By Mitsuo Ochi, Konsei Shino, Kazunori Yasuda, Masahiro Kurosaka
This quantity offers targeted details on surgically proper anatomy and histology of the anterior cruciate ligament (ACL), biomechanics, diagnostics, and ACL reconstruction. In mild of the growing to be physique of facts demonstrating some great benefits of anatomic ACL reconstruction over conventional equipment, there also are discussions of unmarried anteromedial package reconstruction and anatomic ACL reconstruction with considerable descriptions of experimental and scientific experiences. additionally, specific recognition is given not just to concepts similar to ACL augmentation, bone-patella tendon-bone reconstruction and computer-assisted navigation, however it additionally provides specialist research of revision of ACL reconstruction, problems, and the longer term views of ACL reconstruction. Edited by means of authoritative orthopedic healthcare professional from the japanese Orthopaedic Society of Knee, Arthroscopy and activities medication (JOSKAS), this booklet presents up to date info for orthopedic surgeons and actual therapists focusing on the ACL. The learn proof will expand readers’ realizing and permit them to optimize results for sufferers. As ACL rupture is a typical damage specifically for high-level athletes, it is going to additionally allure activities running shoes and workforce physicians who're attracted to a up to date replace in this field.
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Extra info for ACL Injury and Its Treatment
The lateral meniscus attaches to the base of lateral groove and the lateral aspect of the protrusion with connective tissue. AC: articular cartilage of lateral tibial plateau. White dot area: connective tissue (CT) of anterior horn of lateral meniscus. Black dash line: bony protrusion of ACL tibial footprint. 1 mm , and the morphology of the attachment also varies by case, such as oval and triangular attachments . There were various interpretations of ACL components including single bundle [9, 10], double bundle [11, 12], and triple bundle , while the arrangement of these components at the tibial footprint was widely varied.
The insertion part forms an ellipsoid or anterior truncated ellipsoid shape (Figs. 3). The AM bundle occupies most of the proximal part, and the PL bundle occupies the distal part. In cases of triplebundle separation, the AM-L bundle occupies the anterior part, and the AM-M bundle occupies the posterior part of the insertion of the AM bundle. According to Ferretti et al. , the femoral insertion has a ridge, named the lateral bifurcate ridge, indicating the boundary between the AM and PL bundles.
Although the ACL attaches anteriorly at the base of the groove, in terms of its histology, the lateral meniscus attaches to the base of lateral groove and the lateral aspect of the protrusion mediated by connective tissue as the attachment site moves posteriorly (Fig. 4). 5 Posterior Border of ACL Tibial Footprint Under gross observation, fibrous tissue was found between the medial intercondylar tubercles, tibial ACL ridge, and ACL. A careful removal of these tissues revealed that ligaments were attached to the medial intercondylar tubercle; however, these ligaments were not attached to the ACL tibial ridge and the intertubercular fossa (Fig.