All-Inside Bicruciate Ligament Reconstruction Technique: A Focus on Graft Tensioning Sequence
| Autor: | Gilles Clowez, Antoine Desseaux, Colin G. Murphy, Mathieu Thaunat, Bertrand Sonnery-Cottet, Jean Marie Fayard, Tales Mollica Guimarães |
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| Rok vydání: | 2017 |
| Předmět: |
Orthopedic surgery
musculoskeletal diseases 030222 orthopedics medicine.medical_specialty All inside business.industry Anterior cruciate ligament 030229 sport sciences musculoskeletal system Tendon Surgery 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure Posterior cruciate ligament Technical Note medicine Ligament Orthopedics and Sports Medicine Femur Tibia business RD701-811 Fixation (histology) |
| Zdroj: | Arthroscopy Techniques, Vol 6, Iss 3, Pp e655-e660 (2017) |
| ISSN: | 2212-6287 |
| DOI: | 10.1016/j.eats.2017.01.012 |
| Popis: | Bicruciate ligament (BCL) reconstructions are challenging procedures. One of the main operative goals is to stabilize the knee in the correct anterior-posterior position. We present an all-inside arthroscopic BCL reconstruction technique using hamstring tendon grafts. Ipsilateral semitendinosus (ST) and gracilis tendons are used for TriLink (Arthrex, Naples, FL) double-bundle posterior cruciate ligament (PCL) reconstruction and contralateral ST tendon is used for GraftLink (Arthrex) single-bundle anterior cruciate ligament (ACL) reconstruction. The use of instruments for retrograde reaming and devices for adjustable cortical suspensory fixation allows for a safe, reproducible all-inside BCL reconstruction by simplifying these difficult steps. To minimize the risk of anterior-posterior malposition, the ACL graft is first tensioned with the knee in full extension, ensuring a neutral anteroposterior positioning of the tibia under the femur. The PCL anterolateral bundle can then be independently tensioned with the knee at 90° of flexion, and the posteromedial bundle at 30° of flexion, while applying an anterior translation to the tibia to reduce the posterior drawer without any risk of overcorrection. The purpose of this Technical Note was to describe an all-inside BCL reconstruction with a specific focus on the graft tensioning sequence. |
| Databáze: | OpenAIRE |
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