Key advantages

Natural Stress Distribution 

The ACL is neither round nor double round but it is flat (ribbon-like) with a specific C-shape tibial insertion. The M-ARS ACL ribbon-like structure of the reconstruction reproduces the anatomy and kinematics of the native ACL bundles. 

M-ARS ACL

 

Improved Healing and Reduced Necrosis Risk

The M-ARS ACL technique lowers necrosis risk, due to the reduced distance to bone of the ligament internal fibers: the graft’s healing process is estimated to be shorter and safer.

M-ARS ACL

 

Dedicate Technique Versatility

Medacta offer the versatility of creating the ACL reconstruction with two dedicate techniques:

  • A rectangular Femoral tunnel and “C-Shaped” anatomic Tibial tunnel using dedicated instrumentation
  • A simplified approach with circular Tibial tunnel and rectangular Femoral tunnel with dedicated instrumentation
Clinical data

[1] Sanders TL, Maradit Kremers H, Bryan AJ, Larson DR, Dahm DL, Levy BA, Stuart MJ, Krych MJ. Incidence of Anterior Cruciate Ligament Tears and Reconstruction: a 21-Year Population-Based Study. American Journal Sports Medicine. 2016 June; 44(6): 1502-7. doi 10.1177/0363546516629944. 

[2] David Zbrojkiewicz, Christopher Vertullo and Jane E Grayson. Increasing rates of anterior cruciate ligament reconstruction in young Australians, 2000–2015. Medical Journal of Australia. 2018; 208 (8): 354-358. || doi: 10.5694/mja17.00974. 

[3] Pierre Chambat,corresponding author Christian Guier, Bertrand Sonnery-Cottet, Jean-Marie Fayard, and Mathieu Thaunat. The evolution of ACL reconstruction over the last fifty years. Int Orthop. 2013 Feb; 37(2): 181–186. doi: 10.1007/s00264-012-1759-3. 

[4] Śmigielski R, Zdanowicz U, Drwięga M, Ciszek B, Ciszkowska-Łysoń B, Siebold R. Ribbon like appearance of the midsubstance fibres of the anterior cruciate ligament close to its femoral insertion site: a cadaveric study including 111 knees. Knee Surgery, Sports Traumatology, Arthroscopy. 2015;23(11):3143-3150. doi:10.1007/s00167-014-3146-7. 

[5] Rainer Siebold, Peter Schuhmacher, Axel Brehmer, Francis Fernadez, Robert Smigielski, Joachim Kirsch. Tibial C-Shaped Insertion of the Anterior Cruciate Ligament Without Posterolateral Bundle. Anterior Cruciate Ligament Reconstruction: A Practical Surgical Guide, Springer Berlin Heidelberg. 2014;19-27. 

[6] Robert Śmigielski, Urszula Zdanowicz, Michał Drwięg, Bogdan Ciszek , and Rainer Siebold, Ribbon like Anatomy of the Anterior Cruciate Ligament from Its Femoral Insertion to the Midsubstance. Anterior Cruciate Ligament Reconstruction: A Practical Surgical Guide, Springer Berlin Heidelberg. 2014;3-10. 

[7] Tomoyuki Mochizuki, Akimoto Nimura, Kazunori Yasuda, Takeshi Muneta, and Keiichi Akita, Anatomic and Histological Analysis of the Midsubstance and Fanlike Extension Fibers of the ACL, Anterior Cruciate Ligament Reconstruction: A Practical Surgical Guide, Springer Berlin Heidelberg. 2014;11-17. 

[8] Rainer Siebold and Robert S´migielski, Arthroscopic Appearance of the “C” –Shaped Insertion of the Anterior Cruciate Ligament, Anterior Cruciate Ligament Reconstruction: A Practical Surgical Guide, Springer Berlin Heidelberg. 2014;33-35. 

[9] CD. Murawski et al, Anatomic Anterior Cruciate Ligament Reconstruction Current Concepts and Future Perspective, Cartilage. 2013 Jul; 4(3 Suppl): 27S–37S. doi: 10.1177/1947603513486557. 

[10] Petersen W, Forkel P, Achtnich A, Metzlaff S, Zantop T. Technique of anatomical footprint reconstruction of the ACL with oval tunnels and medial portal aimers. Arch Orthop Trauma Surg. 2013 Jun;133(6):827-33. doi: 10.1007/s00402-013-1741-6. PMID: 23632778 [PubMed - indexed for MEDLINE]. 

[11] R. Siebold, P Schuhmacher, F Fernandez, R S´migielski, C Fink, A Brehmer, J Kirsch Flat midsubstance of the anterior cruciate ligament with tibial ‘‘C’’-shaped insertion site Knee Surg Sports Traumatol Arthrosc (2015) 23:3136–3142. 

[12] R. Śmigielski, U. Zdanowicz, M. Drwięga, B. Ciszek, A. Williams The anatomy of the anterior cruciate ligament and its relevance to the technique of reconstruction Bone Joint J 2016;98-B:1020–6. 

[13] C Janovsky, C Cohen Kaleka, MT Seixas Alves, M Ferretti, M Cohen Synovial C-Shaped Tibial Footprint of the Anterior Cruciate Ligament The Orthopaedic Journal of Sports Medicine, 4(11), 2325967116671300. 

Supporting devices
  • Instruments: M-ARS ACL Instruments and Implants Set 

  • Accessories: Graft Preparation Board, Knee General Instruments Set 

  • Sutures: PowerSuture, PowerKnot 

Resources
For additional resources please visit resources.medacta.com