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Document Title: Brand-AJSM-Sep00
Article Title: Graft fixation in cruciate ligament
reconstruction
Author: Jefferson Brand Jr, Andreas Weiler, David N.M. Caborn, Charles H. Brown Jr, Darren L. Johnson.
Publication: The American Journal of Sports Medicine
ISSN: 03635465
Date: September-October 2000.
(Figures included. Reference-denoting numbers appear in the same point size as document text.)
Volume: 28
Issue: 5
Pages: 761-774
Key Words: Knee, ligaments, sports medicine, surgery, ACL, graft, reconstruction, fixation.
This article discusses ACL-graft anchorage techniques.
ABSTRACT
Cruciate ligament reconstruction has progressed dramatically in the last 20 years. Anatomic placement of ligament substitutes has fostered rehabilitation efforts that stress immediate and full range of motion, immediate weightbearing, neuromuscular strength and coordination, and early return to athletic competition (3 months). This has placed extreme importance on secure graft fixation at the time of ligament reconstruction. Current ligament substitutes require a bony or soft tissue component to be fixed within a bone tunnel or on the periosteum at a distance from the normal ligament attachment site. Fixation devices have progressed from metal to biodegradable and from far to nearnormal native ligament attachment sites. Ideally, the biomechanical properties of the entire graft construct would approach those of the native ligament and facilitate biologic incorporation of the graft. Fixation should be done at the normal anatomic attachment site of the native ligament (aperture fixation) and, over time, allow the biologic return of the histologic transition zone from ligament to fibrocartilage, to calcified fibrocartilage, to bone. The purpose of this article is to review current fixation devices and techniques in cruciate ligament surgery.
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