Revision of anterior cruciate ligament reconstruction (ACL-R) presents many challenges that are not encountered in the primary setting and, therefore, requires thorough preoperative planning. Recently, there has been growing evidence showing that combining the anterolateral ligament (ALL) reconstruction with ACL-R revision reduces the risk of postoperative ACL rupture and meniscal tears, and therefore, the ALL reconstruction becomes essential to a complex ACL revision. The technique that we describe is mainly used in the setting of complex ACL revision with extensive tunnel osteolysis associated with rotational instability of the knee. This article presents a technique for a one-stage complex ACL-R revision combined with ALL reconstruction using an Achilles tendon allograft with a bone plug.
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http://dx.doi.org/10.1016/j.eats.2023.09.002 | DOI Listing |
JBJS Case Connect
January 2025
Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut.
Case: A 16-year-old woman presented with acute on chronic knee pain and instability following a twisting injury. The tibial insertion of the anterior cruciate ligament (ACL) was nonvisualized on magnetic resonance imaging. A cord-like ACL, originating from the lateral intercondylar notch and inserting smoothly into the anterior horn of the intact lateral meniscus, was found on arthroscopy.
View Article and Find Full Text PDFSports Med
January 2025
School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia.
Following anterior cruciate ligament (ACL) injury, quadriceps muscle atrophy persists despite rehabilitation, leading to loss of lower limb strength, osteoarthritis, poor knee joint health and reduced quality of life. However, the molecular mechanisms responsible for these deficits in hypertrophic adaptations within the quadriceps muscle following ACL injury and reconstruction are poorly understood. While resistance exercise training stimulates skeletal muscle hypertrophy, attenuation of these hypertrophic pathways can hinder rehabilitation following ACL injury and reconstruction, and ultimately lead to skeletal muscle atrophy that persists beyond ACL reconstruction, similar to disuse atrophy.
View Article and Find Full Text PDFClin Pract
December 2024
Complex Operational Unit of Sports Traumatology and Joint Reconstruction, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Roma, Italy.
Multi-ligament reconstruction in adolescent patients affected by congenital femoral deficiency is an extremely rare and delicate surgical procedure. There are very few reported cases of complete anterior and posterior cruciate ligament agenesis in these patients. We present a complex case of a 16-year-old girl affected by congenital femoral deficiency and ipsilateral tibial hypoplasia who was treated successfully for a complete agenesis of the anterior (ACL) and posterior (PCL) cruciate ligament with single-sitting ACL and PCL reconstruction.
View Article and Find Full Text PDFBioengineering (Basel)
January 2025
Department of Orthopaedic Surgery, University of Illinois at Chicago, Chicago, IL 60612-7342, USA.
The anterior cruciate ligament (ACL) is a major ligament in the knee joint, and its function is crucial for both the movement and stability of the knee. Our research takes a novel approach by investigating the effect of meniscus tears on the ACL, how such tears will impact the stress on the ACL, and its overall compensation in response to the changes in the meniscus. : This study aims to investigate how the ACL compensates for the change in knee joint stability and contact pressures due to partial horizontal cleavage tears (HCTs) in the meniscus, such as partial meniscectomy and partial transplantation on knee joint stability and contact pressures.
View Article and Find Full Text PDFBioengineering (Basel)
January 2025
Department of Physiology, School of Medicine, University of Patras, Asklepiou Street 1, Rio, 26504 Patras, Greece.
The anterior cruciate ligament (ACL) is one of the most injured ligaments, with approximately 100,000 ACL reconstructions taking place annually in the United States. In order to successfully manage ACL rupture, it is of the utmost importance to understand the anatomy, unique physiology, and biomechanics of the ACL, as well as the injury mechanisms and healing capacity. Currently, the "gold standard" for the treatment of ACL ruptures is surgical reconstruction, particularly for young patients or athletes expecting to return to pivoting sports.
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