Anatomic Anterior Cruciate Ligament Reconstruction With a Flexible Reamer System and 70° Arthroscope

Rasmussen, Jeffrey F.; Lavery, Kyle P.; Dhawan, Aman

doi:10.1016/j.eats.2013.04.003

Cited by 10 publications

(6 citation statements)

References 8 publications

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“…An alternative to rigid drilling, introduced by Cain and Clancy [4], is the use of flexible reamers to create the femoral tunnel. This technique allows for creation of longer anatomic tunnels without violating the articular cartilage, posterior cortex or peroneal nerve, and the need of knee hyperflexion [4, 11, 14, 16, 17] (Fig. 1).…”

Section: Introductionmentioning

confidence: 99%

“…Since flexible tunnel drilling has several theoretical advantages, this technique is becoming increasingly popular [14]. This study is clinically relevant for ACL and ACL revision surgery, since post-operative determination of tunnel position following ACL reconstruction, by measuring the FTA, has implications for post-operative evaluation and preoperative treatment planning for ACL revision surgery.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Does flexible tunnel drilling affect the femoral tunnel angle measurement after anterior cruciate ligament reconstruction?

Muller

Hofbauer

Atte

et al. 2014

Knee Surg Sports Traumatol Arthrosc

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Does flexible tunnel drilling affect the femoral tunnel angle measurement after anterior cruciate ligament reconstruction?

Muller

Hofbauer

Atte

et al. 2014

Knee Surg Sports Traumatol Arthrosc

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“…Instrumentation is introduced through this portal for addressing associated intra-articular pathology, and this portal is also used to view the lateral wall of the intercondylar notch during preparation and drilling of the ACL femoral tunnel. This procedure can easily be performed using a 30° arthroscope viewing from a tight anteromedial portal but has also been described using a 70° arthroscope viewing from the anterolateral portal to avoid the “sword fighting phenomenon” described by Rasmussen et al 15 as a result of 2 medial portals. Once meniscal and chondral pathologies have been treated, attention is turned to the technical aspects of the ACL reconstruction.…”

Section: Surgical Techniquementioning

confidence: 99%

Anterior Cruciate Ligament Reconstruction Using a Flexible Reamer System

Fitzgerald

Saluan

Richter

et al. 2015

Orthopaedic Journal of Sports Medicine

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Anatomic reconstruction of the anterior cruciate ligament (ACL) has been shown to improve stability of the knee, particularly rotational stability, potentially leading to superior clinical outcomes and a shorter return to sport. Nonanatomic ACL reconstruction has been linked to graft failure and abnormal cartilage loading thought to contribute to progression of degenerative joint disease. Use of the far anteromedial portal (FAMP) to uncouple the tibial and femoral tunnels has led to improved reproduction of the femoral footprint and facilitates drilling of the femoral tunnel in an anatomic position. The use of the FAMP and straight reamer systems introduces its own set of potential complications, including short femoral tunnels and peroneal nerve injury. These potential complications have been addressed by drilling the femoral tunnel in a hyperflexed position, which can lead to difficulty with positioning the operative extremity, visualization, and identification of anatomic landmarks. The purpose of this case report was to review the advantages and technical aspects of using a flexible reamer system and the FAMP to achieve an anatomic ACL reconstruction while avoiding potential complications and pitfalls. Flexible reamer systems allow an additional way of uncoupling the tibial and femoral tunnels to clearly visualize and establish an anatomic starting point within the femoral footprint of the native ACL while avoiding the complications associated with knee hyperflexion and straight reamers with the far anteromedial portal. In the authors’ experience, an anatomic reconstruction of the ACL can be achieved safely using flexible reamers while avoiding some of the difficulties seen with straight reamers used in conjunction with an uncoupled, far anteromedial approach.

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“…SB ACLR has been widely used for years, whereas DB ACLR has become a popular choice. The DB technique was described for the first time in 1983 [10], and it is believed by many authors to allow for better rotational stability and pivot resistance compared to the anatomical SB method [11][12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Outcomes Following Arthroscopic Single and Double Bundle Anterior Cruciate Ligament (ACL) Reconstruction Supported by the Comprehensive Early Rehabilitation Program (CERP)

et al. 2020

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The aim of this study was to compare the level of functional condition in patients who had rehabilitation with the comprehensive early rehabilitation program (CERP) following either single bundle (SB) or double bundle (DB) anterior cruciate ligament reconstruction (ACLR) using semitendinosus-gracilis tendon graft (ST-G) method. We hypothesized that 12 weeks after reconstruction followed by a rehabilitation program, there would be a difference in clinical results and functional activity between patients. Material/Methods:This study included 94 patients who had rehabilitation with CERP after knee surgery for a knee injury from a recreational sport. There were 49 patients in Group 1 (mean age, 36.5 years) who had CERP after SB ACLR, and 45 patients in Group 2 (mean age, 35.6 years) who had CERP after DB ACLR. Functional condition was tested using the Lysholm Knee Scoring Scale, and knee stability was measured using KT-2000. The first examination was performed before CERP and the second examination was performed 12 weeks later. Results:The level of functional condition in both groups was similar before rehabilitation with CERP, with no significant difference (P<0.958) and was considered relatively low. In the second examination, 12 weeks after starting CERP, the patients improved in both groups. The improvement was larger in the SB ACLR Group 1 than in the DB ACLR Group 2. The difference was significant (P<0.005). However, the patients in Group 2 achieved better knee stability scores in the KT-2000 examination than the patients in Group 1. The difference was significant (P=0.035). Conclusions:We found that the patients from both groups after 12 weeks of CERP achieved an improvement in stability and functional activity within normal limits. However, SB ACLR was more effective than DB ACLR in terms of the level of functionality achieved with CERP but was less effective in terms of knee stability.

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Anatomic Anterior Cruciate Ligament Reconstruction With a Flexible Reamer System and 70° Arthroscope

Cited by 10 publications

References 8 publications

Does flexible tunnel drilling affect the femoral tunnel angle measurement after anterior cruciate ligament reconstruction?

Does flexible tunnel drilling affect the femoral tunnel angle measurement after anterior cruciate ligament reconstruction?

Anterior Cruciate Ligament Reconstruction Using a Flexible Reamer System

Outcomes Following Arthroscopic Single and Double Bundle Anterior Cruciate Ligament (ACL) Reconstruction Supported by the Comprehensive Early Rehabilitation Program (CERP)

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