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Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 18, Issue 9, pp 1154–1163 | Cite as

The anatomic approach to primary, revision and augmentation anterior cruciate ligament reconstruction

  • Carola F. van Eck
  • Verena M. Schreiber
  • T. Thomas Liu
  • Freddie H. Fu
Knee

Abstract

The anatomic approach is gaining popularity in anterior cruciate ligament (ACL) reconstruction. It is predominantly applied during primary ACL reconstruction. However, following the same principles as during primary surgery, the anatomic approach can also be applied during revision and augmentation surgery. This paper discusses the surgical technique for anatomic single- and double-bundle ACL reconstruction, for primary, revision and augmentation surgery. During primary reconstruction, the choice for single- or double-bundle reconstruction and graft size should be based on ACL insertion site and femoral intercondylar notch dimensions. When there is an isolated anteromedial (AM) or posterolateral (PL) bundle rupture, augmentation of a single-bundle can be performed while protecting the integrity of the intact bundle. Especially during revision surgery, there are many potential situations the surgeon may encounter when entering the knee. There are multiple possible solutions for all of these different situations leading to an anatomic end result. Three-dimensional computed tomography (CT) scanning should be used to evaluate the current tunnel positions and determine the operative strategy.

Keywords

Anterior cruciate ligament ACL Anatomic Primary reconstruction Revision Augmentation 

Notes

Acknowledgments

Our department receives funding from Smith and Nephew to support research related to reconstruction of the ACL. The research that forms the basis for this manuscript was done at our institution.

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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Carola F. van Eck
    • 1
    • 2
  • Verena M. Schreiber
    • 1
  • T. Thomas Liu
    • 1
  • Freddie H. Fu
    • 1
  1. 1.Department of Orthopaedic SurgeryUniversity of Pittsburgh Medical CenterPittsburghUSA
  2. 2.Orthopaedic Research Centre AmsterdamAcademic Medical CenterAmsterdamThe Netherlands

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