Bob's ACL WWWBoard On-Line Knee Library |
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Note: Many articles dealing with rehabilitation and prevention of post-reconstruction problems can be found in Physiotherapy, Rehabilitation, and Post-Operative Aspects Pertaining to Ligament Surgeries.
For a brief overview of knee anatomy, physiology, and biomechanics, please click here.
Lindenfeld-JBJS-99.pdf: Operative Treatment of Arthrofibrosis of the Knee. An excellent, penetratingly insightful discussion on how arthrofibrosis can arise after ACL reconstruction and other knee surgeries.
Infection After ACL Reconstruction: What Happens When Cultures Are Negative?, A.D. Musso et al.; Clinical Journal of Sports Medicine, Lippincott Williams and Wilkins Inc.; September 2005, 15(5), pages 381-384. Comments: This article discusses strategies for dealing with intraarticular infection subsequent to ACL reconstruction, and focuses on cases where bacterial culture (i.e. aspiration from the surgical wound site) reveals nothing. The rate of post-surgical infection is generally very low (e.g. 0.2%), but sometimes there are clusters of elevated infections (e.g. 7.75% from September 2003 to February 2004, in this particular study). The authors note that when the clinical signs (i.e. fever, chills, also wound drainage and redness) of deep intraarticular infection are present, or when there is reason to suspect such infection, then it is appropriate to begin intravenous (IV) antibiotic therapy immediately (rather than waiting until final microbiological-laboratory test result have been received). The authors feel that surgery (i.e. reopening the knee and removing infected issue, pockets of pus, etc.) is mandatory if a prompt response to IV antibiotic therapy does not occur. In any case, promptly dealing with intraarticular infections is important, since the longer such an infection is allowed to linger, the more damage is done to the vulnerable articular-cartilage surfaces. Such damage would then be termed septic arthritis.
Effects of patellar tendon adhesion to the anterior tibia on knee mechanics, Christopher S. Ahmad et al.; The American Journal of Sports Medicine, Baltimore; Sep/Oct 1998, Vol 26/5, p. 715-724. Comments: This article provides good insight into the potential post-ACL-reconstruction problem of patellar-tendon adhesion.
For insight into the process of ACL-graft incorporation/ligamentization, see the August 1992 article The Effect of a Ligament-Augmentation Device on Allograft Reconstructions for Chronic Ruptures of the Anterior Cruciate Ligament, by Frank R. Noyes and Sue D. Barber-Westin, in the Other Topics Pertaining to the Knee (RSD, Synthetic Grafts, etc.) section.
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