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…
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Introduction Interference screw fixation remains an effective technique in bone–patellar tendon–bone (BPTB) anterior cruciate ligament reconstruction (ACLR). It is a well-established and well-studied technique. Interference screws are able to achieve early stability with rigid, aperture fixation of graft to host…
Introduction Tibial side fixation of soft tissue grafts has been challenging because the line of pull on the graft in the tibia is parallel to the axis of the tunnel and because the bone in the tibia has a lower…
Introduction The WasherLoc (Biomet, Warsaw, Indiana) is an extratunnel two-piece lag screw and spiked washer fixation device specifically designed for soft tissue graft fixation for Anterior Cruciate Ligament (ACL) reconstruction. The method of fixation of soft tissue grafts for ACL…