Extract
Outcomes following single-bundle anterior cruciate ligament reconstruction
are generally good. However, a critical review of the literature shows that
some patients have residual instability and pain following single-bundle
anterior cruciate ligament
reconstruction1-4.
Recent clinical investigations have demonstrated that anteroposterior knee
laxity, as measured with the KT-1000 and the Lachman test, is not associated
with functional outcomes after anterior cruciate ligament
reconstruction5.
Conversely, there is a significant association between the pivot-shift test
and functional outcomes after anterior cruciate ligament reconstruction (p =
0.03), which emphasizes the importance of rotational knee stability for
functional
recovery5.
Biomechanical and kinematic studies have suggested that a more anatomical
reconstruction of the anterior cruciate ligament may provide improved
long-term outcomes. In this article, we describe the anatomy, radiographic
characteristics, injury patterns, biomechanics, and kinematics of the anterior
cruciate ligament. We also summarize the surgical technique and augmentation
procedures used in an anatomic two-bundle approach to anterior cruciate
ligament reconstruction.