Surgery for anterior cruciate ligament deficiency: a historical perspective

摘要: The anterior cruciate ligament (ACL) has entertained scientific minds since the Weber brothers provided biomechanical insight into importance of ACL in maintaining normal knee kinematics. Robert Adams described first clinical case rupture 1837 some 175 years to date, followed by Mayo-Robson Leeds who performed repair 1895. At that time, most patients presented late and clinicians started appreciate signs symptoms disabilities associated with such injuries. Hey Groves Bristol initial description an reconstruction autologous tissue graft 1917, almost as we know it today. His knowledge achievements were, however, not uniformly appreciated during his life time. What was a period startling ingenuity which created amazing variety different surgical procedures often based more on fashion absence satisfactory alternative than any indication continued refinements were leading improved results. It is hence surprising real inventors forgotten, good ideas discarded untried methods adopted uncritical enthusiasm only be set aside without further explanation. Over past 100 years, surgeons have experimented sources including xenograft, allografts, whilst remained popular choice. Synthetic materials enjoyed temporary popularity 1980 1990s, misguided belief artificial ligaments may durable better equipped withstand stresses strains. Until 1970s, reconstructions considered formidable procedures, so complex fraught peril they reserved for chosen few, never gaining level are enjoying increasing familiarity arthroscopy, popularised through Jackson Dandy, enhancements technology firmly established common procedure within realm surgeons’ ability. More recently, principle anatomic reconstruction, aiming at functional restoration native dimensions insertion sites, been introduced, superseding somewhat ill-advised concept isometric placement. Double-bundle popularity, combined extra- intra-articular seeing revival, but accurate reliable pre- post-operative assessment tools required provide customised treatment options appropriate evaluation comparability long-term Modern surgery united goal re-establishing joint homoeostasis kinematics function ultimately assist reducing prevalence degeneration. This review hopes historical developments various controversies surrounding its progress. Level evidence V.