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Graft impingement in anterior cruciate ligament reconstruction

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Anterior cruciate ligament (ACL) graft impingement is one of the most troubling complications in ACL reconstruction. In the previous strategy of isometric “non-anatomical” ACL reconstruction, posterior tibial tunnel placement and notchplasty were recommended to avoid graft impingement. Recently, the strategy of ACL reconstruction is shifting towards “anatomical” reconstruction. In anatomical ACL reconstruction, the potential risk of graft impingement is higher than in non-anatomical reconstruction because the tibial tunnel is placed at a more anterior portion on the tibia. However, there have been few studies reporting on graft impingement in anatomical ACL reconstruction. This study will provide a review of graft impingement status in both non-anatomical and the more recent anatomical ACL reconstruction techniques. In conclusion, with the accurate creation of bone tunnels within ACL native footprint, the graft impingement might not happen in anatomical ACL reconstruction. For the clinical relevance, to prevent graft impingement, surgeons should pay attention of creating correct anatomical tunnels when they perform ACL reconstruction. Level of evidence IV.

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Abbreviations

ACL:

Anterior cruciate ligament

AM:

Antero-medial

PCL:

Posterior cruciate ligament

PL:

Postero-lateral

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Acknowledgements

The authors did not receive any outside funding or grants in support of their research for or preparation of this work.

Conflict of interest

The authors declared that they have no conflicts of interest in the authorship and publication of this contribution.

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Authors and Affiliations

  1. Division of Rehabilitation Medicine, Gunma University Hospital, Maebashi City, Showa-machi, Gunma, 3-39-15, Japan

    Takanori Iriuchishima & Kenji Shirakura

  2. Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA

    Freddie H. Fu

Authors
  1. Takanori Iriuchishima
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  2. Kenji Shirakura
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  3. Freddie H. Fu
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Correspondence to Takanori Iriuchishima.

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Iriuchishima, T., Shirakura, K. & Fu, F.H. Graft impingement in anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 21, 664–670 (2013). https://doi.org/10.1007/s00167-012-2014-6

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  • DOI: https://doi.org/10.1007/s00167-012-2014-6

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