الفهرس | Only 14 pages are availabe for public view |
Abstract The ACL is a band of dense connective tissue that connects the femur and the tibia. The ligament is intraarticular but extra-synovial. The ligament originates at the medial side of the lateral femoral condyle and runs an oblique course through the intercondylar fossa distal–anterior–medial to the insertion at the medial tibial eminence. The ACL has been shown to be primary restraint to anterior tibial translation and secondary restraint to internal rotation of the knee. Anatomic ACL reconstruction must be defined as the reconstruction in which all 4 ends of 2 tendon grafts are grafted at the center of the anatomical attachment of the anteromedial (AM) and posterolateral (PL) bundles not on1y on the femur but also on the tibia. When the normal knee was subjected to a combined rotatory load, the in situ force of the PL bundle was 67% of the AM bundle at 15°. These studies suggested the importance of the PL bundle as a stabilizer against anterior and rotatory loads, especially when the knee is near the extension position, which is used in athletic activities. 2-bundle reconstruction provides better stability of the knee compared with the 1-bundle reconstruction under an anterior tibial load of 100 N. |