This book describes all aspects of a purely biological approach to knee ligament reconstruction that entirely avoids the use of foreign materials in a manner analogous to the use of dowels in carpentry. The technique, referred to as "all-press-fit reconstruction", was developed by the author in 1995 for anterior cruciate ligament (ACL) reconstruction and has since been further developed so that it is now applicable to all knee ligaments and also osteochondral autologous transplantation surgery. It has the advantages of maintenance of individual biological resources (no bone loss), rapid rehabilitation, and excellent clinical outcomes in terms of stability and anchoring.
This book explores subtle clinical and technical diagnostics and provides step-by-step descriptions of the various surgical techniques used by the author. Readers will also learn about the history of ACL reconstruction and the results achieved to date, sources of graft for ACL replacement,the surgical instrumentation required for press-fit fixation, the healing response, and procedures for revision of re-rupture. In addition, rehabilitation and prevention programs are fully described for every level of athletic activity.
Introduction.- Overview Anatomy.- Use and overuse of the knee.- Diagnostic.- History of ACL reconstruction.- History of material free ACL-Reconstruction.- Press fit fixation.- Surgical techniques.- Healing response.- Revision of Re-Rupture.- OATS / Mega OATS.- Rehabilitation.- Return to sports & competition.
Gernot Felmet, MD, is a renowned Consultant Orthopedic and Trauma Surgeon who works at the Artico Sports Clinic in Villingen-Schwenningen, Germany, which he himself founded. From 2014 to 2016, Dr. Felmet served as President of EFOST (European Federation of National Associations of Orthopaedic and Sports Traumatology), having previously been Vice-President of the organization. In 2014 he was responsible for the foundation of the Biological Ligament and Joint Academy (BLJA) in collaboration with EFOST. During his career, Dr. Felmet has introduced a variety of techniques and devices. In 1995 he first proposed "all-press-fit" foreign material-free ACL reconstruction and BTT (bottom to top) fixation and self-adapted graft tensioning. Subsequently, he became the first to use a diamond cutter in material-free ACL reconstruction and a hollow reamer in a robotic system (CASPAR, OrthoMaquet). In 2004 he developed a single-stage material-free ACL revision procedure and more recently he introduced use of the crown and micro-crown cutter and the "vastus medialis test" for quadriceps, "ischiocrural test" for hamstring quality and the digital Rolimeter "Articometer" measurement for transversal instability.
