Sports Orthopedics

ACL injury involves sagittal plane and rotatory instability;with its reconstruction aimed at restoring this instability. There remains room for improvement in long-term clinical outcomes and preventing recurrent instability. Therefore, it is important to understand the biomechanical parameters that...

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Autores principales:	Tisherman R, Meredith S, Vaudreuil N, de Sa D, Musahl V
Formato:	article
Lenguaje:	DE EN
Publicado:	Dynamic Media Sales Verlag 2019
Materias:	Sports medicine RC1200-1245
Acceso en línea:	https://doaj.org/article/e7684a3253254f79868af6e5d8b5eed2
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spelling	oai:doaj.org-article:e7684a3253254f79868af6e5d8b5eed22021-11-16T19:01:41ZSports Orthopedics0344-59252510-526410.5960/dzsm.2018.360https://doaj.org/article/e7684a3253254f79868af6e5d8b5eed22019-02-01T00:00:00Zhttps://www.germanjournalsportsmedicine.com/archive/archiv-2019/issue-2/instability-following-acl-rupture-what-do-we-need-to-restore-during-reconstruction/https://doaj.org/toc/0344-5925https://doaj.org/toc/2510-5264ACL injury involves sagittal plane and rotatory instability;with its reconstruction aimed at restoring this instability. There remains room for improvement in long-term clinical outcomes and preventing recurrent instability. Therefore, it is important to understand the biomechanical parameters that require attention during reconstruction to optimize patient outcomes. In the setting of ACL injury, the armamentarium of the orthopaedic surgeon includes multiple physical examination maneuvers, quantitative measures of knee instability, and advanced imaging to determine the pattern of instability and inform surgical planning. The pivot shift phenomenon, as a measure of rotatory instability, is one of the key biomechanical parameters which must be restored after reconstruction and which is not fully restored by non-anatomic ACL reconstruction. Anatomic ACL reconstruction represents the gold-standard, as it has demonstrated enhanced ability to restore rotatory instability, reduce anterior tibial translation, and improve patient reported outcomes compared to non-anatomic techniques. Repair of concurrent ligamentous and meniscal injuries, as well as possible extra-articular procedures, may enhance the restoration of rotatory stability. Lateral extra-articular tenodesis may be indicated in patients with high pivot shift, who play sports with aggressive rotatory motion, or who have generalized laxity. This article details the approach to knee instability following ACL rupture and the optimal techniques to restore the rotatory stability post-reconstruction.KEY WORDS: ACL Reconstruction, ACL Instability, Knee Instability, Multi-Ligament Knee Injury, Lateral Extra-Articular TenodesisTisherman RMeredith SVaudreuil Nde Sa DMusahl VDynamic Media Sales VerlagarticleSports medicineRC1200-1245DEENDeutsche Zeitschrift für Sportmedizin, Vol 70, Iss 2 (2019)
institution	DOAJ
collection	DOAJ
language	DE EN
topic	Sports medicine RC1200-1245
spellingShingle	Sports medicine RC1200-1245 Tisherman R Meredith S Vaudreuil N de Sa D Musahl V Sports Orthopedics
description	ACL injury involves sagittal plane and rotatory instability;with its reconstruction aimed at restoring this instability. There remains room for improvement in long-term clinical outcomes and preventing recurrent instability. Therefore, it is important to understand the biomechanical parameters that require attention during reconstruction to optimize patient outcomes. In the setting of ACL injury, the armamentarium of the orthopaedic surgeon includes multiple physical examination maneuvers, quantitative measures of knee instability, and advanced imaging to determine the pattern of instability and inform surgical planning. The pivot shift phenomenon, as a measure of rotatory instability, is one of the key biomechanical parameters which must be restored after reconstruction and which is not fully restored by non-anatomic ACL reconstruction. Anatomic ACL reconstruction represents the gold-standard, as it has demonstrated enhanced ability to restore rotatory instability, reduce anterior tibial translation, and improve patient reported outcomes compared to non-anatomic techniques. Repair of concurrent ligamentous and meniscal injuries, as well as possible extra-articular procedures, may enhance the restoration of rotatory stability. Lateral extra-articular tenodesis may be indicated in patients with high pivot shift, who play sports with aggressive rotatory motion, or who have generalized laxity. This article details the approach to knee instability following ACL rupture and the optimal techniques to restore the rotatory stability post-reconstruction.KEY WORDS: ACL Reconstruction, ACL Instability, Knee Instability, Multi-Ligament Knee Injury, Lateral Extra-Articular Tenodesis
format	article
author	Tisherman R Meredith S Vaudreuil N de Sa D Musahl V
author_facet	Tisherman R Meredith S Vaudreuil N de Sa D Musahl V
author_sort	Tisherman R
title	Sports Orthopedics
title_short	Sports Orthopedics
title_full	Sports Orthopedics
title_fullStr	Sports Orthopedics
title_full_unstemmed	Sports Orthopedics
title_sort	sports orthopedics
publisher	Dynamic Media Sales Verlag
publishDate	2019
url	https://doaj.org/article/e7684a3253254f79868af6e5d8b5eed2
work_keys_str_mv	AT tishermanr sportsorthopedics AT merediths sportsorthopedics AT vaudreuiln sportsorthopedics AT desad sportsorthopedics AT musahlv sportsorthopedics
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Sports Orthopedics

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