No Abstract Available.
Anterior Cruciate Ligament Reconstruction* ; Anterior Cruciate Ligament*

No abstract available.
Anterior Cruciate Ligament Reconstruction ; Anterior Cruciate Ligament

No abstract available.
Anterior Cruciate Ligament Reconstruction* ; Anterior Cruciate Ligament*

As the number of primary reconstructions of the anterior cruciate ligament (ACL) increase, so do the number of revision ACL reconstructions due to failure. Revision ACL reconstruction has several challenges compared to primary ACL reconstruction. Literature review regarding revision ACL reconstruction was performed to discuss the cause of the failure, results of revision, and to assist the decision-making process and approaches to the patients. Usually good functional stability could be obtained after revision ACL reconstruction, but increased incidence of meniscal and cartilage lesions played a role in patient dissatisfaction. To solve issues such as tunnel widening, malposition, and inserted hardware after primary ACL reconstruction, various surgical technique issues were reviewed.
Anterior Cruciate Ligament ; Anterior Cruciate Ligament Reconstruction ; Cartilage ; Humans ; Incidence

No Abstract Available.
Allografts* ; Anterior Cruciate Ligament Reconstruction* ; Anterior Cruciate Ligament* ; Tendons*

PURPOSE: The purpose of this study was to evaluate the efficacy of our technique that allows direct visualization of seating of suspensory devices in anterior cruciate ligament (ACL) reconstruction. MATERIALS AND METHODS: Three different suspensory devices (TightRope RT, RetroButton, and EndoButton) were used in ACL reconstruction using 3 different techniques (outside-in, anteromedial [AM] portal, and transtibial techniques). Positioning of a guiding material and seating pattern of the suspensory devices were evaluated according to the surgical technique and suspensory device used. RESULTS: On the transtibial technique, 21 of total 26 cases (81%) of single bundle reconstructions and 22 of total 22 cases (100%) of double bundle reconstructions required superolateral capsulotomy where buttons were found in 21 of total 21 cases (100%) and 17 of 22 cases (77%), respectively. On the AM portal technique, all patients required capsulotomy and the button was found in only 18 of total 32 cases (56%) even after capsulotomy. On the outside-in technique, all patients required capsulotomy and the button was found in 86 of total 86 cases (100%). CONCLUSIONS: Our technique for direct visualization of seating of the suspensory devices was more effective in outside-in and single bundle transtibial ACL reconstruction. However, it was less effective in double bundle transtibial and AM portal ACL reconstructions.
Anterior Cruciate Ligament Reconstruction ; Anterior Cruciate Ligament ; Humans ; Knee

PURPOSE: The effect of sagittal plane angle of the tibial tunnel on the severity of tibial intra-articular aperture expansion caused by iatrogenic re-reaming in anterior cruciate ligament (ACL) reconstruction using a modified transtibial technique is unknown. The purpose of this study was to compare the severity of intra-articular aperture widening at different angles (40°, 45°, and 50°) of the tibial guide (TG). MATERIALS AND METHODS: Ninety-seven patients who underwent modified transtibial ACL reconstruction were randomly allocated to TG 40°, 45°, and 50° groups. Intra-articular tibial aperture width (TW) and tibial tunnel length (TTL) were measured intraoperatively using an arthroscopic ruler and a depth gauge. RESULTS: The TG 50° group had significantly greater tibial aperture widening than the TG 40° group. There was a significant difference among TG 40°, 45°, and 50° groups and the percentage of knees with TTL <35 mm was 8%, 9% and 3%, respectively. There were 2 females with TTL <35 mm in TG 40° and 45° groups each. The average mediolateral length of the tibial plateau was 75 mm. CONCLUSIONS: This study shows that the TG angle of 40° would reduce the severity of intra-articular aperture widening of the tibial tunnel compared to 45° or 50° in modified transtibial ACL reconstruction.
Anterior Cruciate Ligament Reconstruction ; Anterior Cruciate Ligament ; Female ; Humans ; Knee

No abstract available.
Anterior Cruciate Ligament Reconstruction ; Anterior Cruciate Ligament ; Methods

PURPOSE: To analyze the location of the femoral tunnel by three-dimensional computed tomography (3D CT) of the lateral condyle in patients who underwent arthroscopic single-bundle anterior cruciate ligament (ACL) reconstruction, performed using a modified transtibial technique, and to compare the results with data from the literature. MATERIALS AND METHODS: Seventeen patients with ACL lesions underwent modified transtibial ACL reconstruction. Postoperatively, 3D CT examinations were performed and the images were analyzed by the quadrant system described by Bernard and Hertel to define the femoral tunnel coordinates. RESULTS: The mean value of femoral tunnel location coordinates was 37.1±5.9 in the horizontal plane and 23.9±7.5 in the vertical plane. Compared with other studies using the transtibial or transportal technique, femoral positioning was improved in the vertical plane. The outside-in technique provided the best results both in the vertical and horizontal planes. CONCLUSIONS: The modified transtibial technique was not effective for systematically anatomic femoral tunnel positioning; however, it was relatively better than the conventional transtibial technique.
Anterior Cruciate Ligament Reconstruction ; Anterior Cruciate Ligament ; Humans ; Knee

Anterior cruciate ligament (ACL) reconstruction is generally accepted as the most reliable method of re-establishing knee kinematics so as to prevent various symptoms related to the instability and subsequent injuries to the knee. Double bundle ACL reconstruction has emerged as a potential solution for single bundle reconstruction, as the latter can restore anteroposterior stability, but it had limitations for improving the rotational stability. However, double bundle reconstruction is a more complex surgical procedure and it remain unclear whether double bundle reconstruction has better results than single bundle reconstruction on long term follow-up. Recent studies have demonstrated that a femoral tunnel could be created independently of the tibial tunnel and in a more anatomic position by using the anteromedial portal technique, so that that there is better restoration of the rotational stability as well as anterior stability than that with performing the transtibial technique.
Anterior Cruciate Ligament ; Anterior Cruciate Ligament Reconstruction ; Biomechanics ; Knee