Operative Treatment of Primary Anterior Cruciate Ligament Rupture in Adults

by Christopher D. Murawski, Carola F. van Eck, James J. Irrgang, Scott Tashman, and Freddie H. Fu

J Bone Joint Surg AmVolume 96(8):685-694

April 16, 2014

©2014 by The Journal of Bone and Joint Surgery, Inc.

An arthroscopic ruler is used to measure the size of the tibial insertion site in the sagittal plane, with the ACL tibial footprint shown dissected and the anteromedial (AM) and posterolateral (PL)

bundles marked with a standard, commercially available, art...

Christopher D. Murawski et al. J Bone Joint Surg Am 2014;96:685-694

©2014 by The Journal of Bone and Joint Surgery, Inc.

A standard 45° flexion weight-bearing posteroanterior (PA) radiograph, made one year after single-bundle ACL reconstruction, demonstrating a 45° femoral tunnel angle relative to the long

axis of the femur, suggestive of anatomic tunnel placement41.

Christopher D. Murawski et al. J Bone Joint Surg Am 2014;96:685-694

©2014 by The Journal of Bone and Joint Surgery, Inc.

Figs. 3-A, 3-B, and 3-C MRI scans of a knee that had an anatomic ACL reconstruction with bone-patellar tendon-bone autograft.

Christopher D. Murawski et al. J Bone Joint Surg Am 2014;96:685-694

©2014 by The Journal of Bone and Joint Surgery, Inc.

Femoral and tibial three-dimensional CT reconstructions demonstrating anatomic tunnel placement of a single-bundle ACL reconstruction.

Christopher D. Murawski et al. J Bone Joint Surg Am 2014;96:685-694

©2014 by The Journal of Bone and Joint Surgery, Inc.

Femoral and tibial three-dimensional CT reconstructions demonstrating anatomic tunnel placement of a double-bundle ACL reconstruction.

Christopher D. Murawski et al. J Bone Joint Surg Am 2014;96:685-694

©2014 by The Journal of Bone and Joint Surgery, Inc.

Figs. 6-A and 6-B Intraoperative arthroscopic photographs demonstrating anatomic tunnel placement for single-bundle ACL reconstruction on the femur and tibia.

Christopher D. Murawski et al. J Bone Joint Surg Am 2014;96:685-694

©2014 by The Journal of Bone and Joint Surgery, Inc.

Figs. 7-A and 7-B Intraoperative arthroscopic photographs demonstrating anatomic tunnel placement for double-bundle ACL reconstruction on the femur and tibia.

Christopher D. Murawski et al. J Bone Joint Surg Am 2014;96:685-694

©2014 by The Journal of Bone and Joint Surgery, Inc.