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Historical and Current Perspectives in the Treatment of Anterior Cruciate Ligament Insufficiency

  • R. P. Jakob
  • J. P. Warner

Abstract

The treatment of anterior cruciate ligament (ACL) insufficiency continues to be a significant problem in orthopedic practice. Although the current problems are well known and have been identified, many questions remain unanswered. Major procedural differences and the contradictory results of many workers attest to the fact that there is still no general consensus regarding the natural history, management, and biomechanics of the knee with anterior instability. To appreciate the complexity of these problems, we must first understand the historical foundations laid by our predecessors. Otherwise we risk repeating previous mistakes or making “new” discoveries that actually are rediscoveries of previously known facts. A grasp of history is essential if we are to explore new areas in ACL surgery. A chronologic summary of historical milestones relating to the ACL and its injuries is presented in Table 1. Galen of Pergamum and Rome is credited with first describing the anatomy and nature of the ACL. Before Galen it was thought that the cruciate ligaments were part of the nervous system and had contractile properties. Galen developed the concept of these ligaments as static stabilizing structures that limit abnormal motion in diarthrotic joints. During the next 1600 years, scant attention was given to the knee ligaments except in descriptions of dislocations and severe sprains.

Keywords

Anterior Cruciate Ligament Anterior Cruciate Ligament Reconstruction Pivot Shift Tear Anterior Cruciate Ligament Anterior Cruciate Ligament Surgery 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag Berlin Heidelberg 1992

Authors and Affiliations

  • R. P. Jakob
  • J. P. Warner

There are no affiliations available

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