1. Pathomechanism: Different mechanism of ACL tears are discussed. The mechanism will decide on the type of lesion. Isolated or combined lesions are possible. Meniscal tears and cartilage lesions are often associated. 2. Anatomy: Current trends have opened our eyes. The anterior cruciate ligament consists of two separate identities. Two different anatomic bundles, that each have their function, the anteromedial and the posterolateral bundle. Anatomy of the different bundles are discussed and the clinical exam related to the type of bundle damaged, is demonstrated. 3. Treatment: Conservative treatment is possible in the isolated anteromedial bundle tear at the femoral level. Arthroscopic minimal invasive surgery is possible for the isolated anteromedial bundle tear at the femoral level with a microfracture technique (healing response). Early diagnosis is necessary. Augmentation plasty in isolated reconstruction of the anteromedial bundle with a triple loop semitendinosus autograft Full reconstruction of both bundles can be performed with a double bundle technique (triple loop semiT for the anteromedial and double loop gracilis for the posterolateral bundle) or with our preferred intermediate triple loop reconstruction (single tunnel). Synthetic ligaments have been banned for many years but came back into fashion with the LARS ligament. Early return to sports at the late/end stage of the athlete`s career can be an indication. 4. Rehabilitation: Rehab programs differ depending on the technique but are focused on 1. Disappearance of hemarthosis and swelling 2. Recuperation of full extension and progressive flexion 3. Muscle return of quadriceps in the first stage (closed chain) and after 3 months hamstrings (if been used as an autograft) 4. Proprioception 5. Return to sports depending on the surgical technique used
© Copyright 2008 Abstractbook. The First International Low Lands Congress on Science and Skiing, Brussels, October 11th. Veröffentlicht von Vrije Universiteit Brussel. Alle Rechte vorbehalten.