The Anterior Cruciate Ligament

Section 1: Anatomy and Genetics of ACL Injury

1. Anatomy and Biomechanics of the ACL

2. Genetic Influences on ACL Injury

3. The Association Between ACL Tear and Femoro-Aceteblar Impingement

Section 2: Mechanism, Incidence and Epidemiology of ACL Injury

4. Mechanisms of Noncontact Anterior Cruciate Ligament Injuries

5. Risk and Gender Factors for Noncontact Anterior Cruciate Ligament Injury

6. Risk of ACL injury as a function of type of Playing Surface

7. The Incidence of Anterior Cruciate Ligament Injury as a Function of Gender, Sport, and Injury-Reduction Programs

8. Analysis of ACL Injury Prevention Programs for the Female Athlete

Section 3: Diagnosis and Treatment of ACL tears

9. Diagnosis of Anterior Cruciate Ligament Tear

10. MRI for the diagnosis and treatment of ACL tears

11. Nonoperative Management of Anterior Cruciate Ligament Deficient Patients

Section 4: Economics of ACLR

12. The Economics of Anterior Cruciate Ligament Tear and Reconstruction

13. An Economic Analysis of ACL Tear Treatment: 1. Reconstruction versus Rehabilitation and 2. Early Reconstruction versus Rehabilitation with Optional Late Reconstruction

Section 5: Graft Mechanical Properties

14. The Relative Strengths of Anterior Cruciate Ligament Autografts and Allografts

15. Comparative and Morphological Analysis of Commonly Used Autografts for Anterior Cruciate Ligament Reconstruction with the Native ACL: An Electron, Microscopic and Morphologic Study

Section 6: Graft Choices

16. The Case for the Bone-Patellar Tendon-Bone Autograft with ACL Reconstruction

17. The Case for Hamstring ACL Reconstruction

18. The case for Quadriceps Autograft

19. Current Status on Synthetic Grafts

Section 7: Graft Harvest Techniques, Preparation and Complications

20. Hamstring Harvest Technique for ACL Reconstruction

21. Posterior Mini-Incision Hamstring Harvest Approach for Anterior Cruciate Ligament Reconstruction

22. Technique for Harvesting a Mid-Third Patella Tendon Graft for Anterior Cruciate Ligament Reconstruction

23. The Central Quadriceps Free Tendon for Anterior Cruciate Ligament Reconstruction

24. Hamstring Anterior Cruciate Ligament Reconstruction with a Quadrupled or Tripled Semitendinosus Tendon Graft

25. 5- and 6-Strand Hamstring Tendon Graft Preparation for Single-Bundle Hamstring ACL Reconstruction

26. Harvest Complications and Donor Site Morbidity: Hamstring Grafts

27. Harvest Complications and Morbidity of Patellar Tendon Harvest for BPTB ACL Reconstruction

28. Harvest Complications and Donor Site Morbidity: Quadriceps Grafts

29. Chemical sterilization techniques for Allograft preparation for ACLR

30. Radiation Sterilization techniques for Allograft preparation for ACLR

31. Hamstring Regeneration Following Harvest for ACL Reconstruction: A Review of the Current Literature

32. Regeneration of the Donor Site After Bone-Patellar Tendon-Bone Graft Harvest for ACL Reconstruction, and Possible Enhanced Regeneration Using Platelet Rich Plasma

Section 8: Reconstruction Techniques

33. Pearls for ACL Reconstruction

34. Anterior Cruciate Ligament Reconstruction Using Hamstrings in Press-Fit Technique Without Hardware

35. Anterior Cruciate Ligament Reconstruction with Quadriceps Tendon Autograft

36. Three Portal Technique for Anatomic Single-Bundle ACL Reconstruction

37. Anatomical Double-Bundle Anterior Cruciate Ligament Reconstruction Procedure Using the Semitendinosus and Gracilis Tendons

38. Anatomical Double-Bundle Anterior Cruciate Ligament Reconstruction with a Semitendinosus Hamstring Tendon Graft

39. Anatomic Double-Bundle Reconstruction of the Anterior Cruciate Ligament

40. Augmented Grafts: Synthetic/Allograft/Autograft

41. A Systematic Review of Single vs Double Bundle Results

Section 9: Principles of Tunnel Formation

42. Trans Tibial Tunnel Drilling of the Femoral Tunnel for Anatomic Single Bundle ACL Reconstruction

43. The Anteromedial Portal for Anterior Cruciate Ligament Reconstruction

44. Intraoperative Fluoroscopy for ACL Tunnel Placement

45. ACL All-Inside Retroconstruction: Single- and Double-Bundle Techniques

46. SwitchCut all inside tunnel formation

47. Use of the Pinpoint Guide System for ACL Reconstruction

48. Femoral Tunnel Placement to Restore Normal Knee Laxity After ACL Reconstrution

49. A Description of the Direct Femoral Attachment of the ACL: Implication for Femoral Tunnel Placement in Reconstruction

50. Use of Versitomic Flexible Reamer System for ACL Reconstruction

Section 10: Control of Pain in ACLR

51. Risks and Benefits of Femoral Nerve Block for ACLR

52. Saphenous Nerve Block for ACL Reconstruction

53. Efficacy of Cryotherapy for postoperative ACL Reconstruction Analgesia

54. Chondrolysis: Risk Benefit Analysis of Caine Local Anesthetics for ACL Reconstruction

55. Use of Preoperative Gabapentin for Postoperative Pain Relief After ACL Reconstruction

56. Obturator and Sciatica Nerve Block for ACL Reconstruction

Section 11: Additional Surgical Considerations

57. Notch Anatomy and Notchplasty

58. Computer-Assisted Navigation for Anterior Cruciate Ligament Reconstruction

59. Sparing the ACL Remnant: Is it worth the hassle?

60. Graft Tensioning in Anterior Cruciate Ligament Reconstruction

61. The Use of CO2 instead of fluid in Arthroscopic ACL Reconstruction

Section 12: Fixation Biomechanics

62. Intratunnel ACL Graft Fixation

63. Biomechanical Considerations of Suspensory Cortical Fixation Devices

Section 13: Soft-Tissue Graft Cortical Fixation

64. Endobutton Anterior Cruciate Ligament Reconstruction Femoral Fixation

65. Cortical Screw Post Femoral Fixation Using Whipstitches, Fabric Loop or Endobutton: the Universal Salvage

66. Arthrex Tightrope Fixation of a Soft Tissue Graft

67. RigidLoop Femoral Fixation Techniques

68. MedShape Exo Shape Fixation

69. Biomet ToggleLoc

70. EZLoc : Optimizing Femoral Fixation for Soft Tissue Graft Anterior Cruciate Ligament Reconstruction

Section 14: Soft-Tissue Graft Interference Screw Fixation

71. Hamstring Tendon Interference Screw Fixation

72. Cayenne Aperfix Fixation

73. Milagro Advance (Beta-Tricalcium Phosphate, Poly Lactide Co-Glycolide Biocomposite) Interference Screw for ACL Reconstruction

74. Hamstring ACL Reconstruction with BioIntraFix Femoral Fastener

75. ComposiTCP Fixation

76. Bioabsorbable Versus Metal Interference Screws: Adverse Events and Clinical Results

77. Use of TunneLoc for Anterior Cruciate Ligament Reconstruction

78. Improving Biodegradable Interference Screw Properties by Combining Polymers

Section 15: Soft-Tissue Graft Tibial Fixation

79. Whipstitch-Post Tibial Fixaton for ACL Reconstruction

80. WasherLoc: Optimizing Tibial Fixation of Soft Tissue Grafts used for Anterior Cruciate Ligament Reconstruction

81. Hamstring Anterior Cruciate Ligament Reconstruction with INTRAFIX and BioINTRAFIX Tibial Fastener Systems

Section 16: BTB Graft Fixation

82. Interference Screw Fixation in Bone-Patellar Tendon-Bone ACL Reconstruction

83. Use of the Tightrope BTB for ACL Reconstruction

84. Anterior Cruciate Ligament Reconstruction Using a Mini-Arthrotomy Technique with Either an Ipsilateral or a Contralateral Autogenous Patellar Tendon Graft

85. ACL Reconstruction using ENDOBUTTON CL BTB Fixation System: For both Antero-Medial and Transtibial Reaming of the Femoral Tunnel

Section 17: Graft Healing and Ligamentization

86. Graft Remodeling and Ligamentization After ACL Reconstruction

87. Graft-tunnel healing

88. Graft Length in the Tunnel in Anterior Cruciate Ligament Reconstruction

Section 18: Revision ACLR

89. Revision ACL Reconstruction Using Autologous Hamstring Tendons

90. Hamstring Four to Six Strand Double Bundle Graft for Revision or High Risk Primary ACL Reconstruction

91. Revision Anterior Cruciate Ligament Reconstruction with Bone-Patellar Tendon-Bone Autograft

92. Revision ACL Reconstruction: Management of Femoral Tunnel Malposition

93. Revision Anterior Cruciate Ligament Reconstruction - the MARS Study

Section 19: ACLR in Skeletally Immature Patients

94. Techniques and Complications of Transphyseal Anterior Cruciate Ligament Reconstruction in the Skeletally Immature Patient

95. An Overview of the Diagnosis and Treatment of the Torn ACL in the Skeletally Immature Athlete

96. Operative Versus Nonoperative Treatment and Timing of Surgery in Skeletally Immature Patients with ACL Tear

Section 20: ACL Partial Tears

97. Partial Tear of the Anterior Cruciate Ligament: Management with One Bundle Augmentation Technique

98. Acute ACL Rupture: A Biological Approach Through Primary ACL Repair; Augmentation with Bone Marrow Stimulation; Growth Factor Injection

99. Anterior Cruciate Ligament Reconstruction of Partial Tears: Isolated Single Bundle Reconstruction

100. Sonographically Guided Anterior Cruciate (ACL) Injection: Technique and Potential Use for the Treatment of Partial ACL Tear

Section 21: Associated Injuries of the Bone, Ligament, Meniscus, Cartilage and Nerve

101. Anterior Cruciate Ligament Injury Combined with Medial Collateral Ligament, Posterior Cruciate Ligament, and/or Lateral Collateral Ligament Injury

102. Treatment of Meniscus Tears with Anterior Cruciate Ligament Reconstruction

103. Meniscal repair with ACLR

104. Anterior Cruciate Ligament Reconstruction Combined with High-Tibial Osteotomy, Autologous Chondrocyte Implantation, Microfracture, Osteochondral, and/or Meniscal Allograft Transplantation

105. ACL-Deficiency in the Varus-Angulated Knee: Diagnosis, Surgical Techniques, Clinical Outcomes

106. W6: The Treatment of Combined Posterolateral Knee Injures and Anterior Cruciate Ligament Tears

107. ACLR Related Bone Contusions: Association with Intrarticular Injury, Pain and Outcomes

108. Ganglion Cyst

Section 22: ACLR and UKA

109. Indications for Anterior Cruciate Ligament Reconstruction in ACL Deficient Patients undergoing Unicondylar Knee Arthroplasty

110. Techniques for Combined ACLR and UKA

Section 23: Rehabilitation

111. ACL Strain Behavior During Rehabilitation Exercises

112. Principles of ACL Rehabilitation

113. The Stability-Conservative ACL Reconstruction Rehabilitation Protocol

114. Proprioception and ACL Reconstruction

115. Functional Bracing for ACL Injuries: Current State and Future Direction

116. Prehabilitation Before ACLR

Section 24: Outcomes After ACLR

117. Stability Results After ACL Reconstruction

118. Health Related Quality of Life After ACLR

119. Allografts Have Higher Failure Rates Than Autografts in Anterior Cruciate Ligament Reconstruction in Young, Active Patients

120. Factors Associated With the Increased Allograft Failure Rate In ACL Reconstruction

121. Are Articular Cartilage Lesions and Meniscus Tears Predictive of IKDC, KOOS, and Marx Activity Level Outcomes After ACLR

122. Arthrosis Following ACL Tear and Reconstruction

123. Criteria for Return to Sports After ACLR

124. A comparison of the Standardized Rating Forms for Evaluation of ACL Injured or Reconstructed Patients

Section 25: Patient Factors that Contribute to Success or Failure

125. ACLR Outcomes as a Function of Age

126. BMI and Weight Effects on the Results of ACLR

127. The Effects of Smoking on ACLR Outcomes

128. Psychological Predictors of ACLR Outcomes

Section 26: Return to Sports

129. Anterior Cruciate Ligament Reconstruction in Patients with Hereditary Abnormalities Involving Connective Tissue

130. Performance and Return to Sport After Anterior Cruciate Ligament Reconstruction in Skiers and Snowboarders

131. Return to play and future ACL Injury Risk After ACL reconstruction in Soccer Players

132. Return to American Football After ACL Reconstruction

Section 27: Complications

133. Infections in ACL Surgery

134. Osteoporosis After ACL Reconstruction?

135. Tunnel Widening After ACL Reconstruction

136. Numbness/Saphenous Nerve

137. Hardware Complications After ACL Reconstruction

138. Vascular Complications After ACL Reconstruction and DVT prophylaxis

139. Fracture Complications After ACL Reconstruction

140. Anterior Knee Problems After ACL Reconstruction

141. Stiffness: Prevention and Treatment

142. Treatment of Tibial Eminence Fractures: A Systematic Review

Section 28: Gait Analysis and ExtraArticular Reconstruction

143. Gait Analysis in ACL Deficient and Reconstructed Knees

144. Extra-Articular Tenodesis and ACL Recontruction: Techniques and Outcomes

Section 29: Tissue Engineering and the Future

145. Growth Factors and Other New Methods for Graft-Healing Enhancement

146. The Future Possibilities of Biologic ACLR