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Remodeling of Hamstring Tendon Grafts After ACL Reconstruction

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Anterior Cruciate Ligament Reconstruction

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Abstract

Anterior cruciate ligament (ACL) reconstruction techniques have been improved over the last 10 years, but graft failure is not uncommon: 0.7–10 % [1, 2]. Successful ACL reconstruction requires understanding of several factors: anatomical graft placement, mechanical properties of the selected graft tissue, mechanical behavior and fixation strength of fixation materials, as well as the biological processes that occur during graft remodeling, maturation, and incorporation. They influence directly the mechanical properties of the knee joint after ACL reconstruction and, therefore, determine the rehabilitation and time course until normal function of the knee joint can be expected [2–10]. Even though substantial research efforts have been published on various aspects of ACL reconstruction, there is limited knowledge on the biology of the human ACL graft [2, 4–8, 11–21]. Graft healing after ACL reconstruction occurs at two different sites: intra-tunnel graft incorporation [22, 23] and intra-articular graft remodeling, often referred to as “ligamentization” [2, 5, 6, 8, 9, 12, 20, 24, 25]. This chapter presents the current knowledge on intra-articular remodeling of ACL grafts with special focus on human hamstring autografts.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Orthopaedic Center Máxima, Máxima Medical Center, Ds. Th. Fliednerstraat 1, 5631 BM, Eindhoven, The Netherlands

    Rob P. A. Janssen MD, PhD

  2. Department of Orthopaedic Surgery, COPV – Chirurgisch Orthopädischer PraxisVerbund, Breitenbachplatz 8, 14195, Berlin, Germany

    Sven U. Scheffler PD Dr. med.

Authors
  1. Rob P. A. Janssen MD, PhD
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  2. Sven U. Scheffler PD Dr. med.
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Correspondence to Rob P. A. Janssen MD, PhD .

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Editors and Affiliations

  1. ATOS Hospital Heidelberg, Heidelberg, Germany

    Rainer Siebold

  2. Lyon Ortho Clinic, Lyon, France

    David Dejour

  3. Istituti Ortopedico Rizzoli Clinica Ortopedica Traumatologica III, Bologna, Italy

    Stefano Zaffagnini

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Janssen, R.P.A., Scheffler, S.U. (2014). Remodeling of Hamstring Tendon Grafts After ACL Reconstruction. In: Siebold, R., Dejour, D., Zaffagnini, S. (eds) Anterior Cruciate Ligament Reconstruction. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-45349-6_25

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  • DOI: https://doi.org/10.1007/978-3-642-45349-6_25

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