My Orthopaedic Surgeon

Anterior cruciate ligament (ACL) rupture is a common, and initially often overlooked injury of the knee. Whether the true incidence of the injury is on the increase, or simply its professional recognition, is hard to say, but reconstruction for functional instability has developed rapidly over the last two decades. Not all ACL-deficient knees need stabilising, and unfortunately not all stabilised knees return to full function, so careful patient selection is very important in this group of patients. Once selected, adequate time must be spent in preoperative counselling to discuss the issues of the time implications, the critical importance of post-operative physiotherapy and rehabilitation, the risks of success and failure, as well as the complications, potential graft site morbidity and the alternative conservative approaches. These latter include proprioceptive physiotherapy and/or bracing for specific sporting activities. In support of this we provide a patient leaflet which includes details of the knee’s anatomy, surgical techniques, rehabilitation protocols, as well as expected outcomes and references.
C.M. Fergusson Department of Orthopaedic Surgery, Royal Berkshire and Battle Hospitals NHS Trust, Reading, U.K. J.R.Coll.Surg.Edinb., 45, February 2000, 33-43

We report the design of a surgical instrument that facilitates the harvest of the autologous patellar tendon in anterior cruciate ligament (ACL) reconstruction. The advantage of this jig is that it is a simple, self-centring device resulting in a reproducible and consistent autograft. Its use also minimises the potential risks of donor site morbidity such as patellar fracture and tendon rupture. We briefly describe our technique and discuss its advantages.
A.B.Y. NG and S.R. BOLLEN Department of Orthopaedic Surgery and Trauma, Bradford Royal Infirmary, Bradford, U.K. J.R.Coll.Surg.Edinb., 45,October 2000, 318-320