Clinics in sports medicine

Cover......Page 1
Foreword......Page 2
Preface......Page 3
Biology of Autograft and Allograft Healing in Anterior Cruciate Ligament Reconstruction......Page 5
Tendon-to-Bone Healing in Anterior Cruciate Ligament Reconstruction......Page 6
Bone-to-Bone Healing in Anterior Cruciate Ligament Reconstruction......Page 13
Intra-Articular Graft Healing......Page 14
Allograft Healing in Anterior Cruciate Ligament Reconstruction......Page 15
References......Page 17
Bone-Patella Tendon-Bone Autograft Anterior Cruciate Ligament Reconstruction......Page 21
Preoperative Evaluation......Page 22
Diagnostic Arthroscopy......Page 23
Graft Harvest......Page 24
Arthroscopy and Notch Preparation......Page 26
Notchplasty......Page 27
Tibial Tunnel Placement......Page 28
Femoral Tunnel Placement......Page 30
Fixation......Page 32
Femoral Tunnel Fixation......Page 33
Tibial Tunnel Fixation......Page 34
Rehabilitation......Page 35
Complications......Page 36
Outcomes......Page 37
References......Page 39
Rationale for Using the Contralateral Patellar Tendon Autograft......Page 44
Preoperative Rehabilitation......Page 45
Femoral Tunnel......Page 46
Fixation with Buttons......Page 47
Postoperative Rehabilitation......Page 48
Anterior cruciate ligament-reconstructed knee......Page 49
Graft-donor knee......Page 51
Anterior cruciate ligament-reconstructed knee......Page 52
Graft-donor knee......Page 53
Return to Competition......Page 55
Results of Using the Contralateral Patellar Tendon Graft......Page 56
Discussion......Page 57
References......Page 58
History......Page 61
Tibial Fixation......Page 62
Femoral Fixation......Page 63
Tunnel Placement......Page 64
Patient Positioning......Page 65
Tendon harvest......Page 66
Portal placement......Page 68
Tibial tunnel placement......Page 69
Femoral tunnel placement......Page 72
Preparing the WasherLoc......Page 73
EZLoc sizing and insertion......Page 74
WasherLoc tibial fixation......Page 76
Postoperative Care and Rehabilitation......Page 77
References......Page 78
Quadriceps Tendon-A Reliable Alternative for Reconstruction of the Anterior Cruciate Ligament......Page 80
Technique of Central Quadriceps Free Tendon Anterior Cruciate Ligament Reconstruction......Page 81
Clinical Outcomes of Anterior Cruciate Ligament Reconstruction Using the Quadriceps Tendon......Page 84
References......Page 87
Allograft Use in the United States......Page 90
Infection History......Page 92
Graft Procurement and Preparation......Page 93
Efficacy of Allograft in Anterior Cruciate Ligament Reconstruction......Page 95
Summary......Page 96
References......Page 97
Graft Choice......Page 99
Tissue Banking and Allograft Preparation......Page 100
Allograft Choice......Page 101
Bone-Patellar Tendon-Bone Allograft Surgical Technique......Page 102
Allograft Preparation......Page 103
Tibial Tunnel and Notch Preparation......Page 104
Femoral Tunnel......Page 106
Graft Passage and Fixation......Page 107
Bone Block Preparation......Page 110
Rehabilitation......Page 111
References......Page 112
Freeze-Dried Allografts for Anterior Cruciate Ligament Reconstruction......Page 116
Allograft Processing......Page 117
Freeze-Dried Allografts: Mechanical Properties......Page 118
Freeze-Dried Allografts: Biologic Incorporation, Immunogenicity, and Disease Transmission......Page 119
Basic Science Outcomes: Freeze-Dried Bone-Patellar Tendon-Bone and Soft Tissue Tendon......Page 120
Clinical Outcomes: Freeze-Dried Allograft Constructs......Page 121
Freeze-Dried Allograft: Summary of Advantages and Disadvantages......Page 123
Future Directions: Anterior Cruciate Ligament Allograft......Page 124
References......Page 125
Rationale for Double-Bundle Reconstruction......Page 129
Surgical Technique: Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction......Page 132
Surgical Technique: Single-Bundle Augmentation......Page 138
Clinical Results: Double-Bundle Reconstruction......Page 140
Graft Choice: Double-Bundle Reconstruction......Page 141
The Future......Page 143
References......Page 145
Clinical Outcomes of Allograft Versus Autograft in Anterior Cruciate Ligament Reconstruction......Page 151
Clinical Outcomes of Autograft versus Allograft Reconstruction......Page 152
Disease Transmission and Infection......Page 160
Graft Biomechanical Properties and Incorporation......Page 163
Summary......Page 165
References......Page 166
Peripheral Versus Aperture Fixation for Anterior Cruciate Ligament Reconstruction......Page 172
Biomechanics......Page 173
Clinical Results......Page 177
References......Page 178
Biomechanics of Intratunnel Anterior Cruciate Ligament Graft Fixation......Page 183
Limitations of Biomechanical Studies......Page 184
Bone Mineral Density......Page 187
Bone-Patella Tendon-Bone Fixation......Page 188
Soft Tissue Grafts......Page 191
Alternative Intratunnel Tibial Fixation Techniques......Page 195
Hybrid Fixation......Page 196
Clinical Studies......Page 197
Future Directions......Page 198
References......Page 199