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20.05.2020 | Arthropedia | Online-Artikel

VKB-Ruptur – Therapie

VKB-erhaltende Techniken

A. Achtnich, M. Herbort

Literatur

VKB-erhaltende Techniken

  1. Taylor SA, Khair MM, Roberts TR, DiFelice GS. Primary Repair of the Anterior Cruciate Ligament: A Systematic Review. Arthroscopy. 2015;31(11):2233-47.
  2. Weninger P, Wepner F, Kissler F, Enenkel M, Wurnig C. Anatomic Double-Bundle Reinsertion After Acute Proximal Anterior Cruciate Ligament Injury Using Knotless PushLock Anchors. Arthrosc Tech. 2015;4(1):e1-6.
  3. DiFelice GS, Villegas C, Taylor S. Anterior Cruciate Ligament Preservation: Early Results of a Novel Arthroscopic Technique for Suture Anchor Primary Anterior Cruciate Ligament Repair. Arthroscopy. 2015;31(11):2162-71.
  4. Wasmaier J, Kubik-Huch R, Pfirrmann C, Grehn H, Bieg C, Eid K. Proximal anterior cruciate ligament tears: the healing response technique versus conservative treatment. J Knee Surg. 2013;26(4):263-71.
  5. Kaplan N, Wickiewicz TL, Warren RF. Primary surgical treatment of anterior cruciate ligament ruptures. A long-term follow-up study. Am J Sports Med. 1990;18(4):354-8.
  6. O'Donoghue DH, Frank GR, Jeter GL, Johnson W, Zeiders JW, Kenyon R. Repair and reconstruction of the anterior cruciate ligament in dogs. Factors influencing long-term results. J Bone Joint Surg Am. 1971;53(4):710-8.
  7. Sherman MF, Lieber L, Bonamo JR, Podesta L, Reiter I. The long-term followup of primary anterior cruciate ligament repair. Defining a rationale for augmentation. Am J Sports Med. 1991;19(3):243-55.
  8. Henle P, Roder C, Perler G, Heitkemper S, Eggli S. Dynamic Intraligamentary Stabilization (DIS) for treatment of acute anterior cruciate ligament ruptures: case series experience of the first three years. BMC Musculoskelet Disord. 2015;16:27.
  9. van der List JP, DiFelice GS. Preservation of the Anterior Cruciate Ligament: Surgical Techniques. Am J Orthop (Belle Mead NJ). 2016;45(7):E406-E14.
  10. Steadman JR, Cameron-Donaldson ML, Briggs KK, Rodkey WG. A minimally invasive technique ("healing response") to treat proximal ACL injuries in skeletally immature athletes. J Knee Surg. 2006;19(1):8-13.
  11. Achtnich A, Herbst E, Forkel P, Metzlaff S, Sprenker F, Imhoff AB, et al. Acute Proximal Anterior Cruciate Ligament Tears: Outcomes After Arthroscopic Suture Anchor Repair Versus Anatomic Single-Bundle Reconstruction. Arthroscopy. 2016;32(12):2562-9.
  12. Achtnich A, Rosslenbroich S, Beitzel K, Imhoff AB, Petersen W. [Arthroscopic refixation of acute proximal anterior cruciate ligament rupture using suture anchors]. Oper Orthop Traumatol. 2017;29(2):173-9.
  13. Murray MM, Flutie BM, Kalish LA, Ecklund K, Fleming BC, Proffen BL, et al. The Bridge-Enhanced Anterior Cruciate Ligament Repair (BEAR) Procedure: An Early Feasibility Cohort Study. Orthop J Sports Med. 2016;4(11):2325967116672176.

Die dynamische intraligamentäre Stabilisierung (DIS) mittels des Ligamys®-Verfahrens

  1. Ateschrang, A. et al., 2018. Recovery of ACL function after dynamic intraligamentary stabilization is resultant to restoration of ACL integrity and scar tissue formation. Knee Surgery, 26(2), pp.589–595.
  2. Eggli, S. et al., 2015. Dynamic intraligamentary stabilization: novel technique for preserving the ruptured ACL. Knee Surgery Sports Traumatology Arthroscopy, 23(4), pp.1215–1221.
  3. Häberli, J. et al., 2016. Knee joint kinematics with dynamic augmentation of primary anterior cruciate ligament repair - a biomechanical study. Journal of Experimental Orthopaedics, 3(1), p.2230.
  4. Henle, P. et al., 2015. Dynamic Intraligamentary Stabilization (DIS) for treatment of acute anterior cruciate ligament ruptures: case series experience of the first three years. BMC musculoskeletal disorders, 16(1), p.27.
  5. Hoogeslag, R.A.G. et al., Improved control of knee laxity after “dynamic” augmentation of ACL suture repair
  6. Biomechanical comparison of three ACL suture repair techniques in the human cadaveric knee. In isakos.com. Shanghay, China.
  7. Kohl, S. et al., 2016. Dynamic intraligamentary stabilisation: initial experience with treatment of acute ACL ruptures. The bone & joint journal, 98-B(6), pp.793–798.
  8. Kösters, C. et al., 2015. [Dynamic intraligamentary stabilization of the anterior cruciate ligament : Operative technique and short-term clinical results]. Unfallchirurg, 118(4), pp.364–371.
  9. Lubowitz, J.H., 2014. Anatomic ACL reconstruction produces greater graft length change during knee range-of-motion than transtibial technique. Knee Surgery, 22(5), pp.1190–1195.
  10. Meister, M. et al., 2018. ACL suturing using dynamic intraligamentary stabilisation showing good clinical outcome but a high reoperation rate: a retrospective independent study. Knee Surgery, 26(2), pp.655–659.
  11. Schliemann, B., Herbort, M., et al., 2015. Dynamische intraligamentäre Stabilisierung frischer Rupturen des vorderen Kreuzbands (Ligamys). Trauma und Berufskrankheit, 18(3), pp.254–259.
  12. Schliemann, B., Lenschow, S., et al., 2015. Knee joint kinematics after dynamic intraligamentary stabilization: cadaveric study on a novel anterior cruciate ligament repair technique. Knee Surgery, 25(4), pp.1–7.

VKB-Refixation mittels Anker

  1. Achtnich A, Herbst E, Forkel P, Metzlaff S, Sprenker F, Imhoff AB, et al. Acute Proximal Anterior Cruciate Ligament Tears: Outcomes After Arthroscopic Suture Anchor Repair Versus Anatomic Single-Bundle Reconstruction. Arthroscopy. 2016;32(12):2562-9.
  2. Achtnich A, Rosslenbroich S, Beitzel K, Imhoff AB, Petersen W. [Arthroscopic refixation of acute proximal anterior cruciate ligament rupture using suture anchors]. Oper Orthop Traumatol. 2017;29(2):173-9.

VKB-Reinsertion mit Internal BracingTM

  1. Mackay, G. M., Blyth, M. J. G., Anthony, I., Hopper, G. P., & Ribbans, W. J. (2015). A review of ligament augmentation with the InternalBrace: the surgical principle is described for the lateral ankle ligament and ACL repair in particular, and a comprehensive review of other surgical applications and techniques is presented. Surgical Technology International, 26, 239–255.
  2. Crain, E. H., Fithian, D. C., Paxton, E. W., & Luetzow, W. F. (2005). Variation in anterior cruciate ligament scar pattern: does the scar pattern affect anterior laxity in anterior cruciate ligament-deficient knees? Arthroscopy: the Journal of Arthroscopic & Related Surgery, 21(1), 19–24. http://doi.org/10.1016/j.arthro.2004.09.015
  3. Sherman, M. F., Lieber, L., Bonamo, J. R., Podesta, L., & Reiter, I. (1991). The long-term followup of primary anterior cruciate ligament repair. Defining a rationale for augmentation. The American Journal of Sports Medicine, 19(3), 243–255. http://doi.org/10.1177/036354659101900307
  4. Achtnich, A., Herbst, E., Forkel, P., Metzlaff, S., Sprenker, F., Imhoff, A. B., & Petersen, W. (2016). Acute Proximal Anterior Cruciate Ligament Tears: Outcomes After Arthroscopic Suture Anchor Repair Versus Anatomic Single-Bundle Reconstruction. Arthroscopy: the Journal of Arthroscopic & Related Surgery, 32(12), 2562–2569. http://doi.org/10.1016/j.arthro.2016.04.031
  5. van der List, J. P., & DiFelice, G. S. (2017). Role of tear location on outcomes of open primary repair of the anterior cruciate ligament: A systematic review of historical studies. The Knee, 24(5), 898–908. http://doi.org/10.1016/j.knee.2017.05.009
  6. DiFelice, G. S., & van der List, J. P. (2018). Clinical Outcomes of Arthroscopic Primary Repair of Proximal Anterior Cruciate Ligament Tears Are Maintained at Mid-term Follow-up. Arthroscopy: the Journal of Arthroscopic & Related Surgery, 34(4), 1085–1093. http://doi.org/10.1016/j.arthro.2017.10.028

Remnant-Preserving

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  2. Ahn JH, Lee SH, Choi S-H, Lim TK (2010) Magnetic resonance imaging evaluation of anterior cruciate ligament reconstruction using quadrupled hamstring tendon autografts: comparison of remnant bundle preservation and standard technique. Am J Sports Med 38:1768–1777
  3. Ahn JH, Lee YS, Ha HC (2009) Anterior cruciate ligament reconstruction with preservation of remnant bundle using hamstring autograft: technical note. Arch Orthop Trauma Surg 129:1011–1015
  4. Ahn JH, Lee YS, Lee SH (2014) Creation of an anatomic femoral tunnel with minimal damage to the remnant bundle in remnant-preserving anterior cruciate ligament reconstruction using an outside-in technique. Arthrosc Techn 3:e175–9
  5. Boutsiadis A, Karampalis C, Tzavelas A, Vraggalas V, Christodoulou P, Bisbinas I (2015) Anterior Cruciate Ligament Remnant-Preserving Reconstruction Using a “Lasso-Loop” Knot Configuration. Arthrosc Techn 4:e741–6
  6. Bray RC, Leonard CA, Salo PT (2002) Vascular physiology and long-term healing of partial ligament tears. J Orthop Res 20:984–989
  7. Cha J, Choi S-H, Kwon JW, Lee SH, Ahn JH (2012) Analysis of cyclops lesions after different anterior cruciate ligament reconstructions: a comparison of the single-bundle and remnant bundle preservation techniques. Skeletal Radiol 41:997–1002
  8. Chun KC, Lee SH, Kim JW, Jin EJ, Kim KM, Chun CH (2017) Immunohistochemical and immunocytochemical study of mechanoreceptors in anterior cruciate ligament reconstruction with the remnant-preserving technique using Achilles tendon allografts. J Orthop Surg Res 12:93
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  10. Crain EH, Fithian DC, Paxton EW, Luetzow WF (2005) Variation in anterior cruciate ligament scar pattern: does the scar pattern affect anterior laxity in anterior cruciate ligament-deficient knees? Arthroscopy 21:19–24
  11. da Silveira Franciozi CE, Ingham SJM, Gracitelli GC, Luzo MVM, Fu FH, Abdalla RJ (2014) Updates in biological therapies for knee injuries: anterior cruciate ligament. Curr Rev Musculoskelet Med 7:228–238
  12. Dejour D, Ntagiopoulos PG, Saggin PR, Panisset J-C (2013) The diagnostic value of clinical tests, magnetic resonance imaging, and instrumented laxity in the differentiation of complete versus partial anterior cruciate ligament tears. Arthroscopy 29:491–499
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  14. Dhillon MS, Bali K, Prabhakar S (2012) Differences among mechanoreceptors in healthy and injured anterior cruciate ligaments and their clinical importance. Muscles Ligaments Tendons J 2:38–43
  15. Di Matteo B, Loibl M, Andriolo L, Filardo G, Zellner J, Koch M, Angele P (2016) Biologic agents for anterior cruciate ligament healing: A systematic review. World J Orthop 7:592–603
  16. Dodds JA, Arnoczky SP (1994) Anatomy of the anterior cruciate ligament: a blueprint for repair and reconstruction. Arthroscopy 10:132–139
  17. Falconiero RP, DiStefano VJ, Cook TM (1998) Revascularization and ligamentization of autogenous anterior cruciate ligament grafts in humans. Arthroscopy 14:197–205
  18. Fehske K, Steinert A, Eichhorn HJ (2013) Intraoperative biological augmentation techniques for ligament surgery. Arthroskopie 26:133–138
  19. Fritschy D, Panoussopoulos A, Wallensten R, Peter R (1997) Can we predict the outcome of a partial rupture of the anterior cruciate ligament? A prospective study of 43 cases. Knee Surg Sports Traumatol Arthrosc 5:2–5
  20. Gao F, Zhou J, He C, Ding J, Lou Z, Xie Q, Li H, Li F, Li G (2016) A Morphologic and Quantitative Study of Mechanoreceptors in the Remnant Stump of the Human Anterior Cruciate Ligament. Arthroscopy 32:273–280
  21. Georgoulis AD, Pappa L, Moebius U, Malamou-Mitsi V, Pappa S, Papageorgiou CO, Agnantis NJ, Soucacos PN (2001) The presence of proprioceptive mechanoreceptors in the remnants of the ruptured ACL as a possible source of re-innervation of the ACL autograft. Knee Surg Sports Traumatol Arthrosc 9:364–368
  22. Guo L, Chen H, Luo J-M, Yang L, Gu L-C, Fu D-J (2016) An Arthroscopic Second-Look Study on the Effect of Remnant Preservation on Synovialization of Bone-Patellar Tendon-Bone Allograft in Anterior Cruciate Ligament Reconstruction. Arthroscopy 32:868–877
  23. Hong L, Li X, Zhang H, Liu X, Zhang J, Shen JW, Feng H (2012) Anterior cruciate ligament reconstruction with remnant preservation: a prospective, randomized controlled study. Am J Sports Med 40:2747–2755
  24. Kim MK, Lee SR, Ha JK, Ra HJ, Kim SB, Kim JG (2014) Comparison of second-look arthroscopic findings and clinical results according to the amount of preserved remnant in anterior cruciate ligament reconstruction. Knee 21:774–778
  25. Koch M, Matteo BD, Eichhorn J, Zellner J, Mayr F, Krutsch W, Achenbach L, Woehl R, Nerlich M, Angele P (2018) Intra-ligamentary autologous conditioned plasma and healing response to treat partial ACL ruptures. Arch Orthop Trauma Surg 138:675–683
  26. Kondo E, Yasuda K, Onodera J, Kawaguchi Y, Kitamura N (2015) Effects of Remnant Tissue Preservation on Clinical and Arthroscopic Results After Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction. Am J Sports Med 43:1882–1892
  27. Lee B-I, Kim BM, Kho DH, Kwon S-W, Kim HJ, Hwang HR (2016) Does the tibial remnant of the anterior cruciate ligament promote ligamentization? Knee 23:1133–1142
  28. Lee B-I, Kwon S-W, Choi H-S, Chun D-I, Kim Y-B, Kim BM (2015) Anatomic Single-Bundle Anterior Cruciate Ligament Reconstruction With Remnant Preservation Using Outside-In Technique. Arthrosc Techn 4:e331–4
  29. Lee B-I, Kwon S-W, Kim J-B, Choi H-S, Min K-D (2008) Comparison of clinical results according to amount of preserved remnant in arthroscopic anterior cruciate ligament reconstruction using quadrupled hamstring graft. Arthroscopy 24:560–568
  30. Lee B-I, Min K-D, Choi H-S, Kim J-B, Kim S-T (2006) Arthroscopic anterior cruciate ligament reconstruction with the tibial-remnant preserving technique using a hamstring graft. Arthroscopy 22:340.e1–7
  31. Lee B-I, Min K-D, Choi H-S, Kwon S-W, Chun D-I, Yun ES, Lee DW, Jin SY, Yoo JH (2009) Immunohistochemical study of mechanoreceptors in the tibial remnant of the ruptured anterior cruciate ligament in human knees. Knee Surg Sports Traumatol Arthrosc 17:1095–1101
  32. Lee D-H, Ng J, Chung J-W, Sonn CH, Lee K-M, Han SB (2014) Impact of chronicity of injury on the proportion of mesenchymal stromal cells derived from anterior cruciate ligaments. Cytotherapy 16:586–598
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  34. Mitani G, Sato M, Yamato M, Kokubo M, Takagaki T, Ebihara G, Okano T, Mochida J (2014) Potential utility of cell sheets derived from the anterior cruciate ligament and synovium fabricated in temperature-responsive culture dishes. J Biomed Mater Res 102:2927–2933
  35. Muneta T, Koga H, Ju Y-J, Horie M, Nakamura T, Sekiya I (2013) Remnant volume of anterior cruciate ligament correlates preoperative patients' status and postoperative outcome. Knee Surg Sports Traumatol Arthrosc 21:906–913
  36. Nakamae A, Ochi M, Deie M, Adachi N, Shibuya H, Ohkawa S, Hirata K (2014) Clinical outcomes of second-look arthroscopic evaluation after anterior cruciate ligament augmentation: comparison with single- and double-bundle reconstruction. Bone Joint J 96-B:1325–1332
  37. Noh JH, Kyung HS, Roh YH, Kang TS (2017) Remnant-preserving and re-tensioning technique to cover the graft in anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 25:1205–1210
  38. Noh JH, Yoon KH, Song SJ, Roh YH (2014) Re-tensioning technique to cover the graft with remnant in anterior cruciate ligament reconstruction. Arthrosc Techn 3:e679–82
  39. Nohmi S, Yamamoto Y, Mizukami H, Ishibashi Y, Tsuda E, Maniwa K, Yagihashi S, Motomura S, Toh S, Furukawa K-I (2012) Post injury changes in the properties of mesenchymal stem cells derived from human anterior cruciate ligaments. Int Orthop 36:1515–1522
  40. Ochi M, Adachi N, Deie M, Kanaya A (2006) Anterior cruciate ligament augmentation procedure with a 1-incision technique: anteromedial bundle or posterolateral bundle reconstruction. Arthroscopy 22:463.e1–5
  41. Park SY, Oh H, Park SW, Lee JH, Lee SH, Yoon KH (2012) Clinical outcomes of remnant-preserving augmentation versus double-bundle reconstruction in the anterior cruciate ligament reconstruction. Arthroscopy 28:1833–1841
  42. Schultz RA, Miller DC, Kerr CS, Micheli L (1984) Mechanoreceptors in human cruciate ligaments. A histological study. J Bone Joint Surg Am 66:1072–1076
  43. Schutte MJ, Dabezies EJ, Zimny ML, Happel LT (1987) Neural anatomy of the human anterior cruciate ligament. J Bone Joint Surg Am 69:243–247
  44. Shimizu T, Takahashi T, Wada Y, Tanaka M, Morisawa Y, Yamamoto H (1999) Regeneration process of mechanoreceptors in the reconstructed anterior cruciate ligament. Arch Orthop Trauma Surg 119:405–409
  45. Sonnery-Cottet B, Freychet B, Murphy CG, Pupim BHB, Thaunat M (2014) Anterior Cruciate Ligament Reconstruction and Preservation: The Single-Anteromedial Bundle Biological Augmentation (SAMBBA) Technique. Arthrosc Techn 3:e689–93
  46. Strobel MJ, Zantop T (2014) Arthroskopische Chirurgie. Teil 1 Kniegelenk, Band 3 Vorderes Kreuzband, VKB Revision. Springer
  47. Sutter EG, Anderson JA, Garrett WE (2015) Direct Visualization of Existing Footprint and Outside-In Drilling of the Femoral Tunnel in Anterior Cruciate Ligament Reconstruction in the Knee. Arthrosc Techn 4:e107–13
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  49. Tanabe Y, Yasuda K, Kondo E, Kitamura N (2016) Clinical results of anterior cruciate ligament reconstruction with ligament remnant tissue preservation: A systematic review. Asia Pac J Sports Med Arthrosc Rehabil Technol 4:1–8
  50. Uefuji A, Matsumoto T, Matsushita T, Ueha T, Zhang S, Kurosaka M, Kuroda R (2014) Age-Related Differences in Anterior Cruciate Ligament Remnant Vascular-Derived Cells. Am J Sports Med 42:1478–1486
  51. Zhang Q, Zhang S, Cao X, Liu L, Liu Y, Li R (2014) The effect of remnant preservation on tibial tunnel enlargement in ACL reconstruction with hamstring autograft: a prospective randomized controlled trial. Knee Surg Sports Traumatol Arthrosc 22:166–173

Die Anmeißelung des vorderen Kreuzbands in der sog. Healing-Response-Technik

  1. Ahlden M, Samuelsson K, Sernert N, Forssblad M, Karlsson J, Kartus J (2012) The Swedish National Anterior Cruciate Ligament Register: a report on baseline variables and outcomes of surgery for almost 18,000 patients. Am J Sports Med 40:2230-2235
  2. Altmann D (2006) Operativer Standard bei frischen Kreuzbandverletzungen: Healing-response-Technik - eine moderne Alternative? Trauma und Berufskrankheit 6:1-10
  3. Fehske K, Jovic S, Ziai P, Meffert RH, Eichhorn HJ (2012) Mittel- und langfristige Ergebnisse nach Anmeißelung des vorderen Kreuzbands in der sogenannten Healing Response Technik. 29 AGA Kongress, Zürich:
  4. Jorjani J, Altmann D, Auen R, Koopmann C, Lyutenski B, Wirtz DC (2013) Mittel- bis langfristige Ergebnisse nach vorderer Kreuzbandruptur und Versorgung in Healing-Response-Technik. Z Orthop Unfall 151:570-579
  5. Koch M, Matteo BD, Eichhorn J, Zellner J, Mayr F, Krutsch W, Achenbach L, Woehl R, Nerlich M, Angele P (2018) Intra-ligamentary autologous conditioned plasma and healing response to treat partial ACL ruptures. Arch Orthop Trauma Surg 138:675-683
  6. Muaidi QI, Nicholson LL, Refshauge KM, Adams RD, Roe JP (2009) Effect of anterior cruciate ligament injury and reconstruction on proprioceptive acuity of knee rotation in the transverse plane. Am J Sports Med 37:1618-1626
  7. Murray MM, Martin SD, Martin TL, Spector M (2000) Histological changes in the human anterior cruciate ligament after rupture. J Bone Joint Surg Am 82-A:1387-1397
  8. Nagai T, Heebner NR, Sell TC, Nakagawa T, Fu FH, Lephart SM (2012) Restoration of sagittal and transverse plane proprioception following anatomic double-bundle ACL reconstruction. Knee Surg Sports Traumatol Arthrosc:epup DOI10.007/s00167-00012-02188-y
  9. Petersen W, Zantop T (2007) Anatomy of the anterior cruciate ligament with regard to its two bundles. Clin Orthop Relat Res 454:35-47
  10. Rathbone S, Maffulli N, Cartmell SH (2012) Most british surgeons would consider using a tissue-engineered anterior cruciate ligament: a questionnaire study. Stem Cells Int 2012:303724
  11. Steadman JR (2002) Healing Resonse Treatment for ACL Injuries. Orthop Technol Rev 3-3
  12. Steadman JR, Cameron-Donaldson ML, Briggs KK, Rodkey WG (2006) A minimally invasive technique ("healing response") to treat proximal ACL injuries in skeletally immature athletes. J Knee Surg 19:8-13
  13. Steadman JR, Matheny LM, Briggs KK, Rodkey WG, Carreira DS (2012) Outcomes following healing response in older, active patients: a primary anterior cruciate ligament repair technique. J Knee Surg 25:255-260
  14. Steinert AF, Kunz M, Prager P, Barthel T, Jakob F, Noth U, Murray MM, Evans CH, Porter RM (2011) Mesenchymal stem cell characteristics of human anterior cruciate ligament outgrowth cells. Tissue Eng Part A 17:1375-1388

Healing Response mit Knochenschuppe

  1. Steadman, J.R., et al., A minimally invasive technique ("healing response") to treat proximal ACL injuries in skeletally immature athletes. J Knee Surg, 2006. 19(1): p. 8-13.
  2. Steadman, J.R., et al., Outcomes following healing response in older, active patients: a primary anterior cruciate ligament repair technique. J Knee Surg, 2012. 25(3): p. 255-60.
  3. Jorjani, J., et al., [Medium- to long-term follow-up after anterior cruciate ligament rupture and repair in healing response technique]. Z Orthop Unfall, 2013. 151(6): p. 570-9.
  4. Wasmaier, J., et al., Proximal anterior cruciate ligament tears: the healing response technique versus conservative treatment. J Knee Surg, 2013. 26(4): p. 263-71.
  5. Felmet, G., Healing Response - indications and results, in World Sports Trauma Congress & 7th EFOST Congress. 2012: London.
  6. Felmet, G., ACL & PCL Healing Response - indication and results, in SICOT International Orthopedics. 2016: Wuerzburg, Germany.
  7. Felmet, G., Healing Response - Indikation und Ergebnisse, in 32. AGA Kongress. 2015: Dresden.
  8. Koch, M., et al., Intra-ligamentary autologous conditioned plasma and healing response to treat partial ACL ruptures. Arch Orthop Trauma Surg, 2018. 138(5): p. 675-683.

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