The knee and the cruciate ligaments anatomy, biomechanics, clinical aspects, reconstruction, complications, rehabilitation ; with 91 tables

This book summarizes the experience gained by the Orthopedic Study Group for the Knee (OAK) of the Swiss Orthopedic Society in dealing with knee problems relating to deficiencies of the cruciate ligaments. The editors, R.P. Jakob and H.-U.Staubli, have collaborated with international authorities to produce this ex­ cellent work dealing with a great many aspects of knee surgery and especially the problems of the cruciate ligaments. For clarity, the book begins with definitions and explanations of basic biomechan­ ical terms. The chapters on Anatomy and Biomechanics present up-to-date scien­ tific information based on anatomic and biomechanical principles as they are ap­ plied in modern knee surgery. The second part of the book focuses on the OAK-sanctioned approach to knee documentation and evaluation, which is a valuable supplement to other knee evaluation schemes. The European Society for Knee Surgery (ESKA) and the American Orthopedic Society for Sports Medicine (AOSSM) are currently at­ tempting to combine the advantages of the OAK system with an internationally valid evaluation scheme to create a standard evaluation and documentation sys­ tem that will be acceptable to all physicians. Front Matter....Pages I-XXIII Terms, Definitions, and Glossaries....Pages 1-21 Historical and Current Perspectives in the Treatment of Anterior Cruciate Ligament Insufficiency....Pages 22-27 Front Matter....Pages 29-29 Surgical Anatomy of the Knee Joint....Pages 31-47 The Popliteus Muscle....Pages 48-61 Structural Molecules in Articular Cartilage, Tendons, and Ligaments....Pages 62-77 Functional Anatomy of the Cruciate Ligaments....Pages 78-91 Anatomy and Biomechanics of the Anterior Cruciate Ligament: A Three-Dimensional Problem....Pages 92-109 Significance of Anatomy and Biomechanics....Pages 110-119 Front Matter....Pages 121-121 OAK Knee Evaluation: A New Way to Assess Knee Ligament Injuries....Pages 123-133 Evaluation of Knee Ligament Injuries: The OAK and IKDC Forms....Pages 134-139 Front Matter....Pages 141-141 Diagnosis of Acute Tears of the Anterior Cruciate Ligament, and the Clinical Features of Chronic Anterior Instability....Pages 143-156 Pathomechanical and Clinical Concepts of the Pivot Shift Phenomenon....Pages 157-168 Anterior Subluxation in Knees with Chronic Anterior Cruciate Ligament Insufficiency: A Comparison of Arthrometry and Stressradiography....Pages 169-176 Our Current Technique of Stressradiography Near Extension....Pages 177-183 Anterior Subluxation in the Chronically Anterior Cruciate Ligament-Deficient Knee: Comparison of Simultaneous Arthrometry and Stressradiography Using the KT 1000....Pages 184-189 The Various Faces of Anterior Cruciate Ligament Tears During Arthroscopic Examination....Pages 190-192 New Imaging Techniques....Pages 193-195 The Drawer Simulator: A Practice-Oriented Training Device for Anteroposterior Stability Testing in the Knee....Pages 196-200 Morphology and Function of the Cruciate Ligaments in a Computer Simulation Model....Pages 201-214 Production of Mechanical Knee Models for Training....Pages 215-224 Front Matter....Pages 141-141 Femoropatellar Problems Associated with Anterior Cruciate Ligament Insufficiency....Pages 225-229 Classification of Meniscal Tears Associated with Lesions of the Anterior Cruciate Ligament....Pages 230-236 Natural History of Untreated Tears of the Anterior Cruciate Ligament....Pages 237-245 Natural History of Associated Intraarticular Pathology in the Chronic Anterior Cruciate Ligament-Deficient Knee....Pages 246-249 Aplasia of the Cruciate Ligaments....Pages 250-254 Front Matter....Pages 255-255 Healing Processes....Pages 257-261 Morphologic Ultrastructure of Repaired and Reconstructed Ligaments....Pages 262-265 Indications for the Operative and Conservative Treatment of Cruciate Ligament Injuries....Pages 266-269 Indications for Cruciate Ligament Reconstruction: A Recapitulation....Pages 270-275 Front Matter....Pages 277-277 Treatment of Acute Tears....Pages 279-288 Primary Repair of Acute Ruptures....Pages 289-292 Late Results after Primary Repair....Pages 293-298 Avulsion Fractures of the Intercondylar Eminence in Adolescents: Pathophysiology, Case Material, and Late Results....Pages 299-306 Dislocation of the Knee....Pages 307-317 Front Matter....Pages 319-319 Instability of the Medial Collateral Ligament: Operative or Nonoperative Treatment?....Pages 321-324 Treatment of Combined Injuries of the Anterior Cruciate Ligament and Medial Collateral Ligament Complex....Pages 325-328 Meniscus Repairs....Pages 329-332 Meniscus Repair with Special Reference to Arthroscopic Technique....Pages 333-342 Open Meniscus Repair: Technique, Postoperative Treatment, and Results....Pages 343-354 Front Matter....Pages 355-355 Autologous or Allogeneic Reconstruction?....Pages 357-362 Front Matter....Pages 355-355 Arthroscopically Assisted Reconstruction of the Anterior Cruciate Ligament. Preoperative Planning: Two-Tunnel Technique....Pages 363-369 Reconstruction of the ACL with a Patellar Tendon Graft Based on the Infrapatellar Fat Pad: An Experimental Study in Animals....Pages 370-375 Use of the Semitendinosus Tendon for Anterior Cruciate Ligament Reconstruction....Pages 376-383 Anterior Cruciate Reconstruction Through a Transligamentous Approach....Pages 384-388 Modification of the Clancy Patellar Tendon Reconstruction of the ACL: Analysis of Three-Year Results....Pages 389-400 Surgical Treatment of Anterior Cruciate Ligament Insufficiency: Comparison of Results of Repair, Primary Augmentation, and Reconstruction....Pages 401-411 Late Results after ACL Reconstruction with an Autologous Free Patellar Tendon Graft....Pages 412-415 Extraarticular Lateral Reconstructions....Pages 416-423 Front Matter....Pages 425-425 Kenneth Jones Technique of Arthroscopic Cruciate Reconstruction....Pages 427-436 Arthroscopically Assisted Cruciate Ligament Reconstruction Using a Free Patellar Tendon Graft....Pages 437-442 Arthroscopically Assisted ACL Reconstruction Using Autologous Quadriceps Tendon....Pages 443-451 Cruciate Reconstruction under Arthroscopic Control: Technique and Preliminary Results....Pages 452-459 Front Matter....Pages 461-461 Lateral and Posterolateral Rotatory Instability of the Knee....Pages 463-494 The Popliteus Tendon and Its Fascicles in the Popliteal Hiatus: Arthroscopic Functional Anatomy with and without ACL Insufficiency....Pages 495-502 Front Matter....Pages 503-503 Biomechanical Considerations....Pages 505-517 Current Status of Synthetic Ligament Reconstruction....Pages 518-531 Synthetic Augmentation of Anterior Cruciate Ligament Repairs and Reconstructions....Pages 532-540 Front Matter....Pages 541-541 Instability-Related Osteoarthritis: Special Indications for Osteotomies in the Treatment of the Unstable Knee....Pages 543-567 Monopodal Weight-Bearing Radiography of the Chronically Unstable Knee....Pages 568-576 Role of Unicompartmental Arthroplasty in Femorotibial Osteoarthritis with a Deficient Central Pivot....Pages 577-585 Front Matter....Pages 587-587 Intra- and Postoperative Complications....Pages 589-600 Role of Arthroscopy in the Diagnosis and Treatment of Complications of ACL Reconstruction....Pages 601-604 Front Matter....Pages 605-605 Aspects of Rehabilitation in the Anterior Cruciate Ligament-Deficient Knee....Pages 607-612 Functional Rehabilitation after Anterior Cruciate Ligament Reconstruction....Pages 613-618 Isokinetic Testing to Evaluate Quadriceps and Hamstring Strength after a Primary Anterior Cruciate Ligament Repair or Reconstruction....Pages 619-624 Front Matter....Pages 625-625 Rationale and Benefit of Treating Cruciate Ligament Lesions: The Payer’s Perspective....Pages 627-629 Future Outlook....Pages 630-631 Back Matter....Pages 633-637 This book summarizes the experience gained by the Orthopedic Study Group for the Knee (OAK) of the Swiss Orthopedic Society in dealing with knee problems relating to deficiencies of the cruciate ligaments. The editors, R.P. Jakob and H.-U. Staubli, have collaborated with international authorities to produce this ex cellent work dealing with a great many aspects of knee surgery and especially the problems of the cruciate ligaments. For clarity, the book begins with definitions and explanations of basic biomechan ical terms. The chapters on Anatomy and Biomechanics present up-to-date scien tific information based on anatomic and biomechanical principles as they are ap plied in modern knee surgery. The second part of the book focuses on the OAK-sanctioned approach to knee documentation and evaluation, which is a valuable supplement to other knee evaluation schemes. The European Society for Knee Surgery (ESKA) and the American Orthopedic Society for Sports Medicine (AOSSM) are currently at tempting to combine the advantages of the OAK system with an internationally valid evaluation scheme to create a standard evaluation and documentation sys tem that will be acceptable to all physicians The knowledge of leading orthopedic surgeons is channeled into this monograph to convey all the facts necessary for the successful surgical treatment of the cruciate ligaments. The various aspects of reconstructive knee surgery are given equal weight in the well-balanced text, making the study of these procedures easy as well as informative. The contents cover: * Anatomy and biomechanics * Diagnosis * Treatment of recent and chronic cruciate ligament insufficiency, including new arthroscopic reconstruction techniques * Accompanying injuries of the meniscus and important secondary stabilizers, including the posterolateral capsules *Accompanying lesions of the posterior ligament or of artificial ligaments * Early and late complications, including problems with artificial ligaments * Treatment of late arthrosis * Rehabilitation * Documentation and evaluation The knowledge of leading orthopaedic surgeons has been channelled into this volume to provide a reference of successful techniques for reconstructive knee surgery as well as surgical treatment of the cruciate ligaments.