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Anterior cruciate ligament surgery is a complex operation that requires expertise in the field of orthopedic and sports medicine. Many factors should be considered when discussing surgery, including the athlete's level of competition, age, previous knee injury, other injuries sustained, leg alignment, and graft choice.
The anterior cruciate ligament (ACL) of the knee is commonly injured. There is insufficient re-vascularization of the ligament after complete rupture, which limits its ability to heal and necessitates reconstruction surgery. Within the last 20 years, new types of synthetic ligaments have been developed.
Relative to the femur, the ACL keeps the tibia from slipping forward and the PCL keeps the tibia from slipping backward. Another structure of this type in human anatomy is the cruciate ligament of the dens of the atlas vertebra, also called "cruciform ligament of the atlas", a ligament in the neck forming part of the atlanto-axial joint .
The Lachman test is a clinical test used to diagnose injury of the anterior cruciate ligament (ACL). It is recognized as reliable, sensitive, and usually superior to the anterior drawer test . [ 1 ]
An increased amount of anterior tibial translation compared with the opposite limb or lack of a firm end-point may indicate either a sprain of the anteromedial bundle or complete tear of the ACL. [2] If the tibia pulls forward or backward more than normal, the test is considered positive.
On the tibia, the anterior reflection and attachment of the synovial membrane is located near the cartilage. [2] Anteriorly, the infrapatellar fat pad is inserted below the patella and between the two membranes. It extends from the lower margin of the patella above, to the infrapatellar synovial fold below.
The next step of identifying the POL femoral attachment is done by locating the gastrocnemius tubercle (2.6 mm distal and 3.1 mm anterior to the medial gastrocnemius tendon attachment on the femur). If the posteromedial capsule is not intact, the POL attachment site is located 7.7 mm distal and 2.9 mm anterior to the gastrocnemius tubercle.
An anterior cruciate ligament injury occurs when the anterior cruciate ligament (ACL) is either stretched, partially torn, or completely torn. [1] The most common injury is a complete tear. [ 1 ] Symptoms include pain, an audible cracking sound during injury, instability of the knee, and joint swelling . [ 1 ]