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Anatomic, Radiographic, Biomechanical, and Kinematic Evaluation of the Anterior Cruciate Ligament and Its Two Functional Bundles
Anikar Chhabra, MD; James S. Starman, BS; Mario Ferretti, MD; Armando F. Vidal, MD; Thore Zantop, MD; Freddie H. Fu, MD, DSc(Hon), DPs(Hon)
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The authors did not receive grants or outside funding in support of their research for or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2006 Dec 01;88(suppl 4):2-10. doi: 10.2106/JBJS.F.00616
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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.
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