Skip to main content
SpringerLink
Log in

Isoanatomical bone-patellar tendon-bone single-bundle ACL reconstruction: the wedge that gives the edge!

  • Technical Note
  • Published:
European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

The purpose of the present paper is to describe the isoanatomical, single bundle, bone-patellar tendon-bone A3B-ACL reconstruction technique (A3B = Anatomical Bruderholz, Burkart, Biedert) in detail. The technical key factors and the pitfalls are highlighted. In addition, the pros and cons of the technique are discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

References

  1. Howell SM (1998) Principles for placing the tibial tunnel and avoiding roof impingement during reconstruction of a torn anterior cruciate ligament. Knee Surg Sports Traumatol Arthrosc 6(1):S49–S55

    Article  PubMed  Google Scholar 

  2. Howell SM, Clark JA (1992) Tibial tunnel placement in anterior cruciate ligament reconstructions and graft impingement. Clin Orthop 283:187–195

    PubMed  Google Scholar 

  3. Reat JF, Lintner DM (1997) One-versus two-incision ACL reconstruction. A prospective, randomized study. Am J Knee Surg 10(4):198–208

    PubMed  CAS  Google Scholar 

  4. Lohmander LS, Ostenberg A, Englund M, Roos H (2004) High prevalence of knee osteoarthritis, pain, and functional limitations in female soccer players twelve years after anterior cruciate ligament injury. Arthritis Rheum 50(10):3145–3152

    Article  PubMed  CAS  Google Scholar 

  5. Fu FH, Ranawat A (2007) Tensioning in double-bundle ACL reconstruction. Arthroscopy 23(9):1027; author reply 1027-1028

    Google Scholar 

  6. Shino K, Nakata K, Nakamura N, Mae T, Ohtsubo H, Iwahashi T, Nakagawa S (2005) Anatomic anterior cruciate ligament reconstruction using two double-looped hamstring tendon grafts via twin femoral and triple tibial tunnels. Op Tech Orthop 15:130–134

    Article  Google Scholar 

  7. Siebold R, Dehler C, Ellert T (2008) Prospective randomized comparison of double-bundle versus single-bundle anterior cruciate ligament reconstruction. Arthroscopy 24(2):137–145

    Article  PubMed  Google Scholar 

  8. Kanaya A, Ochi M, Deie M, Adachi N, Nishimori M, Nakamae A (2009) Intraoperative evaluation of anteroposterior and rotational stabilities in anterior cruciate ligament reconstruction: lower femoral tunnel placed single-bundle versus double-bundle reconstruction. Knee Surg Sports Traumatol Arthrosc 17(8):907–913

    Article  PubMed  Google Scholar 

  9. Meredick RB, Vance KJ, Appleby D, Lubowitz JH (2008) Outcome of single-bundle versus double-bundle reconstruction of the anterior cruciate ligament: a meta-analysis. Am J Sports Med 36(7):1414–1421. doi:10.1177/0363546508317964

    Article  PubMed  Google Scholar 

  10. Arnold MP, Verdonschot N, van Kampen A (2005) ACL graft can replicate the normal ligament’s tension curve. Knee Surg Sports Traumatol Arthrosc 13(8):625–631

    Article  PubMed  Google Scholar 

  11. Bernard M, Hertel P, Hornung H, Cierpinski T (1997) Femoral insertion of the ACL. Radiographic quadrant method. Am J Knee Surg 10(1):14–21

    PubMed  CAS  Google Scholar 

  12. Deehan DJ, Pinczewski L (2002) How I do it: Endoscopic anterior cruciate ligament reconstruction using a four strand hamstring tendon construct. J R Coll Surg Edinb 47:428–436

    PubMed  CAS  Google Scholar 

  13. Dye SF, Cannon WD Jr (1988) Anatomy and biomechanics of the anterior cruciate ligament. Clin Sports Med 7(4):715–725

    PubMed  CAS  Google Scholar 

  14. Garofalo R, Mouhsine E, Chambat P, Siegrist O (2006) Anatomic anterior cruciate ligament reconstruction: the two-incision technique. Knee Surg Sports Traumatol Arthrosc 14(6):510–516

    Article  PubMed  Google Scholar 

  15. Gill TJ, Steadman JR (2002) Anterior cruciate ligament reconstruction the two-incision technique. Orthop Clin North Am 33(4):727–735, vii

    Google Scholar 

  16. Loh JC, Fukuda Y, Tsuda E, Steadman RJ, Fu FH, Woo SL (2003) Knee stability and graft function following anterior cruciate ligament reconstruction: Comparison between 11 o’clock and 10 o’clock femoral tunnel placement. Arthroscopy 19(3):297–304

    Article  PubMed  Google Scholar 

  17. Markolf KL, Hame SL, Hunter DM, Oakes DA, Zoric B, Gause P, Finerman GA (2002) Effects of femoral tunnel placement on knee laxity and forces in an anterior cruciate ligament graft. J Orthop Res 20:1016–1024

    Article  PubMed  Google Scholar 

  18. Scopp JM, Jasper LE, Belkoff SM, Moorman CT 3rd (2004) The effect of oblique femoral tunnel placement on rotational constraint of the knee reconstructed using patellar tendon autografts. Arthroscopy 20(3):294–299

    Article  PubMed  Google Scholar 

  19. Duquin TR, Wind WM, Fineberg MS, Smolinski RJ, Buyea CM (2009) Current trends in anterior cruciate ligament reconstruction. J Knee Surg 22(1):7–12

    Article  PubMed  Google Scholar 

  20. Hospodar SJ, Miller MD (2009) Controversies in ACL reconstruction: bone-patellar tendon-bone anterior cruciate ligament reconstruction remains the gold standard. Sports Med Arthrosc 17(4):242–246

    Article  PubMed  Google Scholar 

  21. Kopf S, Musahl V, Tashman S, Szczodry M, Shen W, Fu FH (2009) A systematic review of the femoral origin and tibial insertion morphology of the ACL. Knee Surg Sports Traumatol Arthrosc 17(3):213–219

    Article  PubMed  Google Scholar 

  22. Arnold MP, Kooloos J, van Kampen A (2001) Single-incision technique misses the anatomical femoral anterior cruciate ligament insertion: a cadaver study. Knee Surg Sports Traumatol Arthrosc 9(4):194–199

    PubMed  CAS  Google Scholar 

Download references

Conflict of interest

No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery and Traumatology, Kantonsspital Bruderholz, 4101, Bruderholz, Switzerland

    Markus P. Arnold & Michael T. Hirschmann

  2. Sportclinic Villa Linde, 2503, Biel, Switzerland

    Roland M. Biedert

  3. Rijnstate Ziekenhuis, NL 6815 AD, Arnhem, The Netherlands

    Corné van Loon

Authors
  1. Markus P. Arnold
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Roland M. Biedert
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Corné van Loon
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Michael T. Hirschmann
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Markus P. Arnold.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Arnold, M.P., Biedert, R.M., van Loon, C. et al. Isoanatomical bone-patellar tendon-bone single-bundle ACL reconstruction: the wedge that gives the edge!. Eur J Orthop Surg Traumatol 22, 77–80 (2012). https://doi.org/10.1007/s00590-011-0793-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00590-011-0793-y

Keywords

Search

Navigation