ARTHROSCOPIC SURGERY 

Minerva Ortopedica e Traumatologica 2013 June;64(3):225-37

Copyright © 2013 EDIZIONI MINERVA MEDICA

language: English

The actual management of ACL instability

Van Diek F. M., Ohashi B., Hofbauer M., Muller B., Fu F. H. ✉

Department of Orthopedic Surgery, University of Amsterdam, Amsterdam, The Netherlands

The anterior cruciate ligament (ACL) is frequently injured in the young and active population. Since the ACL is unlikely to adequately heal when torn, operative reconstruction is often the treatment of choice. Traditional techniques have systematically failed to restore the native anatomy and knee biomechanics, thereby possibly exposing the injured knee to the development of early degenerative changes of the articular cartilage. Reconstructing the native anatomy as closely as possible seems a logical step towards better reproduction of healthy knee biomechanics. More recent techniques have turned attention back to the knee anatomy. Many different techniques have been proposed and a lot of the used terminology is confusing. ACL reconstruction should be performed anatomically, the surgical technique should be individualized to each patient and any reconstruction should be founded on the double bundle concept, regardless of the used technique. We define the individualization of anatomic ACL reconstruction as a procedure that is customized to the objective appreciation of individual native anatomy by pre- and intraoperative measurements that facilitate ACL reconstruction as closely as possible to the native knee anatomy. The purpose of this article was to provide a concise overview and guidance for the actual management of ACL instability.