Anatomic ACL Reconstruction Demonstration Overview

Robert LaPrade, MD, PhD performed an anatomic ACL reconstruction Live on Facebook Friday, October 20 at 9 AM MDT.  (Click here to watch on Facebook or scroll down to watch below.)

Anterior cruciate ligament (ACL) injuries are one of the most common injuries that occur in active individuals. There are approximately 366,000 ACL reconstructions performed in the U.S.annually, however replacing the ACL surgically has yet to be mastered. As orthopedic surgery has evolved, there has been a focus on reconstructing the ACL according to its native anatomic locations.

Ground breaking research by many in the field, including Dr. LaPrade, has led to the development of anatomic ACL reconstruction techniques. Specifically, Dr. LaPrade and colleagues have developed an ACL surgical technique and have validated this with biomechanical research, resulting in similar behaviors of the ACL reconstructed graft compared to the native ACL. This biomechanically validated ACL reconstruction has been evaluated further clinically, with improved patient reported outcomes and return to preinjury levels of activity, including Olympic and professional level sports.

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ACL Reconstruction Live Demonstration

[fb_plugin video href=https://www.facebook.com/kneespecialist/videos/1467444103333558]

Facebook Live Series Overview

ACL Reconstruction References

  1. Arthroscopically pertinent landmarks for tunnel positioning in single-bundle and double-bundle anterior cruciate ligament reconstructions. Ziegler CG, Pietrini SD, Westerhaus BD, Anderson CJ, Wijdicks CA, Johansen S, Engebretsen L, LaPrade RF. Am J Sports Med. 2011 Apr;39(4):743-52.
  2. Biomechanical comparison of anatomic single- and double-bundle anterior cruciate ligament reconstructions: an in vitro study. Goldsmith MT, Jansson KS, Smith SD, Engebretsen L, LaPrade RF, Wijdicks CA. Am J Sports Med. 2013 Jul;41(7):1595-604.
  3. Outcomes After 1-Stage Versus 2-Stage Revision Anterior Cruciate Ligament Reconstruction. Mitchell JJ, Chahla J, Dean CS, Cinque M, Matheny LM, LaPrade RF.Am J Sports Med. 2017 Jul;45(8):1790-1798.
  4. Overlap Between Anterior Cruciate Ligament and Anterolateral Meniscal Root Insertions: A Scanning Electron Microscopy Study. Steineman BD, Moulton SG, Haut Donahue TL, Fontboté CA, LaPrade CM, Cram TR, Dean CS, LaPrade RF.Am J Sports Med. 2017 Feb;45(2):362-368
  5. Direct versus indirect ACL femoral attachment fibres and their implications on ACL graft placement. Moulton SG, Steineman BD, Haut Donahue TL, Fontboté CA, Cram TR, LaPrade RF.Knee Surg Sports Traumatol Arthrosc. 2017 Jan;25(1):165-171.
  6. Posterior Wall Blowout in Anterior Cruciate Ligament Reconstruction: A Review of Anatomic and Surgical Considerations.Mitchell JJ, Dean CS, Chahla J, Menge TJ, Cram TR, LaPrade RF. Orthop J Sports Med. 2016 Jun 9;4(6):2325967116652122
  7. Clinically relevant anatomy and what anatomic reconstruction means. LaPrade RF, Moulton SG, Nitri M, Mueller W, Engebretsen L. Knee Surg Sports Traumatol Arthrosc. 2015 Oct;23(10):2950-9
  8. Return to play following anterior cruciate ligament reconstruction. Ellman MB, Sherman SL, Forsythe B, LaPrade RF, Cole BJ, Bach BR Jr. J Am Acad Orthop Surg. 2015 May;23(5):283-96
  9. Consequences of tibial tunnel reaming on the meniscal roots during cruciate ligament reconstruction in a cadaveric model, Part 1: The anterior cruciate ligament. LaPrade CM, Smith SD, Rasmussen MT, Hamming MG, Wijdicks CA, Engebretsen L, Feagin JA, LaPrade RF. Am J Sports Med. 2015 Jan;43(1):200-6.
  10. Outcomes and Complication Rates After Primary Anterior Cruciate Ligament Are Similar in younger and Older Patients. Cinque ME, Chahla J, Moatshe G, DePhillipo NN, Kennedy NI, Godin JA, LaPrade RF. Ortho J Sports Med. 2017 Oct;5(10).Click edit button to change this text.

ACL Reconstruction Images

Pre-Operative Imaging

Anterior Tibial Translation

Anterior Tibial Translation

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Torn ACL MRI

MRI ACL Tear

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ACL Bone Bruise

ACL Bone Bruise Pattern

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Post-Operative Radiographs

Anatomic ACL Good Hardware Placement

Anatomic ACL Good Hardware Placement

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Anatomic ACL Good Hardware Placement

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Non-Anatomic Poor Hardware Placement

Non-Anatomic Poor Hardware Placement

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Non-Anatomic Poor Hardware Placement

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CT Scan for Tunnel Placement and Size – Non-Anatomic ACL Reconstruction

ACL Tibial Tunnel Osteolysis

ACL Tibial Tunnel Osteolysis

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Anterior Malpositioned ACL Femoral Tunnel

Anterior Malpositioned ACL Femoral Tunnel

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Posterior Malpositioned ACL Femoral Tunnel

Posterior Malpositioned ACL Femoral Tunnel

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