Abstract:The TightRope RT (Arthrex, Naples, FL) is a suspensory device for anterior cruciate ligament reconstruction. However, there is a potential risk of the button being pulled too far off the lateral femoral cortex into the soft tissue because the adjustable loop is long. The purpose of this article is to present an easy and safe technique for self-flip. As to the preparation of the graft, we draw the first line in the loop of the TightRope RT at the same length as the femoral tunnel, and we draw the second line 7 … Show more
“…Then, the tibial tunnel was made with the use of an ACL tibial guide. Finally, the prepared graft was fixed by a bioabsorbable interference screw with a post tie for the tibial side and a TightRope ® RT (Arthrex, Naples, FL, US) for the femoral side [ 19 ]. The two surgeons performed all operations using the same technique.…”
A limited number of studies has investigated the gastrocnemius and soleus in patients undergoing anterior cruciate ligament reconstruction (ACLR). This study investigated the muscle strength (Nm kg−1 × 100) and reaction time (acceleration time (AT), milliseconds) of thigh and calf muscles in patients undergoing ACLR. Thirty-two patients with ACLR and 32 normal control subjects were included. One year postoperatively, the strength of thigh muscles was significantly reduced after ACLR compared with that of controls (hamstring: 80 ± 31.3 vs. 142 ± 26.4, p < 0.001, quadriceps: 159 ± 63.7 vs. 238 ± 35.3, p < 0.001). However, the strength of calf muscles was not significantly different compared with that of controls (gastrocnemius: 77 ± 22.9 vs. 81 ± 22.5, p = 0.425, soleus: 54 ± 15.9 vs. 47 ± 16.1, p = 0.109). The AT of calf muscles was significantly faster after ACLR than that of controls (gastrocnemius: 26 ± 9.8 vs. 31 ± 9, p = 0.030, soleus: 18 ± 6.7 vs. 22 ± 8.5, p = 0.026). The AT of thigh muscles was significantly elongated after ACLR than that of controls (hamstring: 72 ± 18 vs. 55 ± 12.4, p < 0.001, quadriceps: 63 ± 17.6 vs. 47 ± 17, p < 0.000). The strength of thigh muscles was reduced, and the ATs of thigh muscles were slower one year after ACLR. However, the AT of the triceps surae was faster than that of controls. This may implicate a compensatory mechanism of the triceps surae for the weakness and delayed activation in hamstring and quadriceps muscles.
“…Then, the tibial tunnel was made with the use of an ACL tibial guide. Finally, the prepared graft was fixed by a bioabsorbable interference screw with a post tie for the tibial side and a TightRope ® RT (Arthrex, Naples, FL, US) for the femoral side [ 19 ]. The two surgeons performed all operations using the same technique.…”
A limited number of studies has investigated the gastrocnemius and soleus in patients undergoing anterior cruciate ligament reconstruction (ACLR). This study investigated the muscle strength (Nm kg−1 × 100) and reaction time (acceleration time (AT), milliseconds) of thigh and calf muscles in patients undergoing ACLR. Thirty-two patients with ACLR and 32 normal control subjects were included. One year postoperatively, the strength of thigh muscles was significantly reduced after ACLR compared with that of controls (hamstring: 80 ± 31.3 vs. 142 ± 26.4, p < 0.001, quadriceps: 159 ± 63.7 vs. 238 ± 35.3, p < 0.001). However, the strength of calf muscles was not significantly different compared with that of controls (gastrocnemius: 77 ± 22.9 vs. 81 ± 22.5, p = 0.425, soleus: 54 ± 15.9 vs. 47 ± 16.1, p = 0.109). The AT of calf muscles was significantly faster after ACLR than that of controls (gastrocnemius: 26 ± 9.8 vs. 31 ± 9, p = 0.030, soleus: 18 ± 6.7 vs. 22 ± 8.5, p = 0.026). The AT of thigh muscles was significantly elongated after ACLR than that of controls (hamstring: 72 ± 18 vs. 55 ± 12.4, p < 0.001, quadriceps: 63 ± 17.6 vs. 47 ± 17, p < 0.000). The strength of thigh muscles was reduced, and the ATs of thigh muscles were slower one year after ACLR. However, the AT of the triceps surae was faster than that of controls. This may implicate a compensatory mechanism of the triceps surae for the weakness and delayed activation in hamstring and quadriceps muscles.
“…КТ сразу после операции не выполняли, а сравнивали полученные результаты с известными диаметрами из протоколов операций всех пациентов. Связано это с доказанным соответствием диаметра сверла, используемого во время хирургического вмешательства, и результатов измерений по КТ, проведенных на следующий день после него [7,15].…”
Section: материал и методыunclassified
“…Из-за расширения костных каналов могут возникнуть такие проблемы, как замедленная интеграция трансплантата с костной тканью и развитие вторичной нестабильности, что приводит к удорожанию и двухэтапности ревизионной реконструкции ПКС при ее необходимости [3,6,7]. На сегодня причина расширения костных каналов в послеоперационном периоде до конца не ясна.…”
Section: Introductionunclassified
“…Компьютерная томография (КТ) является золотым стандартом оценки состояния костной ткани. Ее использовали для измерений во всех работах, посвященных проблемам расширения костных каналов после пластики ПКС [5,7,15,21]. Несмотря на нерешенность указанной проблемы, опубликовано лишь небольшое количество исследований, в которых сравнивали влияние различных методов фиксации на эффект расширения костных каналов в послеоперационном периоде.…”
“…The literature of a flip technique of the similar device was reported as self-flip technique. 1 However, there is no report about the technique of the ToggleLoc with ZipLoop. We describe the pearls and pitfalls of the ToggleLoc with ZipLoop for ACL reconstruction.…”
The ToggleLoc with ZipLoop is an adjustable suspensory device for anterior cruciate ligament reconstruction. However, there is no string to flip the button in the device because it has only one hole and one string. Therefore, the surgeon cannot use the button flip technique. The purpose of this article is to present the pearls and pitfalls of using ToggleLoc with ZipLoop. While preparing the ACL graft, we draw a 15- to 20-mm-width marking in the adjustable loop at the same length as the femoral tunnel depth. While passing of the graft, the tensioning sutures are placed at the anterior side to make sure they pass through the medial portal smoothly. The proximal passing suture and distal adjustable loop is pulled to the opposite direction by one surgeon's hands while passing the button. We stop pulling the sutures just at the marking while feeling the button being passed over the lateral femoral cortex. The distal artificial ligament is held distally with moderate tension while passing the graft. Although there are some pitfalls and knacks, the present technique is easy and certainly helps surgeons achieve appropriate positioning of the button.
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