Graft fixation in cruciate ligament reconstruction

Jeff Brand, Andreas Weiler, David N.M. Caborn, Charles H. Brown, Darren L. Johnson

Research output: Contribution to journalReview articlepeer-review

380 Scopus citations

Abstract

Cruciate ligament reconstruction has progressed drarnatically 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 near-normal 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.

Original languageEnglish
Pages (from-to)761-774
Number of pages14
JournalAmerican Journal of Sports Medicine
Volume28
Issue number5
DOIs
StatePublished - 2000

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation

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