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Application of the Anatomic Double-Bundle Reconstruction Concept to Revision and Augmentation Anterior Cruciate Ligament Surgeries
Wei Shen, MD, PhD1; Brian Forsythe, MD1; Sheila McNeill Ingham, MD1; Nicholas J. Honkamp, MD1; Freddie H. Fu, MD1
1 Department of Orthopedic Surgery, University of Pittsburgh, 3471 Fifth Avenue, Suite 1011, LSK, Pittsburgh, PA 15213. E-mail address for F.H. Fu: ffu@upmc.edu
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Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received 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, division, center, clinical practice, or other charitable or nonprofit organization with which the authors, or a member of their immediate families, are affiliated or associated.
Note: The authors thank Dr. Susan Jordan, Dr. James Irrgang, Dr. Samuel Robinson, and Dr. Morey Moreland for their helpful discussion during the writing of this manuscript.

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2008 Nov 01;90(Supplement 4):20-34. doi: 10.2106/JBJS.H.00919
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Anatomy is the basis of orthopaedic surgery. Our approach to anterior cruciate ligament reconstruction surgery is governed by this principle. In this article, we describe the concept of anatomic anterior cruciate ligament reconstruction as well as its application to single and double-bundle anterior cruciate ligament reconstruction, revision anterior cruciate ligament surgery, and anteromedial and posterolateral-bundle anterior cruciate ligament augmentation surgery.Traditional single-bundle anterior cruciate ligament reconstruction has been shown to achieve good-to-excellent results in only 60% of patients1. As many as 20% to 30% of athletes fail to achieve their previous level of performance, suggesting that there is room for improvement. Because of this high failure rate, we have been driven to explore alternative reconstruction techniques. Our goal is to restore the native anatomy, which we believe will result in superior outcomes and performance levels.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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