Anterior Cruciate Ligament Reconstruction: A Practical by Rainer Siebold, David Dejour, Stefano Zaffagnini

By Rainer Siebold, David Dejour, Stefano Zaffagnini

This sensible and educational guidebook, written through overseas specialists in anterior cruciate ligament (ACL) reconstruction, covers all not easy points of ACL rupture within the acute and persistent atmosphere. It covers the newest, impressive anatomical findings, therapy of partial ACL tears, a number of thoughts for unmarried- and double-bundle ACL reconstruction, and intricate ACL revision surgical procedure. vital surgical steps are truly defined with assistance from instructive, high quality images. vital counsel, methods, and pitfalls are highlighted and intra- and postoperative problems, rehabilitation, and prevention of re-rupture are mentioned. All authors are famous and skilled ACL surgeons.

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The “indirect” fibers extended from the midsubstance fibers and broadly spread underneath the transverse ligament toward the anterior rim of the tibial plateau. 5 mm2). 7 mm2). * AH PH Fig. 6 ACL Fiber Bundles The distal flat part of the ACL midsubstance consisted of several small fiber bundles (Fig. 5a, b). It was impossible to macroscopically clearly R. Siebold et al. 24 a b * * AH PH Fig. 5 (a, b) No separate anteromedial and posterolateral bundles could be distinguished during preparation of the ACL and its midsubstance; however, several fiber a bundles were identified in most knees.

Ferretti M, Levicoff EA, Macpherson TA et al (2007) The fetal anterior cruciate ligament: an anatomic and histologic study. Arthroscopy 23(3):278–283 12. Fu FH, Karlsson J (2010) A long journey to be anatomic. Knee Surg Sports Traumatol Arthrosc 18(9): 1151–1153 13. Girgis FG, Marshall JL, Monajem A (1975) The cruciate ligaments of the knee joint. Anatomical, functional and experimental analysis. Clin Orthop Relat Res 106:216–231 14. Gray H, Gross CM (1973) Anatomy of the human body. Lea & Febiger, Philadelphia 15.

3 times the respective values of the older group. In addition, there was a significant difference in failure mode and site of failure in these ACLs. The ACLs from younger humans failed predominantly as midsubstance tear, whereas older humans also showed bony avulsions [46, 47]. The latter do not represent failure of the ligament per se. When older (40–60 years) ACLs failed midsubstance, they did not show lower ultimate load to failure than younger ones. Furthermore, it has been found in ACL experiments on rhesus monkeys that elongation of the ACL is similar at the slow and fast rate of deformation.

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