4.5 Editorial Material

Editorial Commentary: The Importance of Bony Morphology in the Anterior Cruciate Ligament-Injured Patient

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W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.arthro.2021.05.043

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The outcome of ACL surgery is influenced by factors such as patient characteristics, underlying knee pathologies, and bony morphology. Personalizing ACL surgery by evaluating each patient's specific anatomy can improve outcomes and reduce failure rates. Further research and awareness of relevant bony parameters are key to enhancing the ability to prevent injury and increase diagnostic accuracy.
The outcome of anterior cruciate ligament (ACL) surgery depends on many factors. Successful ACL surgery includes evaluating patients' characteristics and addressing all the underlying knee pathologies, including the meniscus tears and ramp lesions. In recent years, there has been a growing interest in ramp lesions as well as the role that bony morphology plays in predisposing patients to ACL injury and failed ACL surgery. Not only pathologic but also physiologic variations in bony morphology like tibial slope and lateral femoral condyle ratio have been correlated with clinical outcomes, failure rates, rotatory instability, and even lesions to the contralateral knee. Evaluating each patient's specific anatomy is recommended when customizing ACL surgery. With further research and increased awareness of relevant bony parameters, we will be able to improve our ability to prevent injury, increase the diagnostic accuracy of associated lesions, and tailor surgery to improve the outcomes and reduce failure rates.

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