Technical aspects of anterior cruciate ligament reconstruction for the general orthopaedic surgeon.

Anterior cruciate ligament reconstruction is the sixth most common procedure performed by orthopaedic surgeons. The goals of the procedure are to restore knee stability and patient function. These goals are dependent on proper graft positioning and incorporation.

Retrograde femoral nailing: computed tomography angiogram demonstrates no relative safe zone for prevention of small diameter arterial vascular injury during proximal anteroposterior interlocking.

Background: Reported iatrogenic injury to the proximal femoral vascular structures is rare after retrograde femoral nailing. Previous cadaveric dissections have recommended placement of proximal interlocking screws above the level of the lesser trochanter.

Methods: This study is designed to define the arterial vascular anatomy anterior to the proximal medullary canal of the femur, which could be damaged with the placement of anteroposterior (AP) proximal interlocking screws.

Biomechanical evaluation of bioabsorbable versus metallic screws for posterior cruciate ligament inlay graft fixation: a comparative study.

Background: Although a tibial inlay technique for posterior cruciate ligament reconstruction is advantageous, metallic screw fixation of the bone block is required. This may pose problems for future surgery (eg, osteotomies, total knee replacement).

Hypothesis: There is no significant difference in the biomechanical integrity of bone block fixation using stainless steel versus bioabsorbable screw fixation of the tibial inlay graft in posterior cruciate ligament reconstruction.

Posterior wall blowout in anterior cruciate ligament reconstruction: avoidance, recognition, and salvage.

Posterior wall blowout is an important potential source of anterior cruciate ligament reconstruction failures that can be avoided if surgeons adhere to proper technique and are vigilant in confirming appropriate femoral tunnel placement. This article reviews techniques for avoidance, recognition, and salvage of posterior wall blowouts in anterior cruciate ligament reconstruction surgery.

Prospective evaluation of concurrent meniscus transplantation and articular cartilage repair: minimum 2-year follow-up.

Background: Recognition of the symbiotic relationship between the meniscus and articular cartilage is critical to the success of meniscal allograft transplantation. Simultaneous combined meniscal allograft transplantation and cartilage restoration procedures have been proposed for patients with a symptomatic postmeniscectomy knee with a focal chondral defect that would have traditionally been considered a contraindication to meniscal allograft transplantation.

Hypothesis: Combined meniscal allograft transplantation and cartilage restoration procedures can be used to neutralize traditional contraindications to meniscal allograft transplantation with results comparable to either procedure performed in isolation.

Complications of anterior cruciate ligament reconstruction with bone-patellar tendon-bone constructs: care and prevention.

Rupture of the anterior cruciate ligament is a common injury. Correct diagnosis and patient selection, along with proper surgical technique, with careful attention to anatomic graft placement, followed by attention to proper rehabilitation, leads to predictably good to excellent results. This article reviews the recognition and avoidance of complications associated with bone-patellar tendon-bone constructs of anterior cruciate ligament reconstruction.

Fresh-frozen allograft anterior cruciate ligament reconstruction.

Reconstruction of the anterior cruciate ligament provides consistently good to excellent results allowing return to work and sport. Allograft tissue is an alternative to autografts when appropriate donor tissue is not available or its use is not advisable for other reasons. The technique and results for allograft use are similar to those for autograft, making its use appropriate in a variety of clinical scenarios.

Hardware removal: indications and expectations.

Although hardware removal is commonly done, it should not be considered a routine procedure. The decision to remove hardware has significant economic implications, including the costs of the procedure as well as possible work time lost for postoperative recovery. The clinical indications for implant removal are not well established.

Functional outcomes following displaced talar neck fractures.

Objectives: To determine the outcome of displaced talar neck fractures at long-term follow-up in terms of functional outcome and secondary reconstructive surgery.

Design: Retrospective cohort study.

Setting: Academic level 1 trauma center.