such as "Introduction", "Conclusion"..etc
February 2009 — An improved understanding of
the anatomy of the anterior cruciate ligament (ACL) in recent years has
generated a renewed interest in the evaluation of surgical techniques
to repair the knee ligament. In a study to be presented at the 2009
American Orthopaedic Society of Sports Medicine Specialty Day in Las
Vegas, researchers analyzed various aspects of two of the most common
ACL reconstruction techniques.
“Studies have demonstrated improved movement and stability with
restoration of the native anatomy of the knee. However, the surgical
technique to achieve the best movement and stability outcomes remains
controversial”, says lead author Asheesh Bedi, MD of the Hospital for
Special Surgery in New York City.
Bedi worked with senior mentors Dr. David W. Altchek and Dr. Riley
J. Williams on studying the anatomy and stability of ACL
reconstructions using transtibial versus anteromedial portal drilling
techniques on 19 cadaveric knees. Femoral socket position was
characterized using high-resolution 3D-fluoroscopy with transtibial and
anteromedial portal drilling. “While anteromedial portal drilling
allows for excellent access and restoration of the femoral ACL
footprint, there is a significant learning curve. There can be an
increased risk of shorter femoral tunnels and wall blow-out
intraoperatively” says Dr. Riley Williams, the senior author and
Associate Attending Surgeon at the Hospital for Special Surgery.
Follow-up studies have evaluated the biomechanical stability of ACL
reconstructions completed with transtibial and anteromedial portal
techniques. “The anteromedial portal drilling technique allowed for
better restoration of native ACL anatomy and knee stability compared to
conventional transtibial techniques. We also found that re-reaming of
the tibial tunnel is a bigger issue than has been previously recognized
with transtibial drilling” says Dr. David Altchek, senior author and
Co-Chief of the Sports Medicine Service at the Hospital for Special
Bedi and Altchek will be presenting the second part of their study
at the 2009 AOSSM Annual Meeting in Keystone, CO. “Continued research
into the best techniques for ACL stabilization are ongoing and a vital
part of getting athlete’s back into play at a quicker rate. We are
working to define these techniques in the lab and have them translated
into the operating room” says Altchek.
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