الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Reconstruction of the torn ACL is a common surgical procedure for the orthopaedic surgeon especially who are interested in sports medicine. Although some patients who are not involved in sports can function without complaint with an ACL-deficient knee, most patients experience pain and recurrent episodes of instability
Unfortunately, injuries to this vital ligament are relatively common as they represent about 1/3 of sports injures to the knee joint, although injuries can also occur in non-sportive individuals. Many authors have found football, basketball and skiing to be the most common activities during which a rupture of the ACL has occurred in young patients. Operative treatment is now usually recommended for younger patients who wish to return to competitive activities. Because the menisci, articular surfaces and other restraining structures around the knee are susceptible to injury during episodes of instability, it is generally accepted that ACL reconstruction should be offered to patients who have or are at risk of having recurrent knee instability.
Functionally, it is composed of AMB and PLB and possible an intermediate band. These divisions are important because each has a separate function, with the PLB tight in extension and the AMB tight in flexion. The fascicles of the AMB originate at the most posterior and proximal aspect of the femoral attachment and insert at the anteromedial aspect of the tibial attachment. Conversely, the fascicles of the PLB originate at the antero-distal aspect of the femoral attachment and insert at the posterolateral aspect of the tibial attachment.
With the knee in extension, the fascicles of the ACL run in a fairly parallel fashion when viewed sagittally. During flexion, there is a slight lateral rotation of the ligament as a whole around its longitudinal axis, and the AMB begins to spiral around the rest of the ligament. This relative movement of one bundle upon the other is due to the orientation of the bony attachments of the ACL. The goal of any ACL reconstruction is to restore knee stability to approximate normal knee kinematics. The fact that so many different methods have been described for reconstruction of ACL in patients with chronic functional instability indicates that the ideal solution to this problem has not yet been found.