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. 2017 Sep-Oct;51(5):606-613.
doi: 10.4103/ortho.IJOrtho_237_17.

Anterior Cruciate Ligament Injury, Reconstruction, and the Optimization of Outcome

James Philip Bliss  1
Affiliations

Anterior Cruciate Ligament Injury, Reconstruction, and the Optimization of Outcome

James Philip Bliss. Indian J Orthop. 2017 Sep-Oct.

Abstract

Anterior cruciate ligament reconstruction (ACLR) provides an established surgical intervention to control pathological tibiofemoral translational and rotational movement. ACLR is a safe and reproducible intervention, but there remains an underlying rate of failure to return to preinjury sporting activity levels. Postoperative pathological laxity and graft reinjury remain concerns. Previously, unrecognized meniscal lesions, disruption of the lateral capsule, and extracapsular structures offer potential avenues to treat and to therefore improve kinematic outcome and functional results, following reconstruction. Addressing laterally based injuries may also improve the durability of intraarticular ACLR. Improving the anterior cruciate ligament (ACL) graft replication of the normal ACL attachment points on the femur and the tibia, using either double bundle or anatomical single bundle techniques, improves kinematics, which may benefit outcome and functionality, following reconstruction.

Keywords: Anterior cruciate ligament; Anterior cruciate ligament reconstruction; athletic injuries; graft injury; lateral tenodesis; ramp lesion; sports injuries.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Arthroscopic view showing 9 mm femoral drill hole positioning. PCL: Posterior cruciate ligament, Medial wall LFC: Medial wall lateral femoral condyle. Red arrow: Posterior intercondylar border lateral femoral condyle. Black arrow: Tibiofemoral joint line
Figure 2
Figure 2
Arthroscopic view showing tibial anterior cruciate ligament tunnel. PCL: Anterior border posterior cruciate ligament, MFC: Medial femoral condyle, IM Lig: Anterior intermeniscal ligament, LM: Posterior border of anterior horn of lateral meniscus
Figure 3
Figure 3
Arthroscopic view showing ramp lesion. Post cap: Posteromedial capsular detachment from meniscus, Med M: Posterior region of medial meniscus, Post tib plat: Posterior region of medial tibial plateau visible through ramp tear
Figure 4
Figure 4
Arthroscopic view showing suture repair of Ramp lesion of posteromedial capsule
See this image and copyright information in PMC

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