Anterior Cruciate Ligament Augmentation Procedure With a 1-incision Technique: Anteromedial Bundle or Posterolateral Bundle Reconstruction

2006 ◽  
Vol 22 (4) ◽  
pp. 463.e1-463.e5 ◽  
Author(s):  
Mitsuo Ochi ◽  
Nobuo Adachi ◽  
Masataka Deie ◽  
Atsushi Kanaya
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Posterolateral Bundle ◽  
Anteromedial Bundle ◽  
Ligament Augmentation ◽  
Anterior Cruciate ◽  
Incision Technique ◽  
Augmentation Procedure

Double-Bundle Anterior Cruciate Ligament Reconstruction

2009 ◽  
Vol 37 (8) ◽  
pp. 1548-1553 ◽  
Author(s):  
Andrea Ferretti ◽  
Edoardo Monaco ◽  
Luca Labianca ◽  
Angelo De Carli ◽  
Barbara Maestri ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
External Rotation ◽  
Cruciate Ligament ◽  
Double Bundle ◽  
Posterolateral Bundle ◽  
Anteromedial Bundle ◽  
Cruciate Ligament Reconstruction ◽  
Anterior Cruciate

Background Single-bundle anterior cruciate ligament reconstruction seems to be insufficient to control a combined rotatory load of internal and valgus torque, whereas anatomical double-bundle reconstruction might produce a better biomechanical outcome, especially during rotatory loads. Hypothesis The addition of the posterolateral bundle to the anteromedial bundle, in an in vivo double-bundle computer-assisted anterior cruciate ligament reconstruction, is able to reduce the internal rotation of the tibia at different degrees of flexion. Study Design Controlled laboratory study. Methods Ten consecutive anterior cruciate ligament reconstruction procedures were performed in male patients using double-bundle gracilis and semitendinosus tendon graft with the 2.0 OrthoPilot anterior cruciate ligament navigation system. Anteroposterior displacement at 30°, 60°, and 90° as well as internal and external rotation at 0°, 15°, 30°, 45°, 60°, and 90° of knee flexion were evaluated before reconstruction, after fixation of the anteromedial bundle, and then after fixation of the posterolateral bundle. Results Fixation of the anteromedial bundle significantly (P <. 05) reduced the anteroposterior displacement at 30°, 60°, and 90° of knee flexion; the internal rotation at 15°, 30°, 45°, and 60°; and the external rotation at 0°, 30°, 60°, and 90°. The addition of the posterolateral bundle to the anteromedial bundle did not significantly reduce internal and external rotation of the tibia at degrees of flexion measured (P >. 05). Conclusion The hypothesis that the addition of the posterolateral bundle to the anteromedial bundle is able to reduce internal rotation of the tibia, minimizing the pivot-shift phenomenon, was not confirmed. Clinical Relevance The effective role of the anatomical double-bundle procedure in better restoring knee kinematics and allowing better clinical outcomes should be questioned in an in vivo model of anterior cruciate ligament reconstruction using doubled semitendinosus and gracilis graft.

scholarly journals Conservative Rehabilitation of Partial Anterior Cruciate Ligament Tear - A Case Report

2021 ◽  
pp. 386-394
Author(s):  
Shivani Uttamchandani ◽  
Khushboo Bhageriya ◽  
Mithushi Deshmukh
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Joint ◽  
Cruciate Ligament ◽  
Joint Effusion ◽  
Posterolateral Bundle ◽  
Anteromedial Bundle ◽  
Lower Limb Muscles ◽  
Functional Pain ◽  
Anterior Cruciate ◽  
The Right

The anterior cruciate ligament is one of the most important ligaments in the knee joint (ACL). The ACL is necessary for appropriate knee joint mobility and mechanics. When the ACL is torn, patients may experience issues with their knee's function, as well as instability and the sensation of 'falling away' while walking. The anterior cruciate ligament acts as a main restraint on tibia-to-femur translation (anterior shear). Depending on the angle of knee flexion, this function is allocated to either anteromedial or posterolateral bundle. When the knee is fully extended, the posterolateral bundle is tense; however, when the knee flexes, the posterolateral bundle loosens and the anteromedial bundle tightens. We report the case of a 32-year-old man who twisted his leg while jogging, resulting in a partial thickness ACL rupture and mild joint effusion along the periarticular surface of the right knee, as revealed by radiological symptoms and MRI.Conservative rehabilitation in a patient aged 32 year shows good results and so the surgery was not performed. Initially 10 weeks protocol was managed in hospital under the guidance of a therapist including strengthening, stretching and conditioning of lower limb muscles, later on as pain reduced and patient achieved functional pain free range 12 week protocol was further set for home program.

scholarly journals Ossicle in Anterior Cruciate Ligament: A Rare Occurrence

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Ashish Devgan ◽  
Reetadyuti Mukhopadhyay ◽  
Amanpreet Singh ◽  
Paritosh Gogna ◽  
Rohit Singla ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
English Literature ◽  
Cruciate Ligament ◽  
Rare Occurrence ◽  
Posterolateral Bundle ◽  
Anteromedial Bundle ◽  
Extensive Search ◽  
Accessory Ossicle ◽  
Anterior Cruciate

The occurrence of an intra-articular ossicle is not rare in the knee, with reports suggesting the existence of meniscal osscile. There are also reports describing the attachment of the posterolateral bundle of the anterior cruciate ligament (ACL) to an accessory ossicle. However, despite an extensive search of the English literature we did not find much written about an intrasubstance ossicle in the ACL. We present the case of a 13-year-old male with an intrasubstance ossicle in the anteromedial bundle of the ACL of his right knee.

scholarly journals Failure load of the femoral insertion site of the anterior cruciate ligament in a porcine model: comparison of different portions and knee flexion angles

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Shohei Yamauchi ◽  
Kyohei Ishibashi ◽  
Eiji Sasaki ◽  
Shizuka Sasaki ◽  
Yuka Kimura ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Flexion ◽  
Failure Load ◽  
Cruciate Ligament ◽  
Insertion Site ◽  
Posterolateral Bundle ◽  
Anteromedial Bundle ◽  
Femoral Insertion ◽  
Significant Difference ◽  
Anterior Cruciate

Abstract Background This study compared the failure load of the femoral insertion site of the anterior cruciate ligament between different portions and knee flexion angles. Methods In total, 87 fresh-frozen, porcine knees were used in this study. Three knees were used for histological evaluation; the remaining 84 knees were randomly divided into 4 groups: anterior anteromedial bundle, posterior anteromedial bundle, anterior posterolateral bundle, and posterior posterolateral bundle groups (n=21 per group). The anterior cruciate ligament femoral insertion site was divided into these four areas and excised, leaving a 3-mm square attachment in the center of each bundle. Tibia-anterior cruciate ligament-femur complexes were placed in a material testing machine at 30°, 120°, and 150° of knee flexion (n=7), and the failure load for each portion was measured under anterior tibial loading (0.33 mm/s). Results Histological study showed that the anterior cruciate ligament femoral insertion site consisted of direct and indirect insertions. Comparison of the failure load between the knee flexion angles revealed that all the failure loads decreased with knee flexion; significant decreases were observed in the failure load between 30 and 150° knee flexion in the posterior anteromedial bundle and posterior posterolateral bundle groups. Comparison of the failure load according to different portions revealed a significant difference between the anteromedial and posterolateral bundle groups at 150° of knee flexion, but no significant difference among the groups at 30° of flexion. Conclusions Although the failure load of the posterior portion decreased significantly in the knee flexion position, it (mainly consisting of indirect insertion) plays a significant role against anterior tibial load in the knee extension position; this appears to be related to the characteristics of the insertion site. Reflecting the complex structure and function of the ACL, this study showed that the failure load of the femoral insertion site varies with differences in positions and knee flexion angles.

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