Femoral Fixation Procedure

Background: The anterior cruciate ligament (ACL) rupture is a common and limiting injury among young active population. ACL reconstruction is associated to significant technical advances in recent decades and to a growing trend for the use of hamstring tendon autograft. The use of this graft is apparently associated with lower rates of postoperative morbidity. However there is some concern regarding the risk of laxity.

1. There are three ways to replace your ACL. There is an ACL graft, which is from another human body, a patellar tendon graft, and a hamstring graft.

There are different techniques that repair a torn ACL. The popular method for surgeons is the patellar tendon graft procedure. This type of ACL replacement uses the middle third of the person’s own patellar tendon and replacing the damage tendon with it. The advantages are that the fixation is very strong and the patellar tendon replacing

The anterior cruciate ligament (ACL) is one of the four main ligaments in the knee joint that connect it to the shin bone (tibia) and thigh bone (femur). It 's located deep within the joint, behind the kneecap (patella), above the shinbone, and below the thighbone. The ACL lies diagonally across the middle of the knee and plays a role in keeping the knee stable during movement. Partial tears of the ACL can occur, but are rare. Most ACL tears are either near-completes or complete tears. After experiencing an ACL tear, an athlete has a 15 times

The purpose of this article is to compare the laxity and stiffness of the knee joint in male and female cadavers. Three different directions will be evaluated, anterior-posterior, internal-external, and varus-valgus. Females are at a two to eight times greater risk of an ACL injury than a male. This is due to the laxity in the joints. Females also have limited proprioception in the knee joint, which may attribute to some injuries. This study used a technique using cadaver knees to complete this study.

With an ever increasing number of people becoming involved with athletic activities, there is an increasing number of injuries occurring which can be devastating for the individual. Most of the injuries that affect athletes occur in one of four structures in the human body: bones, muscles, tendons, or ligaments. Because ligaments attach bone to bone and play a major part in providing stability for joints, the major stabilizing ligament in the knee, the anterior cruciate ligament (ACL), assists in performing everyday actions of the human body including sitting, standing, walking, running, dancing, and participating in other sports. The injury that specifically affects this ligament is very serious and always

The Anterior Cruciate Ligament also known as the ACL is deemed the most commonly torn ligament in the knee and can result from both contact and noncontact injuries. Most Anterior Cruciate Ligament injuries result from an extreme force on the lateral side of the person’s knee causing a valgus force which pushes the knee inward (Kisner & Colby, 2012, pp. 802-803). This injury to the side of the knee can also cause a “Terrible Triad” injury which also injures both the medial meniscus and the medial collateral ligament (Kisner & Colby, 2012, p. 803). Our textbook further states that “the most common noncontact mechanism is a rotational mechanism in which the tibia is externally rotated on the planted foot….this mechanism can account for as many as 78% of all ACL injuries” (Kisner & Colby, 2012, p. 803). If the person does not seek medical help with this injury they are susceptible to also injuring the remaining support ligaments as well. Patients usually present with joint effusion; possibly 25 degrees of flexion, joint swelling if blood vessels are involved, limited ROM, stress pain and instability along with quads avoidance gait patterns (Kisner & Colby, 2011, p. 208)

A patient reported measured form, using the IKDC and ADLS was evaluated. Patients recovering from ACL reconstruction surgery were given both forms to fill out simultaneously over a period of time during their recovery. The forms were handed out four times in the course of one year- one month, three months, six months, and yearly. A baseline form was given prior to surgery as a control to determine the progress, impairments, and success of functionality post-surgery.

A torn ACL is one of the most serious and common knee injuries. Many aspects play a role in the treatment and rehabilitation of this injury. This paper will discuss the anatomy of the knee, describe a torn ACL, and the rehabilitation.

: One of the most common ligamentous injuries of the knee is to the anterior cruciate ligament. Early recognition of the pathology is critical when determining the most appropriate course of care to optimize potential outcomes. The Lachman’s test is characterized by clinicians as the most direct and definitive evaluative tool used in determining the status of ACL injuries, because of its sensitivity, specificity and likelihood ratios. However most clinicians also assign a categorical grade to describe the end feel of the tibial translation, yet the reliability, accuracy, and clinical utility of this assessment has not been subjected to critical

The knee joint consists of four ligaments, two intra-capsular which are the ACL and the PCL and two extra-capsular ligaments including the MCL and LCL. The ACL is an extremely strong stabiliser which prevents anterior displacement of the knee. The ACL is a ligament and therefore connects one bone to another, the femur with the tibia. The ACLs origin is from the anterior intercondylar eminence of the tibia (home,2017) and the fibres pass upwards, backward and laterally inserting into the lateral condyle of the femur.

Patients with major ligamentous instability and neuromuscular disease were excluded. Recurvatum deformity were categorized into three group; I: < 5 degrees (n=32), II: 5-9 degrees (n=40), III: > 10 degrees (n=18) as measured by lateral standing full extension knee radiographs. One surgeon operated all patients using techniques of under-resection distal femur first (2-4 mm) then downsizing femoral component (3 mm) by increased posterior condylar bone cut then implant the femoral component 2 mm proud if needed to correct recurvatum deformity. Intraoperatively the knees were forced to fully extend to confirm that anterior part of tibial post and the lowest part of intercondylar femoral box did not contact each other. Iliotibial band was palpated after the trial component was put in place if it was tight which was defined as unable to put the surgeon index through the space between IT band and the lateral condyle of the femur, it would be pie crusted released. Eighty four patients had varus deformity with the average of 10 degrees and 6 patients had valgus deformity with the average of 18 degrees. Genesis II posterior-stabilized implants were used in all patients. The surgeon prospectively measured and recorded the thickness of distal femoral and posterior condylar bone cut in the operative records. Knee range of motion, functional score measured by WOMAC and radiographic evaluation were routinely collected before surgery, at 3 months and yearly follow up. The minimum follow up times was two

Many people go several years before acknowledging they have AVN of the femoral head due to the presence of nonspecific symptoms and radiographic changes of the hip (Steppacher). AVN is a disease that typically progresses over time, and those with AVN of the femoral head characteristically experience joint pain in the early stages (Brown). The pain is, as expected in the hip region, but can also be seen present in the buttocks or the anterior and lateral thigh (Kaushik) This joint pain comes primarily from activities that involve bearing weight on the affected joint, the hip, or more specifically in this case, the femoral head (Brown). Pain in the groin may be seen as unilateral or bilateral, and is usually present in the patient with a slow-onset

The knee’s anatomy, specifically the soft tissue cruciate ligaments insertion points are critical for both primary research and development in patient-specific surgery for knee reconstructions and biomechanical models. Despite its importance, there is insufficient data on such subject-specific anatomical models. This is stagnating improvements in surgery [1] most specifically relating to surgical navigation [2] and the ability to restore the ligaments as closely to the native anatomy

Several studies have demonstrated a lower rate of deep infection after ACL reconstruction (ACLR) using allograft compered to hamstring autograft tendons and equal possibilities with the use of bone patellar tendon bone (BPTB) autograft.4-8 The increasing use of primary allograft ACLR during the last few decades9 can be