OWL: OCOSH Classification/Trauma/Leg Injuries/Knee Injuries/Knee Ligament Injuries/ACL

ACL reconstruction failure and revisions

Sheila Strover — 2008-06-09 23:42:35 GMT

The kNEEguru website presents a new course by Dr Frank Noyes on the reasons for ACL graft failure and the pitfalls of reconstruction surgery. Aimed at the consumer, but at a good level for family practitioners, the rehabilitation team, nurses and medical students. [Free]

All inside ACL reconstruction Technique with SemiT and Biosc

Staeheli — 2002-02-04 23:42:35 GMT

No Description Available

Allograft Reconstruction ACL-Deficient Knee eMedicine Orthopedics

Andrew Turtel, MD — 2008-04-04 23:42:35 GMT

Multiple techniques are available for reconstruction of the anterior cruciate ligament (ACL). Controversy certainly exists as to which autograft is best and which methods of placement and fixation should be used. Instances exist in which autograft is not available due to multiple reconstructions or in combined ligament injuries. In addition, after discussing the advantages and drawbacks of the various graft materials available, patients may choose not to use autograft material. In these situations, other graft sources must be considered. This article simply deals with the grafts available and is aimed at providing the reader with an increased confidence in choosing from various materials. This article does not cover surgical indications or techniques, as other articles in this publication address these issues.
Synonyms and related keywords: anterior cruciate ligament reconstruction materials, ACL reconstruction, knee reconstruction
Author: Andrew Turtel, MD 2004

Anterior Cruciate Ligament

C.R.Wheeless — 2002-02-04 23:42:35 GMT

Discussion:
- anatomy of ACL
- biomechanics of ACL:
- mechanism: ACL Tear:
- natural history of the ACL-deficient knee
- partial ACL injury
- pediatric ACL injuries:
Wheeless' Textbook of Orthopaedics

Anterior Cruciate Ligament Injury eMedicine PMR

Souryal & Adams — 2008-04-11 23:42:35 GMT

The anterior cruciate ligament (ACL) originates from the tibial plateau just medial and anterior to the tibial eminence. The ACL tracts from the tibia superiorly, laterally, and posteriorly to its insertion on the posterior aspect of the medial wall of the lateral femoral condyle. The ACL is composed of 2 bundles, the anteromedial bundle and the posterolateral bundle. The ACL provides 85% of the total restraining force to anterior translation of the tibia. An ACL tear is a common injury that occurs in all types of sports. This injury usually occurs during a sudden cut or deceleration, as it typically is a noncontact injury. The patient states, "I planted, twisted, and then heard a pop." Before the advent of arthroscopic knee surgery in the early 1970s, ACL tear was often a career-ending injury.
Synonyms and related keywords: anterior cruciate ligament injury, ACL injury, ACL tear, anteromedial bundle, posterolateral bundle, hemarthrosis, Segond fracture
Souryal & Adams 2006

Anterior Cruciate Ligament Pathology eMedicine Orthopedics

Maguire & Cross — 2008-04-04 23:42:35 GMT

The anterior cruciate ligament (ACL) is one of the most commonly injured ligaments of the knee. Injuries occur predominately in a young and sports-active population. Many patients are left with significant disability following injury to the ACL. Understanding and preventing associated meniscal pathology is the key to management of this condition. This article endeavors to explain the complex nature of the ligament and its injuries and aid the reader in making informed management decisions.
Synonyms and related keywords: anterior cruciate ligament injury, ACL injury
Maguire & Cross 2004

Anterior Cruciate Ligament Reconstruction

Wismer & Alexander — 2007-07-08 23:42:35 GMT

ACL Reconstruction: Current Concepts Review. McMaster Orthopaedic Grand Rounds Presentation 2001

Anterior cruciate ligament reconstruction Middle-third bone/patella tendon/bone autograft

C.M. Fergusson — 2008-09-09 23:42:35 GMT

Anterior cruciate ligament (ACL) rupture is a common, and initially often overlooked injury of the knee. Whether the true incidence of the injury is on the increase, or simply its professional recognition, is hard to say, but reconstruction for functional instability has developed rapidly over the last two decades. Not all ACL-deficient knees need stabilising, and unfortunately not all stabilised knees return to full function, so careful patient selection is very important in this group of patients. Once selected, adequate time must be spent in preoperative counselling to discuss the issues of the time implications, the critical importance of post-operative physiotherapy and rehabilitation, the risks of success and failure, as well as the complications, potential graft site morbidity and the alternative conservative approaches. These latter include proprioceptive physiotherapy and/or bracing for specific sporting activities. In support of this we provide a patient leaflet which includes details of the knee�s anatomy, surgical techniques, rehabilitation protocols, as well as expected outcomes and references.
C.M. Fergusson Department of Orthopaedic Surgery, Royal Berkshire and Battle Hospitals NHS Trust, Reading, U.K. J.R.Coll.Surg.Edinb., 45, February 2000, 33-43

Anterior Cruiate Ligament Reconstruction using hamstrings

James Lewis — 2007-03-31 23:42:35 GMT

Modern ACL reconstruction using Hamstrings. Diagrams and Video animation. Arthroscopic. Day case.
Anterior Cruciate Ligament Reconstruction.

Arthrofibrosis from ACL Injuries Wheeless

C.R.Wheeless — 2002-02-04 23:42:35 GMT

- need to determine whether the fibrosis has primarily affected flexion or extension;
- need to determine either from radiographs or from MRI, whether incorrect tunnel placement, is the cause of the decrease motion and fibrosis;
- also evaluate for patella baja;
- in some cases, severe patella baja may be associated with limited flexion
Wheeless' Textbook of Orthopaedics

Arthroscopically Assisted Reconstruction of the Anterior Cruciate Ligament

O'Neill — 2002-04-19 23:42:35 GMT

Dr. Daniel B. O'Neill of Nassau Bay, Texas demonstrates his technique for Arthroscopically assisted reconstruction of the ACL deficient knee using a patellar bone-patellar ligament-tibial tubercle bone autograft. In-depth discussion on surgical indications, contraindications, graft selection, fixation options and postoperative protocol is presented. During surgery, Dr. O'Neill provides several "pearls" in preventing complications.

Lachman Test Wheeless

C.R.Wheeless — 2002-02-04 23:42:35 GMT

- this is a variant of the anterior drawer test, in which the examination is carried out w/ the knee in 15 deg of flexion, and external rotation (relaxes the IT band);
Wheeless' Textbook of Orthopaedics

Septic Arthritis Following Anterior Cruciate Ligament Reconstruction Using Tendon Allografts

Lutz et al — 2008-09-05 23:42:35 GMT

In the United States, approximately 50,000 knee surgeries are performed each year for repairing anterior cruciate ligament (ACL) injuries (1). Tissue allografts frequently are used for ACL reconstruction, and septic arthritis is a rare complication of such procedures. This report describes four patients who acquired postsurgical septic arthritis probably associated with contaminated bone-tendon-bone allografts used for ACL reconstruction. Effective sterilization methods that do not functionally alter musculoskeletal tissue are needed to prevent allograft-related infections.
MMWR December 7, 2001 / 50(48);1081-3 Full text

The Effect of Fixation Technique on Graft Position in Anterior Cruciate Ligament Reconstruction

Amendola et al — 2008-09-05 23:42:35 GMT

Iowa Orthop J. 2003; 23: 29�35. A Amendola, MD,� M Menon, BA,* M Clatworthy, MD,* and PJ Fowler, MD
As demonstrated by this study, placement and orientation may vary to accommodate technique and fixation. Clinical outcomes measured were similar in both groups. (full text)