Reconstructions of the anterior cruciate ligament (ACL) are among the most frequently performed procedures in knee surgery nowadays. The history of ACL surgery can be traced as far back as the Egyptian times. The early years reflect the efforts to establish a viable, consistently successful reconstruction technique while, during the early 20th century, we witness an increasing awareness of, and interest in, the ligament and its lesions. Finally, we highlight the most important steps in the evolution of the ACL reconstruction surgery by discussing the various techniques spanning the years using not only autologous grafts (fascia lata, meniscal, hamstring, patella tendon, bone-patella tendon-bone, and double bundle grafts) but also synthetic ones and allografts. 1. Introduction Rupture of the anterior cruciate ligament (ACL) is a common injury in active people, and one of the most common knee injuries in sports. It is estimated that the annual incidence of ACL injury is about 1 in 3,000 amongst the general population in the USA. That means more than 150,000 new ACL ruptures annually [1]. The healing response after ACL rupture is poor. Without surgical reconstruction the ACL deficient knee is limited. So are the patient’s activities and such ACL deficiency can lead to future degenerative changes [2–5]. Nowadays, ACL reconstruction surgery is a major area of research worldwide. This is partly due to the large number of athletes being involved in professional sports where a fast recovery and rehab are essential to return quickly to the sport. It is also due to the greater awareness within the general public of their own healthcare matters and the higher expectations now evident in amateur sports-persons and non-sports-persons alike. We present a brief history of ACL injury and the surgical measures taken to address it over the years as well as the modern ACL reconstruction techniques. 2. The Early Years The cruciate ligaments have been known about since old Egyptian times and their anatomy was described in the famous Smith Papyrus (3000 BC). Hippocrates also (460–370？BC) mentioned the subluxation of the knee joint with ligament pathology, but Claudius Galen, a Greek physician in the Roman Empire, was the first to describe the true nature of the ACL [6]. Prior to Galen’s description, it was believed that the cruciate ligaments were part of the nervous system, but Galen was the first to describe the ACL as being a structure that supports the joint and prevents abnormal knee motion. He called the cruciate ligaments genu cruciata but he did not describe in
References
[1]
K. Miyasaka, D. Daniel, M. Stone, and P. Hirshman, “The incidence of knee ligament injuries in the general population,” The American Journal of Knee Surgery, vol. 4, pp. 3–8, 1991.
[2]
D. L. Butler, “Anterior cruciate ligament: its normal response and replacement,” Journal of Orthopaedic Research, vol. 7, no. 6, pp. 910–921, 1989.
[3]
C. Frank, D. Amiel, S. L.-Y. Woo, and W. Akeson, “Normal ligament properties and ligament healing,” Clinical Orthopaedics and Related Research, vol. 196, pp. 15–25, 1985.
[4]
F. R. Noyes, L. A. Mooar, C. T. Moorman III, and G. H. McGinniss, “Partial tears of the anterior cruciate ligament. Progression to complete ligament deficiency,” Journal of Bone and Joint Surgery. British, vol. 71, no. 5, pp. 825–833, 1989.
[5]
S. M. Strickland, J. D. MacGillivray, and R. F. Warren, “Anterior cruciate ligament reconstruction with allograft tendons,” Orthopedic Clinics of North America, vol. 34, no. 1, pp. 41–47, 2003.
[6]
V. Chouliaras and H. H. Passler, “The history of the anterior cruciate ligament from Galen to double-bundle acl reconstruction,” Acta Orthopaedica et Traumatologica Hellenica.
[7]
G. A. Snook, “A short history of the anterior cruciate ligament and the treatment of tears,” Clinical Orthopaedics and Related Research, vol. 172, pp. 11–13, 1983.
[8]
J. Stark, “Two cases of ruptured crucial ligaments of the knee-joint,” The Edinburgh Medical and Surgical, vol. 5, pp. 267–271, 1850.
[9]
A. W. M. Robson, “Ruptured crucial ligaments and their repair by operation,” Annals of Surgery, vol. 37, pp. 716–718, 1903.
[10]
H. E. Cabaud, “Biomechanics of the anterior cruciate ligament,” Clinical Orthopaedics and Related Research, vol. 172, pp. 26–31, 1983.
[11]
R. Jones, “Disabilities of the knee joint,” British Medical Journal, vol. 2, pp. 169–173, 1916.
[12]
J. A. Feagin Jr. and W. W. Curl, “Isolated tear of the anterior cruciate ligament: 5 year follow up study,” American Journal of Sports Medicine, vol. 4, no. 3, pp. 95–100, 1976.
[13]
K. H. Giertz, “über freie Transplantation der Fascia lata als Ersatz für Sehnen und B？nder,” Deutsche Zeitschrift für Chirurgie, vol. 125, no. 5-6, pp. 480–496, 1913.
[14]
“The classic. Operation for repair of the crucial ligaments Ernest W. Hey Groves, MD., F.R.C.S.,” Clinical Orthopaedics and Related Research, vol. 147, pp. 4–6, 1980.
[15]
R. Galleazzi, “La ricostituzione dei ligamenti cociati del ginocchio,” Atti e Memorie della Società Lombarda di Chirurgia, vol. 13, pp. 302–317, 1924.
[16]
H. Macey, “A new operative procedure for the repair of ruptured cruciate ligaments of the knee joint,” Surgery, Gynecology & Obstetrics, vol. 69, pp. 108–109, 1939.
[17]
K. Lindemann, “Plastic surgery in substitution of the cruciate ligaments of the knee-joint by means of pedunculated tendon transplants,” Zeitschrift für Orthop？die und ihre Grenzgebiete, vol. 79, no. 2, pp. 316–334, 1950.
[18]
R. W. Augustine, “The unstable knee,” The American Journal of Surgery, vol. 92, no. 3, pp. 380–388, 1956.
[19]
J. H. McMaster, C. R. Weinert Jr., and P. Scranton Jr., “Diagnosis and management of isolated anterior cruciate ligament tears: a preliminary report on reconstruction with the gracilis tendon,” Journal of Trauma, vol. 14, no. 3, pp. 230–235, 1974.
[20]
W. Campbell, “Repair of the ligaments of the knee: report of a new operation for the repair of the anterior cruciate ligament,” Surgery, Gynecology & Obstetrics, vol. 62, pp. 964–968, 1936.
[21]
L. C. Abbott, J. B. M. Saunders, F. C. Bost, and C. E. Anderson, “Injuries to the ligaments of the knee joints,” The Journal of Bone and Joint Surgery. American, vol. 26, pp. 503–521, 1944.
[22]
K. G. Jones, “Reconstruction of the anterior cruciate ligament using the central one-third of the patellar ligament,” Journal of Bone and Joint Surgery. American, vol. 52, no. 4, pp. 838–839, 1970.
[23]
H. Brückner, “A new method for plastic surgery of cruciate ligaments,” Chirurg, vol. 37, no. 9, pp. 413–414, 1966.
[24]
K. Franke, “Clinical experience in 130 cruciate ligament reconstructions,” Orthopedic Clinics of North America, vol. 7, no. 1, pp. 191–193, 1976.
[25]
J. L. Marshall, R. F. Warren, T. L. Wickiewicz, and B. Reider, “The anterior cruciate ligament: a technique of repair and reconstruction,” Clinical Orthopaedics and Related Research, vol. 143, pp. 97–106, 1979.
[26]
B. J. Benson, “Elemental carbon as a biomaterial,” Journal of Biomedical Materials Research, vol. 5, no. 6, pp. 41–47, 1972.
[27]
I. W. Forster, Z. A. Ralis, B. McKibbin, and D. H. R. Jenkins, “Biological reaction to carbon fiber implants: the formation and structure of a carbon-induced 'neotendon',” Clinical Orthopaedics and Related Research, vol. 131, pp. 299–307, 1978.
[28]
D. H. R. Jenkins, “The repair of cruciate ligaments with flexible carbon fibre. A longer term study of the induction of new ligaments and of the fate of the implanted carbon,” Journal of Bone and Joint Surgery. British, vol. 60, no. 4, pp. 520–522, 1978.
[29]
D. H. R. Jenkins, I. W. Forster, B. McKibbin, and Z. A. Ralis, “Induction of tendon and ligament formation by carbon implants,” Journal of Bone and Joint Surgery. British, vol. 59, no. 1, pp. 53–57, 1977.
[30]
R. N. Tandogan, ？. Ta？er, A. Kayaalp et al., “Analysis of meniscal and chondral lesions accompanying anterior cruciate ligament tears: relationship with age, time from injury, and level of sport,” Knee Surgery, Sports Traumatology, Arthroscopy, vol. 12, no. 4, pp. 262–270, 2004.
[31]
D. H. R. Jenkins and B. McKibbin, “The role of flexible carbon-fibre implants as tendon and ligament substitutes in clinical practice. A preliminary report,” Journal of Bone and Joint Surgery. British, vol. 62, no. 4, pp. 497–499, 1980.
[32]
N. Rushton, D. J. Dandy, and C. P. E. Naylor, “The clinical, arthroscopic and histological findings after replacement of the anterior cruciate ligament with carbon-fibre,” Journal of Bone and Joint Surgery. British, vol. 65, no. 3, pp. 308–309, 1983.
[33]
D. A. Webster and F. W. Werner, “Freeze-dried flexor tendons in anterior cruciate ligament reconstruction,” Clinical Orthopaedics and Related Research, vol. 181, pp. 238–243, 1983.
[34]
R. J. Curtis, J. C. Delee, and D. J. Drez Jr., “Reconstruction of the anterior cruciate ligament with freeze dried fascia lata allografts in dogs. A preliminary report,” American Journal of Sports Medicine, vol. 13, no. 6, pp. 408–414, 1985.
[35]
K. Shino, T. Kawasaki, and H. Hirose, “Replacement of the anterior cruciate ligament by an allogeneic tendon graft. An experimental study in the dog,” Journal of Bone and Joint Surgery. British, vol. 66, no. 5, pp. 672–681, 1984.
[36]
P. K. Nikolaou, A. V. Seaber, and R. R. Glisson, “Anterior cruciate ligament allograft transplantation. Long-term function, histology, revascularization, and operative technique,” American Journal of Sports Medicine, vol. 14, no. 5, pp. 348–360, 1986.
[37]
D. W. Jackson, E. S. Grood, B. T. Cohn, S. P. Arnoczky, T. M. Simon, and J. F. Cummings, “The effects of in situ freezing on the anterior cruciate ligament: an experimental study in goats,” Journal of Bone and Joint Surgery. American, vol. 73, no. 2, pp. 201–213, 1991.
[38]
S. M. Howell, M. P. Wallace, M. L. Hull, and M. L. Deutsch, “Evaluation of the single-incision arthroscopic technique for anterior cruciate ligament replacement: a study of tibial tunnel placement, intraoperative graft tension, and stability,” American Journal of Sports Medicine, vol. 27, no. 3, pp. 284–293, 1999.
[39]
W. G. Clancy Jr., R. G. Narechania, and T. D. Rosenberg, “Anterior and posterior cruciate ligament reconstruction in rhesus monkeys. A histological, microangiographic, and biomechanical analysis,” Journal of Bone and Joint Surgery. American, vol. 63, no. 8, pp. 1270–1284, 1981.
[40]
F. R. Noyes, D. S. Matthews, P. A. Mooar, and E. S. Grood, “The symptomatic anterior cruciate-deficient knee. Part II. The results of rehabilitation, activity modification, and counseling on functional disability,” Journal of Bone and Joint Surgery. American, vol. 65, no. 2, pp. 163–174, 1983.
[41]
J. Gillquist and M. Odensten, “Arthroscopic reconstruction of the anterior cruciate ligament,” Arthroscopy, vol. 4, no. 1, pp. 5–9, 1988.
[42]
M. Marcacci, A. P. Molgora, S. Zaffagnini, A. Vascellari, F. Iacono, and M. Lo Presti, “Anatomic double-bundle anterior cruciate ligament reconstruction with hamstrings,” Arthroscopy, vol. 19, no. 5, pp. 540–546, 2003.
[43]
H. Asagumo, M. Kimura, Y. Kobayashi, M. Taki, and K. Takagishi, “Anatomic reconstruction of the anterior cruciate ligament using double-bundle hamstring tendons: surgical techniques, clinical outcomes, and complications,” Arthroscopy, vol. 23, no. 6, pp. 602–609, 2007.
[44]
G. Bellier, P. Christel, P. Colombet, P. Djian, J. P. Franceschi, and A. Sbihi, “Double-stranded hamstring graft for anterior cruciate ligament reconstruction,” Arthroscopy, vol. 20, no. 8, pp. 890–894, 2004.
[45]
K. Yasuda, E. Kondo, H. Ichiyama, Y. Tanabe, and H. Tohyama, “Clinical evaluation of anatomic double-bundle anterior cruciate ligament reconstruction procedure using hamstring tendon grafts: comparisons among 3 different procedures,” Arthroscopy, vol. 22, no. 3, pp. 240–251, 2006.
[46]
S.-J. Kim, K.-A. Jung, and D.-H. Song, “Arthroscopic double-bundle anterior cruciate ligament reconstruction using autogenous quadriceps tendon,” Arthroscopy, vol. 22, no. 7, pp. 797.e1–797.e5, 2006.
[47]
P. U. Brucker, S. Lorenz, and A. B. Imhoff, “Aperture fixation in arthroscopic anterior cruciate ligament double-bundle reconstruction,” Arthroscopy, vol. 22, no. 11, pp. 1250.e1–1250.e6, 2006.
[48]
J. H. Ahn and S. H. Lee, “Anterior cruciate ligament double-bundle reconstruction with hamstring tendon autografts,” Arthroscopy, vol. 23, no. 1, pp. 109.e1–109.e4, 2007.
