Category: Orthopaedics Authors: Eleonor Svantesson, Eduard Alentorn-Geli, Olufemi R. Ayeni, Volker Musahl, Ram ón Cugat, Jón Karlsson, Kristian Samuelsson Source Type: research