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No ideal graft site for ACL reconstruction exists. Surgeons have historically regarded patellar tendon grafts as the "gold standard" for knee stability. [15] Hamstring autografts have failed at a higher rate than bone-tendon-bone autografts, after short- to mid-term followup of primary ACL reconstruction.
ACL reconstruction surgery involves replacing the torn ACL with a "graft," which is a tendon taken from another source. Grafts can be taken from the patellar tendon, hamstring tendon, quadriceps tendon from either the person undergoing the procedure (" autograft ") or a cadaver (" allograft ").
The first report focused on children and the timing of an ACL reconstruction. ACL injuries in children are a challenge because children have open growth plates in the bottom of the femur or thigh bone and on the top of the tibia or shin. An ACL reconstruction typically crosses the growth plates, posing a theoretical risk of injury to the growth ...
The knee is then flexed to 20°. Making sure the tibia remains in neutral rotation, a varus force is used to ensure there is no medial compartment gapping of the knee. The sMCL graft is then tightened and fixed with a bioabsorbable screw. [27] The final step of reconstruction ligament fixation is the proximal tibial attachment of the sMCL.
Allograft (taken from a cadaver) patellar tendon, Achilles tendon, semitendinosus, gracilis, or posterior tibialis tendon; The goal of reconstruction surgery is to prevent instability and restore the function of the torn ligament, creating a stable knee. There are certain factors that the patient must consider when deciding for or against surgery.
Most PLC injuries accompany an ACL or PCL tear, and can contribute to ACL or PCL reconstruction graft failure if not recognized and treated. [ 47 ] [ 48 ] A study by LaPrade et al. in 2007 showed the incidence of posterolateral knee injuries in patients presenting with acute knee injuries and hemarthrosis (blood in the knee joint) was 9.1%.
The anterior cruciate ligament (ACL) should be intact, [11] although this is debated by clinicians for people who need a medial compartment replacement. [2] For people needing a lateral compartment replacement, the ACL should be intact and is contraindicated for people with ACL-deficient knees because the lateral component has more motion than ...
The quality of the repair tissue after these "bone marrow stimulating techniques" depends on various factors including the species and age of the individual, the size and localization of the articular cartilage defect, the surgical technique, e.g., how the subchondral bone plate is treated, and the postoperative rehabilitation protocol.