W e would like to congratulate Dr Frank Noyes for the publication of his article “The Function of the Human Anterior Cruciate Ligament and Analysis of Singleand Double-Bundle Graft Reconstructions” in the first issue of Sports Health (volume 1, issue 1, pp 66-75). In the article, Dr Noyes pointed out that the typical “tibial PL [posterolateral] to femoral AM [anteromedial]” tunnel placement is ...

Background/objective Anterior cruciate ligament (ACL) reconstructions often fail without graft rupture. The purpose of this study was to compare the characteristics of patients with elongated and ruptured bone-patellar tendon-bone (BTB) grafts that required revision surgery. Methods Twenty one patients who required revisions of a BTB-reconstructed ACL between 2010 and 2015 were enrolled in th...

PURPOSE To compare femoral graft bending angles and femoral tunnel geometries between the transportal (TP) and outside-in (OI) techniques after anatomic double-bundle (DB) anterior cruciate ligament (ACL) reconstruction. METHODS Thirty-nine patients underwent DB ACL reconstruction with the TP and OI techniques. They were randomized on the day of surgery to either the TP group (group I, 21 cas...

Bone defects caused by femoral and tibial tunnel enlargement can pose a significant technical challenge when planning to perform revision anterior cruciate ligament reconstruction. A number of options have been described for managing osseous deficiencies, including the use of large autograft or allograft bone dowels to provide sufficient tunnel fill and subsequent structural support for revisio...

We developed the anatomic rectangular tunnel anterior cruciate ligament reconstruction (ART ACLR) with a bone-patellar tendon-bone graft to mimic fibre arrangement inside the native ACL via tunnels with smaller apertures. With a 10-mm-wide graft, the cross-sectional area of the tunnels of 50 mm2 in ART ACLR is less than that of 79 mm2 in a 10-mm round tunnel one. Because tunnel encroachment wou...

Revision anterior cruciate ligament reconstruction has inherent technical challenges not encountered during primary reconstruction. Prior tunnel placement and tunnel lysis can significantly alter graft fixation, compromising patient outcome. Preoperative recognition of patients with existing tunnel overlap and severe tunnel lysis will allow appropriate surgical planning and patient counseling, ...

OBJECTIVE To compare the transtibial and two-incision techniques for anterior cruciate ligament (ACL) reconstruction using a single band. METHODS A prospective and randomized study was conducted in blocks. Patients underwent ACL reconstruction by means of two techniques: transtibial (group 1: 20 patients) or two incisions (group 2: 20 patients). The radiographic positioning of the tunnel, inc...

The WasherLoc is a tibial fixation device for soft tissue anterior cruciate ligament (ACL) reconstruction that combines superior fixation properties (945 N strength, 507 N/mm stiffness, and high resistance to slippage) with a simple surgical technique. The WasherLoc is a washer with 13 short spikes that penetrate the soft tissue ACL graft in multiple locations and 4 long peripheral spikes that ...