Introduction In general, the treatment of anterior cruciate ligament (ACL) injuries in adults has been extensively analyzed. However, this does not stand true for skeletally immature patients. The increasing incidence of such injuries, as well as the substantial spectrum and…
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Introduction Revision anterior cruciate ligament (ACL) surgery represents a salvage procedure, and the patient should be counseled that the outcome is not likely to be as good as a primary procedure. The goal of surgery is to provide a stable…
Introduction Anterior cruciate ligament (ACL) reconstruction is a common procedure, with over 100,000 procedures performed annually in patients who have an active lifestyle and who are unable to continue with their activities because of instability. Yet the success rate of…
Introduction This chapter will describe a technique that provides the highest strength known graft for use in revision and high-risk primary anterior cruciate ligament reconstruction (ACLR), while allowing flexibility for femoral tunnel creation in the revision setting. Autograft has consistently…
Introduction The nature of anterior cruciate ligament (ACL) reconstruction is to create new graft-bone connections. Although in native ACL the ligament fibers attach to the bone surface of the femur and tibia, in ACL reconstruction, no one has been reported…
Introduction Graft healing within the bone tunnel and the intra-articular ligamentization process represent together the two main sites of biological incorporation after anterior cruciate ligament (ACL) reconstruction, since they contribute to the determination of the mechanical behavior of the femur-ACL…
Anterior cruciate ligament (ACL) reconstruction techniques have improved over the last 10 years, but graft failure is not uncommon: 0.7%–10%. Successful ACL reconstruction requires understanding of several factors: anatomical graft placement, mechanical properties of the selected graft tissue, mechanical behavior…
Introduction The Endobutton continuous loop (CL) bone–tendon–bone (BTB) Fixation System (Smith and Nephew, Andover, Massachusetts) is a technique for fixation of anterior cruciate ligament (ACL) grafts that have a bone block for the femoral tunnel, such as BTB autografts, BTB…
Introduction There are many techniques for anterior cruciate ligament (ACL) reconstruction that involve using different surgical instruments, graft choices, fixation devices, and postoperative care. Each surgeon needs to become an expert at one technique, track patients’ results, and then make…