How to avoid collision between PCL and MCL femoral tunnels during a simultaneous reconstruction

Grassedonio, Emanuele; Lauria, Michele R.; Midiri, Massimo; D’Arienzo, Michele

doi:10.1007/s00167-014-3446-y

Cited by 15 publications

(12 citation statements)

References 30 publications

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“…Gelber et al 16 reported that aiming the sMCL and POL tunnels 30° in both the axial and coronal planes reduced the risk of tunnel convergence. However, Camarda et al 4 reported that convergence could be avoided by aiming the sMCL tunnel 40° proximally.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, a need to adjust the tunnel orientation during multiligament reconstructions was suggested. 32 Different angles have been suggested in the literature for both medial-sided 4,16 and lateral-sided reconstructions. 3,13,15,20,37 However, to our knowledge, there is no available literature concerning the optimal tunnel orientation for multiple knee ligament reconstructions of all 4 primary ligamentous structures: anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), and posteromedial and posterolateral corners.…”

mentioning

confidence: 99%

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Multiple Ligament Reconstruction Femoral Tunnels: Intertunnel Relationships and Guidelines to Avoid Convergence

et al. 2016

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Multiple Ligament Reconstruction Femoral Tunnels: Intertunnel Relationships and Guidelines to Avoid Convergence

et al. 2016

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“…Aiming the sMCL tunnel 20° to 40° anteriorly and 40° proximally avoided tunnel convergence in 18 of 21 (86%) of patients (Fig 3). Camarda et al 16 . also reported that tunnel convergence could be avoided by aiming the sMCL tunnel 40° proximally.…”

Section: Discussionmentioning

confidence: 99%

Combined Posterior Cruciate Ligament and Superficial Medial Collateral Ligament Knee Reconstruction: Avoiding Tunnel Convergence

Crawford

Kennedy

Bernholt

et al. 2019

Arthroscopy Techniques

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Combined posterior cruciate ligament (PCL) and medial collateral ligament (MCL) injuries represent a complex pathology that requires a thorough clinical and radiographic examination to diagnose and identify all injured structures. Anatomic reconstruction of the injured ligaments is recommended, including double-bundle PCL reconstruction and superficial MCL augmentation. In the setting of this complex reconstruction, several technical aspects require consideration and preoperative planning, including the risk of femoral tunnel convergence on the medial aspect of the femoral condyle. This article details our technique for combined anatomic double-bundle PCL reconstruction and superficial MCL augmentation to avoid tunnel convergence. Level I (knee); level II (PCL).

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“…However, in their study, the PCL tunnels were smaller than the ones used in this technique. Camarda et al 35 reported that proximal orientation of the sMCL tunnel avoided convergence with the PCL tunnel in single-bundle PCL reconstruction with concurrent MCL reconstruction.…”

Section: Discussionmentioning

confidence: 99%

Multiligament Reconstruction of the Knee in the Setting of Knee Dislocation With a Medial-Sided Injury

Ferrari

Chahla

Mitchell

et al. 2017

Arthroscopy Techniques

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Multiple ligament knee injuries are complex pathologies that often result from traumatic knee dislocations. Both a high level of suspicion and a thorough clinical and radiographic examination are mandatory to diagnose and identify all injured structures. Reconstruction of all injured ligaments is recommended to aid in early mobilization and to avoid joint stiffness or graft failure. For knee dislocations involving injury to the anterior cruciate ligament, posterior cruciate ligament, and medial-sided structures, a repair and augmentation of the medial collateral ligament, together with an anatomic reconstruction of the anterior cruciate ligament and double-bundle posterior cruciate ligament, is recommended. In the setting of these complex reconstructions, there are several technical aspects that require consideration to ensure concise and efficient treatment of these injuries. Graft choice, sequence of reconstruction, tunnel position and orientation, and graft tensioning all pose surgical challenges, and require dedicated preoperative preparation and planning. The purpose of this Technical Note is to report a safe, effective, and reproducible surgical technique for treatment of multiligament injuries in the setting of a knee dislocation with a medial-sided component (classified as KD-III-M in the Schenck classification system).

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How to avoid collision between PCL and MCL femoral tunnels during a simultaneous reconstruction

Cited by 15 publications

References 30 publications

Multiple Ligament Reconstruction Femoral Tunnels: Intertunnel Relationships and Guidelines to Avoid Convergence

Multiple Ligament Reconstruction Femoral Tunnels: Intertunnel Relationships and Guidelines to Avoid Convergence

Combined Posterior Cruciate Ligament and Superficial Medial Collateral Ligament Knee Reconstruction: Avoiding Tunnel Convergence

Multiligament Reconstruction of the Knee in the Setting of Knee Dislocation With a Medial-Sided Injury

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