The Knee Joint: Surgical Techniques and Strategies by Michel Bonnin, Ned Annunziato Amendola, Johan Bellemans,

By Michel Bonnin, Ned Annunziato Amendola, Johan Bellemans, Steven J. MacDonald, Jacques Menetrey

Pushed through the growth of biology, know-how and biomechanics, knee surgical procedure has dramatically advanced within the final many years. This booklet is a "state of the paintings" bearing on all facets of knee surgical procedure from ligament reconstruction to overall Knee Arthroplasty. a global panel of well known authors have labored in this didactic totally illustrated publication. it's going to support younger surgeons to appreciate uncomplicated sciences and sleek sugical thoughts. The skilled physician will locate support to house tough circumstances and clarifications in fresh technologic advances resembling cartilage surgical procedure, navigation and mini invasive surgery.

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Initial loads in the toe region result in non-linear increase of elongation due to successive fiber recruitment. The linear region determines maximum ligament stiffness. At these loads, all ligament fibers are recruited and no structural damage can be observed. The load-elongation curve changes to a non-linear relationship after the yield load is reached. This is due to increasing structural, non-reversible damage of ligament fibers until complete failure takes place at maximal sustained loads.

These findings emphasize the nonisometric function of the ACL and bears important implications for tensioning the respective bundles in ACL double-bundle reconstruction at different ff flexion angles. Passive knee flexion between 10° and fl 110° without application of external loads produced no or a very small strain increase of the AM and PL bundles (59). This implies that free range of motion between 0° and 110° of flexion fl should not have a damaging effect ff on a reconstructed ACL. However, if the knee is hyperextended or hyperflexed, fl a substantial surge in in situ forces between 100 and 240 N and strains up to 8% can be experienced in the ACL (60,64).

Orthop Clin North Am 16(1):3–14 7. Keith A, editor (1933) Human embryology and morphology. Baltimore: Williams Wood and Co 8. Tilmann B (1974) Zur funktionellen Morphologie der Gelenkentwicklung. Orthop Prax 12:328–342 9. Girgis FG, Marshall JL, Monajem A (1975) The Th cruciate ligaments of the knee joint. Anatomical, functional and experimental analysis. Clin Orthop Relat Res 106:216– 231 19 20 The Traumatic Knee 10. Smith BA, Livesay GA, Woo SL (1993) Biology and biomechanics of the anterior cruciate ligament.

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