الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 151 |  |  |
| | | from | 151 | | |
Abstract
ACL reconstruction has been the surgery of choice for ACL injury for multiple decades, now with the advancement in technology in detecting injuries and the pursue of high demands in sports, the anterior cruciate ligament became in high focus in how to prevent the injury and the best way to treat the ACL injury whether repair or reconstruction. However there has been debate over ACL reconstruction about tunnel positioning (Garofalo et al., 2007) to restore the patient’s knee kinematics to return to their activities. The kinematics in post ACL reconstruction has been point of research in attempt to restore normal knee function (Iriuchishima et al., 2011; Sadoghi et al., 2011) some studies have noted that 88% of failure is due to non-anatomical placement of the femoral tunnel(Kopf et al., 2010; Marchant et al., 2010; Hosseini et al., 2012) it has been general consensus that placement of the ACL graft within its footprint will lead to normal kinematics rather than non-anatomical placement. Obliquity of the graft plays a major role in providing a restoration of knee kinematics avoiding anterior translation of the tibia and rotational movements (Zampeli et al., 2012). Two techniques are commonly used to ream the femoral tunnel, the transtibial tunnel and the antromedial approach, the conventional transtibial ACL reconstruction results into vertical graft that can prevent anterior translation of the tibia but has poor control on rotational movement. Anatomical reconstruction is to put the graft in the position of the native ACL in the tibial and femoral footprint giving an oblique ligament that can control rotational movement (Zampeli et al., 2012). The Antromedial (trans portal) techniques allow precise aim at the original femoral footprint but it requires to hyper flex the knee to drill a deep tunnel and avoid tunnel blowout (Arnold et al., 2001; Heming et al., 2007; Duquin et al., 2009; Bedi et al., 2011; McRae et al., 2011; Siegel et al., 2012) which is one of the disadvantages as well as presence of acute turn in the graft, injury of medial meniscus, injury the medial femoral condyle surface, injury to lateral structures like common peroneal nerve and it take more time to prepare the femoral site (Yamamoto et al., 2004).