The ACL or anterior cruciate ligament is the most important ligament in the knee. When it is completely torn, it can lead to instability or buckling of the knee. There are several options to choose from when selecting a graft for ACL reconstruction such as using autografts including patellar tendon, hamstring tendon, and quadriceps tendon, and allografts (also known as donor tissue or cadaver tissue). Artificial ligaments are also discussed since they are still used in Europe and Asia. This book summarizes the pros and cons of each graft option in detail.
Master the very latest clinical and technical information on the full range of anterior cruciate ligament reconstruction techniques. Both inside the remarkably user-friendly printed version of this Expert Consult title and on its fully searchable web site, you'll find detailed coverage of hamstring, allograft and bone-tendon-bone (BTB) ACL reconstruction (including single versus double bundle techniques), and hamstring graft harvesting; plus fixation devices, rehabilitation, revision ACLR surgery, and much more! A "dream team" of ACL surgeons provides the advanced guidance you need to overcome the toughest challenges in this area. A comparison of the full range of graft options for ACL reconstruction makes it easier to choose the best approach for each patient. State-of-the-art information on the latest principles and technical considerations helps you avoid complications. ‘How to' principles of post-op rehabilitation and revision ACL surgery optimize patient outcome. Access to the full contents of the book online enables you to consult it from any computer and perform rapid searches. Also available in an upgradeable premium online version including fully searchable text PLUS timely updates.
This practical and instructional guidebook, written by international experts in anterior cruciate ligament (ACL) reconstruction, covers all challenging aspects of ACL rupture in the acute and chronic setting. It covers the latest, spectacular anatomical findings, treatment of partial ACL tears, various techniques for single- and double-bundle ACL reconstruction, and complex ACL revision surgery. Important surgical steps are clearly described with the help of instructive, high-quality photographs. Important tips, tricks, and pitfalls are highlighted and intra- and postoperative complications, rehabilitation, and prevention of re-rupture are discussed. All authors are prominent and experienced ACL surgeons.
The Anterior Cruciate Ligament: Reconstruction and Basic Science, 2nd Edition, by Dr. Chadwick Prodromos, provides the expert guidance you need to effectively select the right procedure and equipment, prevent complications, and improve outcomes for every patient. Written and edited by world leaders in hamstring, allograft, and bone-patellar tendon-bone (BTB) ACL reconstruction, this revised reference is a must-have resource for the full range of anterior cruciate ligament reconstruction techniques, plus fixation devices, rehabilitation, revision ACLR surgery, and much more! Covers the latest clinical and technical information on pain control, genetics and biologics, the use of ultrasound, and much more. Features dozens of new chapters that offer up-to-date information on pain control after ACLR, single vs. double bundle repairs, genetics and collagen type, all-inside techniques, biologics, pediatrics, ACL ganglion cysts, prognosis for ACLR success, allografts vs. autografts, and more. Provides the experience and insight of a "dream team" of ACL experts, including James Andrews on sports medicine, Frank Noyes on HTO and ACLR, and Andrew Amis on the benefits of the older femoral tunnel placement technique.
This new treatise is the most outstanding piece of work on the knee and its associated ligaments currently available. Never before have I seen such an extensive study of the biomechanics of the knee with such a comprehensive review of the literature. The first section of the book, which deals with the functional anatomy (structure and biomechanics), immediately alerts the reader to the necessity of understanding the natural develop ment and action of the related structures, clearly emphasizing that successful diagnosis and treatment cannot otherwise be expected; the many who want an easy standard approach to each classic problem may find this hard to accept. Study what Werner Muller has written and compare it with your own findings from repeated dissection of anatomical specimens. The author goes on to stress that to have a real grasp of reconstructive surgery of the ligaments, one must be properly acquainted with the pathology and the repair of acute lesions. In no other way can one learn to recognize chronic problems. Once this step has been mastered it can be seen that the reconstructive procedures that Muller advocates do, for the most part, follow the laws of Nature rather than create the kind of abnormalities which often disrupt natural anatomical func tion.
From evaluation to outcome, Current Concepts in ACL Reconstruction will help you keep pace with the latest techniques for the treatment of anterior cruciate ligament injuries. This text provides the most complete and up-to-date information for the surgical reconstruction of a torn ACL including details about the newer double-bundle procedure. Both American and international perspectives on the treatment of ACL injuries are included to provide the most comprehensive review on the market today. Inside this richly illustrated text, Drs. Freddie H. Fu and Steven B. Cohen along with contributions from the world's most experienced knee surgeons review the basic science, kinematic, imaging, and injury patterns surrounding the ACL. Surgical concepts, various techniques for reconstruction, and diverse opinions on approaching the ACL are also included. Current Concepts in ACL Reconstruction explains the anatomical basis in order to provide the most current surgical principles to ensure the patient receives the best surgical outcomes. To reflect recent advancements in ACL treatment, the emerging double-bundle technique is comprehensively covered. The differences between the single- and double-bundle techniques are discussed with perspectives from leading international experts in double-bundle reconstruction. An accompanying video CD-ROM demonstrates the various procedures mentioned throughout the text. In addition, several of the world's most experienced surgeons provide their perspective from what they have learned by performing ACL surgery for over 25 years, along with their insight into the future treatment of ACL injuries. What you will want to learn more about: - Differences between single- and double-bundle reconstruction techniques - Outcomes of single- and double-bundle reconstruction - Pediatric ACL reconstruction - Gender differences in ACL injury - Radiographic imaging - Computer navigation assistance for ACL reconstruction - Injury patterns of the ACL - Graft choices in ACL surgery - Revision ACL surgery - Postoperative rehabilitation after ACL reconstruction - Outcome measures to assess success after surgery Current Concepts in ACL Reconstruction answers the need for a comprehensive information source on the treatment of ACL injuries. Orthopedic residents and surgeons will be prepared with this thorough review of ACL reconstruction by their side.
Different views about the biomechanics of the knee joint and late re construction of ligamentous injuries underline the obstacles impeding the establishment of generally acceptable principles for the treat ment of such lesions. As late as June 1976, HUGHSTON emphasized in the Journal of Bone and Joint Surgery that in spite of excellent anatomic studies, substantial uncertainty still prevails in knee joint surgery. Even the signifi cance of the anterior drawer sign for ruptures of the anterior cru ciate ligament is interpreted quite diversely, as illustrated in a comparison of HUGHSTON, GIRGIS, TORG, and SCHIECK, who give varying opinions concerning the indication related to the age of the patient or possible earlier joint damage as well as concerning the prognosis for untreated knee joints. The question still remains as to how often an intra-articular ligamentous replacement should be carried out in addition to extra-articular techniques (0 'DONOGHUE, SLOCUM, NICHOLAS, HUGHSTON). Lastly the question of synthetic ligament replacement must be clarified. After basic research has well advanced, clinical ex perience must be discussed. Statements concerning the therapeutic value of diverse procedures based solely on knowledge of the literature remain problematic. For this reason a workshop was held at the University of Heidelberg in the Orthopedic Clinic (Head: Prof. Dr. H. COTTA) in June 1977, with the aim of bringing together representatives of the different leading schools in a round table discussion to comment on still unsolved ques tions.
Although anterior cruciate ligament (ACL) reconstruction has a high success rate, a substantial number of patients are left with unsatisfactory results. Revision ACL Reconstruction: Indications and Technique provides detailed strategies for planning and executing revision ACL reconstructions. Concise chapters by a leading group of international orthopedic surgeons cover the diagnosis of failed ACL reconstruction, patient evaluation, preoperative planning for revision ACL surgery and complex technical considerations.
The Adult ACL world is constantly changing and is in need of continual updates; approximately 60,000-75,000 ACL reconstructions are performed annually in the United States. Dr. Freddie Fu just held a world-wide symposium on this topic and is considered the expert. In the Clinics survey sent in the fall of 2010, survey takers were most interested in seeing an issue on ACL repair and injury prevention.
Anterior cruciate ligament reconstruction is one of the most common procedures performed in sports medicine centers. However, these procedures can carry a long-term failure rate as high as 5-15%%, and when these procedures fail, revision is significantly more complex. Considerable factors need to be assessed in patients that are indicated for surgery, as revisions carry a higher failure rate and potentially less optimal outcomes and return to sport and activity. These factors include, but are not limited to, the status of the meniscus, overall alignment, graft options, placement of prior implants or tunnels, collateral ligament quality, and whether or not the revision must be staged into two procedures. This text provides a comprehensive, case-based presentation of the most efficient and practical treatment algorithms for patients in need of revision ACL repair and reconstruction. Opening chapters discuss the initial patient work-up, radiography, surgical indications, graft options, and pre-operative considerations and preparations. The main portion of the book then describes both common factors leading to revision surgery as well as the surgical techniques themselves, illustrated via plentiful operative photos and vivid clinical case material. The management of osteolysis, ligamentous laxity, extra-articular tenodesis, plane correction, and meniscus deficiency, among others, are discussed in detail. Special populations, such as the pediatric patient, the elite athlete and the female athlete, are discussed as well. Shedding light on this challenging surgical repair, Revision Anterior Cruciate Ligament Reconstruction is the go-to resource for sports medicine and orthopedic surgeons, knee specialists and residents and fellows in these areas.
