Current thinking of ACL reconstruction
Discussion in 2015 with the Clinical Editor Dr Sheila Strover
The small details can matter in ACL reconstruction
- Surgeons need to better understand the anatomy, especially with regard to the pivot shift and instability
- It is important to assess in particular the anterolateral ligament (the rotational stabiliser of the knee)
- It has become evident that the ACL remnant is important because of its nerve supply, and surgeons are using a new augmentation device of FibreTape wrapped in a porcine scaffold to help preserve the remnant
- Technically the inside-out drilling through an accessory antero-medial portal allows correct identification of the footprint of the ACL, and preserves more bone for any future revision