Guidelines for single- (SB) and double-bundle (DB) ACL reconstruction based on the concept of complete footprint restoration were introduced. The goal of the concept is to reconstruct a maximum of anterior cruciate ligament (ACL) insertion site area to regain a maximum of ACL function. It is based on the hypothesis, that the restored biomechanical envelope of the knee is a function of reconstructed ACL insertion site area.Individual combinations of graft diameters and drill angles were calculated and matched for all individual insertion site lengths between 8-21 mm to maximize the percentage of anatomical footprint restoration. An "insertion site table" was developed to propose individual guidelines during ACL surgery for SB and DB ACL reconstruction based on the intraoperative measurement of the tibial insertion site length.
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