This new treatise is the most outstanding piece of work on the knee and its associated ligaments currently available. Never before have I seen such an extensive study of the biomechanics of the knee with such a comprehensive review of the literature. The first section of the book, which deals with the functional anatomy (structure and biomechanics), immediately alerts the reader to the necessity of understanding the natural develop ment and action of the related structures, clearly emphasizing that successful diagnosis and treatment cannot otherwise be expected; the many who want an easy standard approach to each classic problem may find this hard to accept. Study what Werner Muller has written and compare it with your own findings from repeated dissection of anatomical specimens. The author goes on to stress that to have a real grasp of reconstructive surgery of the ligaments, one must be properly acquainted with the pathology and the repair of acute lesions. In no other way can one learn to recognize chronic problems. Once this step has been mastered it can be seen that the reconstructive procedures that Muller advocates do, for the most part, follow the laws of Nature rather than create the kind of abnormalities which often disrupt natural anatomical func tion.

Anatomy

Form, Function, and Synergisms
Kinematics
Kinematics of the Rolling-Gliding Principle
Model of the Crossed Four-Bar Linkage
Varying Ratio of Rolling to Gliding
Kinematics and Anatomic Form of the Femoral Condyle
Superposition of the Patellar Gliding Surface on the Femoral Condyle
The Cruciate Ligaments as the Foundation of Knee Joint Kinematics
Kinematics and Applied Physiology and Pathophysiology of the Ligaments
Cruciate Ligaments
Collateral Ligaments
Medial Collateral Ligament
Inevitable Placement of Some Ligament Fibers Outside the Theoretical Ideal Line
The Ideal Lines of Ligament Insertion and the "Dynamization" of Articular Ligaments
The Retinaculum and Pes Anserinus as "Dynamized Ligaments"
The Medial Ligament System During Movement
The Lateral Collateral Ligament
The Lateral Ligament System During Movement
The Iliotibial Tract as a Direct Femorotibial Collateral Ligament
The Theoretical Interplay of the Cruciate and Collateral Ligaments
Automatic Rotation, Terminal Rotation, Initial Rotation
The Cruciate Ligaments and Movement of the Knee Joint in More Than One Plane
The Three-Dimensional Four-Bar Linkage and the Central Pivot
The Posteromedial Corner (Semimembranosus Corner)
Interaction of the Ligaments During Rotation
The Posterolateral Corner (Popliteus Corner)
Active Stabilization Under Proprioceptive Control
Rotation
Physiology and Pathophysiology of Free and Active Rotation
Active Rotation by the Extensors
Active Rotation by the Flexors
Varus-Flexion-IR and Valgus-Flexion-ER
Injuries of the Active Rotational System
Agonism and Antagonism Between Extensor-Flexors and Rotators
Passive Rotatory Stabilization
The Principle of the Triangular Structure in Passive Rotatory Stabilization
The Role of the Fabella
The Triangular Arrangement of the MCL and POL as an Aid to Passive Rotatory Stabilization
Physiology and Pathophysiology of the Menisci During Rotation
Examination of the Injured Knee Joint
General Symptoms
Testing the Stability of the Knee
General Considerations and Methods
Testing Lateral Stability
Measurement of Instability
Testing Anterior and Posterior Stability
Roentgenographic Examination
Testing Rotational Stability
Pathophysiology of Rotatory Instabilities
Cruciate Ligament Insufficiency and Lateral Subluxation Phenomena with the Corresponding Clinical Tests
Classification of Instabilities
Instabilities in One Plane or About One Axis
Rotatory Instabilities
Combined Instabilities
Ligamentous Injuries and Instabilities
Analysis of the Biomechanical Effects of Ligamentous Injuries on Stability in the Four Quadrants
Instability - Disability
Injuries of the Ligaments and Capsule
General
The Layers of the Medial Capsuloligamentous System
Medial Ligamentous Injuries with Disruptions of Bone and Ligament Continuity
The Ligamentous Injury as a Function of the Force and Rate of Deformation
The Three Degrees of Severity of Ligamentous Injuries
General Operating Technique
Suturing Technique for the Various Degrees of Ligamentous Injury
The Fixation of Avulsed Ligaments with a Screw and Toothed Washer
Surgical Approaches
Vessels and Nerves
Medial Incisions
Lateral Incisions
Lateral Long Parapatellar Incision
Posterior Approach to the Knee Joint
The Primary Repair of Special Injuries
Injuries of the Medial Side and Their Repair
General
The Normal Medial Aspect
Tears of the Deep Layer and the POL
Proximal Avulsion of Both Medial Ligaments
Principal Tears of the Classic Medial Collateral Ligament
Temporary Internal Splinting
Typical Lesions Accompanying Injuries of the Medial Side
Special Injuries of the Semimembranosus Corner
Concluding Remarks on Medial Injuries
Injuries of the Lateral Side and Their Repair
General
The Major Passive and Active Stabilizing Structures of the Lateral Side
Injuries of the Lateral Collateral Ligament (LCL)
Combined Injuries
Injuries of the Cruciate Ligaments and Their Repair
The Blood Supply of the Cruciate Ligaments
The Normal Structure of the Cruciate Ligaments
Tears of the Anterior Cruciate Ligament and Their Repair
Recurrent Post-Traumatic Hemarthrosis
Compensation Limit and Decompensation Threshold
Compensatory Reserve
Tears of the Posterior Cruciate Ligament
Pure Ligamentous Ruptures
Isolated Cruciate Ligament Tears
Secondary Repair and Plastic Reconstruction of the Ligaments in Old Injuries
General
Cruciate Ligament Reconstruction and Repair of the Central Pivot
Our Current Technique of Anterior Cruciate Ligament Reconstruction
Posterior Cruciate Ligament Reconstruction
Arthroscopy in the Planning of Cruciate Ligament Repairs
Old Combined Ruptures of the Anterior and Posterior Cruciate Ligaments
Secondary Repair of the Periphery and Reconstruction of the Five Main Ligaments and Capsule
The Capsule
The Semimembranosus Corner
The Medial Collateral Ligament and Its Secondary Repair
Repair of the Popliteus Corner
Repair of the Lateral Collateral Ligament
Repair of the Lateral Femorotibial Ligamentous Attachment
Our Current Technique of Anterolateral Femorotibial Reconstruction (1979-1980)
Concomitant Traumatic Cartilage Damage and Its Treatment
Fresh Concomitant Cartilage Damage
Concomitant Cartilage Damage in Chronic Instability
The Treatment of Concomitant Cartilage Damage
The Effect of Cartilage Damage on Postoperative Care
Complications
General Guidelines for Operative Procedures
Preparing for the Operation
Instruments
Suture Material
Antibiotic Prophylaxis
Postoperative Rehabilitation
General
Goals of Rehabilitation
The Physiologic and Pathophysiologic Foundations of Postoperative Rehabilitation
General and Patellar Cartilage Problems
Muscular Atrophy
Problems of the Suprapatellar Pouch
General Pathophysiologic Considerations
Tools of Rehabilitation
Postoperative Positioning
Postoperative Immobilization
Recent Developments in Postoperative Mobilization
Active Mobilization
Weight-Bearing During Rehabilitation
Physical Therapy
Pharmacotherapy
Local Anesthesia
Examination and Mobilization Under General Anesthesia
Psychological Guidance
Clinical Material and Results
General
Operative vs. Non-Operative Treatment
Indication for Operative or Non-Operative Treatment
Our Results for the Period 1971 - 1977
Clinical Material
Results
Assessment of Results
List of Sources
References.