Skip to main content
Top
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 5/2014

01-05-2014 | Knee

The concept of individualized anatomic anterior cruciate ligament (ACL) reconstruction

Authors: M. Hofbauer, B. Muller, C. D. Murawski, C. F. van Eck, F. H. Fu

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 5/2014

Login to get access

Abstract

Purpose

To describe the concept of individualized anatomic anterior cruciate ligament (ACL) reconstruction.

Methods

The PubMed/Medline database was searched using keywords pertaining to ACL reconstruction. Relevant articles were reviewed in order to summarize important concepts of individualized surgery in ACL reconstruction. Surgical experiences with case examples are also highlighted.

Results

Individualized ACL surgery allows for the customization of surgery to each individual patient. Accounting for graft selection and other characteristics such as anatomy, lifestyle and activity preferences may provide the patient with the best potential for a successful outcome. The surgeon should be comfortable with a variety of graft harvests and surgical techniques when practicing individualized surgery.

Conclusion

Individualized anatomic ACL reconstruction is founded on the objective evaluation of functional anatomy and individual characteristics, thereby restoring the ACL as closely as possible to the native anatomy and function. The adoption and subsequent use of individualized surgery may facilitate improved clinical as well as objective outcomes, particularly in the long term.

Level of evidence

V.
Literature
1.
go back to reference Aglietti P, Giron F, Losco M, Cuomo P, Ciardullo A, Mondanelli N (2010) Comparison between single-and double-bundle anterior cruciate ligament reconstruction: a prospective, randomized, single-blinded clinical trial. Am J Sports Med 38:25–34PubMedCrossRef Aglietti P, Giron F, Losco M, Cuomo P, Ciardullo A, Mondanelli N (2010) Comparison between single-and double-bundle anterior cruciate ligament reconstruction: a prospective, randomized, single-blinded clinical trial. Am J Sports Med 38:25–34PubMedCrossRef
2.
3.
go back to reference Araujo PH, van Eck CF, Macalena JA, Fu FH (2011) Advances in the three-portal technique for anatomical single- or double-bundle ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 19:1239–1242PubMedCentralPubMedCrossRef Araujo PH, van Eck CF, Macalena JA, Fu FH (2011) Advances in the three-portal technique for anatomical single- or double-bundle ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 19:1239–1242PubMedCentralPubMedCrossRef
4.
go back to reference Baer GS, Harner CD (2007) Clinical outcomes of allograft versus autograft in anterior cruciate ligament reconstruction. Clin Sports Med 26:661–681PubMedCrossRef Baer GS, Harner CD (2007) Clinical outcomes of allograft versus autograft in anterior cruciate ligament reconstruction. Clin Sports Med 26:661–681PubMedCrossRef
5.
go back to reference Beyzadeoglu T, Akgun U, Tasdelen N, Karahan M (2012) Prediction of semitendinosus and gracilis autograft sizes for ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 20:1293–1297PubMedCrossRef Beyzadeoglu T, Akgun U, Tasdelen N, Karahan M (2012) Prediction of semitendinosus and gracilis autograft sizes for ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 20:1293–1297PubMedCrossRef
6.
go back to reference Chhabra A, Starman JS, Ferretti M, Vidal AF, Zantop T, Fu FH (2006) Anatomic, radiographic, biomechanical, and kinematic evaluation of the anterior cruciate ligament and its two functional bundles. J Bone Joint Surg Am 88(Suppl 4):2–10PubMedCrossRef Chhabra A, Starman JS, Ferretti M, Vidal AF, Zantop T, Fu FH (2006) Anatomic, radiographic, biomechanical, and kinematic evaluation of the anterior cruciate ligament and its two functional bundles. J Bone Joint Surg Am 88(Suppl 4):2–10PubMedCrossRef
7.
go back to reference Ferretti M, Ekdahl M, Shen W, Fu FH (2007) Osseous landmarks of the femoral attachment of the anterior cruciate ligament: an anatomic study. Arthroscopy 23:1218–1225PubMedCrossRef Ferretti M, Ekdahl M, Shen W, Fu FH (2007) Osseous landmarks of the femoral attachment of the anterior cruciate ligament: an anatomic study. Arthroscopy 23:1218–1225PubMedCrossRef
8.
go back to reference Giffin JR, Harner CD (2001) Failed anterior cruciate ligament surgery: overview of the problem. Am J Knee Surg 14:185–192PubMed Giffin JR, Harner CD (2001) Failed anterior cruciate ligament surgery: overview of the problem. Am J Knee Surg 14:185–192PubMed
9.
go back to reference Girgis FG, Marshall JL, Monajem A (1975) The cruciate ligaments of the knee joint. Anatomical, functional and experimental analysis. Clin Orthop Relat Res 106:216–231PubMedCrossRef Girgis FG, Marshall JL, Monajem A (1975) The cruciate ligaments of the knee joint. Anatomical, functional and experimental analysis. Clin Orthop Relat Res 106:216–231PubMedCrossRef
10.
go back to reference Heijne A, Werner S (2010) A 2-year follow-up of rehabilitation after ACL reconstruction using patellar tendon or hamstring tendon grafts: a prospective randomised outcome study. Knee Surg Sports Traumatol Arthrosc 18:805–813PubMedCrossRef Heijne A, Werner S (2010) A 2-year follow-up of rehabilitation after ACL reconstruction using patellar tendon or hamstring tendon grafts: a prospective randomised outcome study. Knee Surg Sports Traumatol Arthrosc 18:805–813PubMedCrossRef
11.
go back to reference Hofbauer M, Valentin P, Kdolsky R, Ostermann RC, Graf A, Figl M, Aldrian S (2010) Rotational and translational laxity after computer-navigated single- and double-bundle anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 18:1201–1207PubMedCrossRef Hofbauer M, Valentin P, Kdolsky R, Ostermann RC, Graf A, Figl M, Aldrian S (2010) Rotational and translational laxity after computer-navigated single- and double-bundle anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 18:1201–1207PubMedCrossRef
12.
go back to reference Hussein M, van Eck CF, Cretnik A, Dinevski D, Fu FH (2012) Individualized anterior cruciate ligament surgery: a prospective study comparing anatomic single- and double-bundle reconstruction. Am J Sports Med 40:1781–1788PubMedCrossRef Hussein M, van Eck CF, Cretnik A, Dinevski D, Fu FH (2012) Individualized anterior cruciate ligament surgery: a prospective study comparing anatomic single- and double-bundle reconstruction. Am J Sports Med 40:1781–1788PubMedCrossRef
13.
go back to reference Hussein M, van Eck CF, Cretnik A, Dinevski D, Fu FH (2012) Prospective randomized clinical evaluation of conventional single-bundle, anatomic single-bundle, and anatomic double-bundle anterior cruciate ligament reconstruction: 281 cases with 3- to 5-year follow-up. Am J Sports Med 40:512–520PubMedCrossRef Hussein M, van Eck CF, Cretnik A, Dinevski D, Fu FH (2012) Prospective randomized clinical evaluation of conventional single-bundle, anatomic single-bundle, and anatomic double-bundle anterior cruciate ligament reconstruction: 281 cases with 3- to 5-year follow-up. Am J Sports Med 40:512–520PubMedCrossRef
14.
go back to reference Illingworth KD, Hensler D, Working ZM, Macalena JA, Tashman S, Fu FH (2011) A simple evaluation of anterior cruciate ligament femoral tunnel position: the inclination angle and femoral tunnel angle. Am J Sports Med 39:2611–2618PubMedCrossRef Illingworth KD, Hensler D, Working ZM, Macalena JA, Tashman S, Fu FH (2011) A simple evaluation of anterior cruciate ligament femoral tunnel position: the inclination angle and femoral tunnel angle. Am J Sports Med 39:2611–2618PubMedCrossRef
15.
go back to reference Karlsson J, Irrgang JJ, van Eck CF, Samuelsson K, Mejia HA, Fu FH (2011) Anatomic single- and double-bundle anterior cruciate ligament reconstruction, part 2: clinical application of surgical technique. Am J Sports Med 39:2016–2026PubMedCrossRef Karlsson J, Irrgang JJ, van Eck CF, Samuelsson K, Mejia HA, Fu FH (2011) Anatomic single- and double-bundle anterior cruciate ligament reconstruction, part 2: clinical application of surgical technique. Am J Sports Med 39:2016–2026PubMedCrossRef
16.
go back to reference Kopf S, Pombo MW, Szczodry M, Irrgang JJ, Fu FH (2011) Size variability of the human anterior cruciate ligament insertion sites. Am J Sports Med 39:108–113PubMedCrossRef Kopf S, Pombo MW, Szczodry M, Irrgang JJ, Fu FH (2011) Size variability of the human anterior cruciate ligament insertion sites. Am J Sports Med 39:108–113PubMedCrossRef
17.
go back to reference Kropf EJ, Shen W, van Eck CF, Musahl V, Irrgang JJ, Fu FH (2013) ACL-PCL and intercondylar notch impingement: magnetic resonance imaging of native and double-bundle ACL-reconstructed knees. Knee Surg Sports Traumatol Arthrosc 21:720–725PubMedCrossRef Kropf EJ, Shen W, van Eck CF, Musahl V, Irrgang JJ, Fu FH (2013) ACL-PCL and intercondylar notch impingement: magnetic resonance imaging of native and double-bundle ACL-reconstructed knees. Knee Surg Sports Traumatol Arthrosc 21:720–725PubMedCrossRef
18.
go back to reference Logan JS, Elliot RR, Wilson AJ (2012) Translateral ACL reconstruction: a technique for anatomic anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 20:1289–1292PubMedCrossRef Logan JS, Elliot RR, Wilson AJ (2012) Translateral ACL reconstruction: a technique for anatomic anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 20:1289–1292PubMedCrossRef
19.
go back to reference Magnussen RA, Lawrence JT, West RL, Toth AP, Taylor DC, Garrett WE (2012) Graft size and patient age are predictors of early revision after anterior cruciate ligament reconstruction with hamstring autograft. Arthroscopy 28:526–531PubMedCrossRef Magnussen RA, Lawrence JT, West RL, Toth AP, Taylor DC, Garrett WE (2012) Graft size and patient age are predictors of early revision after anterior cruciate ligament reconstruction with hamstring autograft. Arthroscopy 28:526–531PubMedCrossRef
20.
go back to reference Mohtadi NG, Chan DS, Dainty KN, Whelan DB (2011) Patellar tendon versus hamstring tendon autograft for anterior cruciate ligament rupture in adults. Cochrane Database Syst Rev (9). doi:10.1002/14651858.CD005960 Mohtadi NG, Chan DS, Dainty KN, Whelan DB (2011) Patellar tendon versus hamstring tendon autograft for anterior cruciate ligament rupture in adults. Cochrane Database Syst Rev (9). doi:10.​1002/​14651858.​CD005960
21.
go back to reference Murray PJ, Alexander JW, Gold JE, Icenogle KD, Noble PC, Lowe WR (2010) Anatomic double-bundle anterior cruciate ligament reconstruction: kinematics and knee flexion angle-graft tension relation. Arthroscopy 26:202–213PubMedCrossRef Murray PJ, Alexander JW, Gold JE, Icenogle KD, Noble PC, Lowe WR (2010) Anatomic double-bundle anterior cruciate ligament reconstruction: kinematics and knee flexion angle-graft tension relation. Arthroscopy 26:202–213PubMedCrossRef
22.
go back to reference Park SY, Oh H, Park S, Lee JH, Lee SH, Yoon KH (2013) Factors predicting hamstring tendon autograft diameters and resulting failure rates after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 21:1111–1118PubMedCrossRef Park SY, Oh H, Park S, Lee JH, Lee SH, Yoon KH (2013) Factors predicting hamstring tendon autograft diameters and resulting failure rates after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 21:1111–1118PubMedCrossRef
23.
go back to reference Siebold R, Ellert T, Metz S, Metz J (2008) Femoral insertions of the anteromedial and posterolateral bundles of the anterior cruciate ligament: morphometry and arthroscopic orientation models for double-bundle bone tunnel placement-a cadaver study. Arthroscopy 24:585–592PubMedCrossRef Siebold R, Ellert T, Metz S, Metz J (2008) Femoral insertions of the anteromedial and posterolateral bundles of the anterior cruciate ligament: morphometry and arthroscopic orientation models for double-bundle bone tunnel placement-a cadaver study. Arthroscopy 24:585–592PubMedCrossRef
24.
go back to reference Siebold R, Ellert T, Metz S, Metz J (2008) Tibial insertions of the anteromedial and posterolateral bundles of the anterior cruciate ligament: morphometry, arthroscopic landmarks, and orientation model for bone tunnel placement. Arthroscopy 24:154–161PubMedCrossRef Siebold R, Ellert T, Metz S, Metz J (2008) Tibial insertions of the anteromedial and posterolateral bundles of the anterior cruciate ligament: morphometry, arthroscopic landmarks, and orientation model for bone tunnel placement. Arthroscopy 24:154–161PubMedCrossRef
25.
go back to reference Siebold R, Schuhmacher P (2012) Restoration of the tibial ACL footprint area and geometry using the Modified Insertion Site Table. Knee Surg Sports Traumatol Arthrosc 20:1845–1849PubMedCrossRef Siebold R, Schuhmacher P (2012) Restoration of the tibial ACL footprint area and geometry using the Modified Insertion Site Table. Knee Surg Sports Traumatol Arthrosc 20:1845–1849PubMedCrossRef
26.
go back to reference Steckel H, Starman JS, Baums MH, Klinger HM, Schultz W, Fu FH (2007) Anatomy of the anterior cruciate ligament double bundle structure: a macroscopic evaluation. Scand J Med Sci Sports 17:387–392PubMed Steckel H, Starman JS, Baums MH, Klinger HM, Schultz W, Fu FH (2007) Anatomy of the anterior cruciate ligament double bundle structure: a macroscopic evaluation. Scand J Med Sci Sports 17:387–392PubMed
27.
go back to reference Tiamklang T, Sumanont S, Foocharoen T, Laopaiboon M (2012) Double-bundle versus single-bundle reconstruction for anterior cruciate ligament rupture in adults. Cochrane Database Syst Rev 11:CD008413PubMed Tiamklang T, Sumanont S, Foocharoen T, Laopaiboon M (2012) Double-bundle versus single-bundle reconstruction for anterior cruciate ligament rupture in adults. Cochrane Database Syst Rev 11:CD008413PubMed
28.
go back to reference van Eck CF, Lesniak BP, Schreiber VM, Fu FH (2010) Anatomic single- and double-bundle anterior cruciate ligament reconstruction flowchart. Arthroscopy 26:258–268PubMedCrossRef van Eck CF, Lesniak BP, Schreiber VM, Fu FH (2010) Anatomic single- and double-bundle anterior cruciate ligament reconstruction flowchart. Arthroscopy 26:258–268PubMedCrossRef
29.
go back to reference van Eck CF, Martins CA, Vyas SM, Celentano U, van Dijk CN, Fu FH (2010) Femoral intercondylar notch shape and dimensions in ACL-injured patients. Knee Surg Sports Traumatol Arthrosc 18:1257–1262PubMedCrossRef van Eck CF, Martins CA, Vyas SM, Celentano U, van Dijk CN, Fu FH (2010) Femoral intercondylar notch shape and dimensions in ACL-injured patients. Knee Surg Sports Traumatol Arthrosc 18:1257–1262PubMedCrossRef
30.
go back to reference van Eck CF, Schkrohowsky JG, Working ZM, Irrgang JJ, Fu FH (2012) Prospective analysis of failure rate and predictors of failure after anatomic anterior cruciate ligament reconstruction with allograft. Am J Sports Med 40:800–807PubMedCrossRef van Eck CF, Schkrohowsky JG, Working ZM, Irrgang JJ, Fu FH (2012) Prospective analysis of failure rate and predictors of failure after anatomic anterior cruciate ligament reconstruction with allograft. Am J Sports Med 40:800–807PubMedCrossRef
31.
go back to reference van Eck CF, Schreiber VM, Liu TT, Fu FH (2010) The anatomic approach to primary, revision and augmentation anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 18:1154–1163PubMedCrossRef van Eck CF, Schreiber VM, Liu TT, Fu FH (2010) The anatomic approach to primary, revision and augmentation anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 18:1154–1163PubMedCrossRef
32.
go back to reference Yagi M, Kuroda R, Nagamune K, Yoshiya S, Kurosaka M (2007) Double-bundle ACL reconstruction can improve rotational stability. Clin Orthop Relat Res 454:100–107PubMedCrossRef Yagi M, Kuroda R, Nagamune K, Yoshiya S, Kurosaka M (2007) Double-bundle ACL reconstruction can improve rotational stability. Clin Orthop Relat Res 454:100–107PubMedCrossRef
33.
go back to reference Yagi M, Wong EK, Kanamori A, Debski RE, Fu FH, Woo SL (2002) Biomechanical analysis of an anatomic anterior cruciate ligament reconstruction. Am J Sports Med 30:660–666PubMed Yagi M, Wong EK, Kanamori A, Debski RE, Fu FH, Woo SL (2002) Biomechanical analysis of an anatomic anterior cruciate ligament reconstruction. Am J Sports Med 30:660–666PubMed
34.
go back to reference Zantop T, Brucker PU, Vidal A, Zelle BA, Fu FH (2007) Intraarticular rupture pattern of the ACL. Clin Orthop Relat Res 454:48–53PubMedCrossRef Zantop T, Brucker PU, Vidal A, Zelle BA, Fu FH (2007) Intraarticular rupture pattern of the ACL. Clin Orthop Relat Res 454:48–53PubMedCrossRef
35.
go back to reference Zantop T, Herbort M, Raschke MJ, Fu FH, Petersen W (2007) The role of the anteromedial and posterolateral bundles of the anterior cruciate ligament in anterior tibial translation and internal rotation. Am J Sports Med 35:223–227PubMedCrossRef Zantop T, Herbort M, Raschke MJ, Fu FH, Petersen W (2007) The role of the anteromedial and posterolateral bundles of the anterior cruciate ligament in anterior tibial translation and internal rotation. Am J Sports Med 35:223–227PubMedCrossRef
Metadata
Title
The concept of individualized anatomic anterior cruciate ligament (ACL) reconstruction
Authors
M. Hofbauer
B. Muller
C. D. Murawski
C. F. van Eck
F. H. Fu
Publication date
01-05-2014
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 5/2014
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-013-2562-4

Other articles of this Issue 5/2014

Knee Surgery, Sports Traumatology, Arthroscopy 5/2014 Go to the issue