الفهرس 
AIM OF THE WORKOnly 14 pages are availabe for public view
 |  | from | 166 |  |  |
| | | from | 166 | | |
Abstract
Surgical replacement of ACL has become a common procedure to restore knee stability. Indication for reconstruction arises from the high activity level, young age, complex ligamentous injuries, degree and morphologic type of injury or a persistent instability after physiotherapy. (Voigt et aI., 2006)
Literature described various methods to reconstruct ACL: single- and double-bundle techniques. All produce predominantly good results. Single- bundle technique is the standard method. Recently, a tendency toward double-bundle technique with the goal of a nearly anatomical ACL reconstruction could be recognized because;
.:. Anatomical studies show that;
• ACL consists of 2 functional bundles, the AM and the PL bundles.
• The changing orientation of the 2 bundles’ footprints as the knee moves .
• :. Biomechanical studies show that;
• The functional tensioning pattern is independent throughout knee range of motion. In extension, AMB is loose, and PLB is tight. In flexion, the AMB is tight and PLB is loose.
• The AM bundle appears to be an important stabilizer against anteroposterior loads. The PL bundle seems to provide additional anteroposterior knee stability and provide stabilization against rotatory loads .
• :. Histological studies show that there is a greater surface area of two thin tendon grafts than of one thick tendon graft. (Ferretti et aI., 2005 - Voigt et aI., 2006)
Although single-bundle ACL reconstructions continue to be the ”gold standard” in the treatment of ACL-deficient knee, several studies have revealed that it provides sufficient anteroposterior knee stability but is unable to restore the rotational stability of the knee joint. (Tashman et aI., 2004 - Ristanis et aI., 2005)
.