Validation of a New Technique to Determine Midbundle Femoral Tunnel Position in Anterior Cruciate Ligament Reconstruction Using 3-Dimensional Computed Tomography Analysis

Bird, Jonathan; Carmont, Michael R.; Dhillon, M.; Smith, Nick; Brown, Charlie; Thompson, P.; Spalding, Tim

doi:10.1016/j.arthro.2011.03.077

Cited by 107 publications

(151 citation statements)

References 42 publications

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“…This method devised by the senior author appears to be reliable and reproducible but has not yet been validated for PCLR. A recent cadaveric study has provided quantitative measurements of tunnel positions from arthroscopic landmarks that can be used for a direct measurement technique, 7 although in contrast to ACL reconstruction, 23 no in vivo studies are available.…”

Section: Discussionmentioning

confidence: 99%

TransMedial All-Inside Posterior Cruciate Ligament Reconstruction Using a Reinforced Tibial Inlay Graft

Nancoo

Lord

Yasen

et al. 2013

Arthroscopy Techniques

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Surgical reconstruction of the posterior cruciate ligament (PCL) is technically demanding. Potential challenges include visualization of the tibial footprint and drilling of the tibial tunnel without damaging posterior neurovascular structures, as well as graft selection, deployment, tensioning, and fixation. We present a novel TransMedial all-inside arthroscopic technique (technique designed by A. J. Wilson with support from Arthrex) using a single hamstring tendon graft, fixed with adjustable cortical suspensory devices. The technique simplifies the difficult steps encountered during PCL reconstruction and is safe and reproducible. All arthroscopic viewing is accomplished from the lateral portal, and femoral socket preparation is performed from the medial side with specially contoured instruments, which allow accurate marking, measuring, and anatomic positioning of the graft. The quadrupled semitendinosus graft can be augmented with composite polymer tape for increased strength and initial stability. We use outside-in drilling to create retrograde femoral and tibial sockets. Cortical suspensory fixation on the tibial side can be supplemented with anchor fixation. We use an arthroscopic tibial inlay technique that better approximates native knee anatomy. This also avoids the "killer turn," a problem seen in transtibial PCL reconstruction techniques, which theoretically induces graft laxity due to abrasion with cyclic loading. This technique can be further adapted to allow a modified double-bundle or TriLink graft (technique designed by A. J. Wilson with support from Arthrex.).

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Section: Discussionmentioning

confidence: 99%

TransMedial All-Inside Posterior Cruciate Ligament Reconstruction Using a Reinforced Tibial Inlay Graft

Nancoo

Lord

Yasen

et al. 2013

Arthroscopy Techniques

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“…12 In such cases, the center of the tunnel is set approximately at the midpoint of a line drawn parallel to the posterior margin of the lateral femoral condyle at a distance equal to the radius of the femoral tunnel plus 2.5 mm from said margin. [6][7][8] In this technique, the femoral tunnel is created via the outside-in method alone. Because this involves making an aperture on the lateral femoral cortex, a retrograde drill need not be used.…”

Section: Discussionmentioning

confidence: 99%

Anatomic Outside-In Anterior Cruciate Ligament Reconstruction Using a Suspension Device for Femoral Fixation

Espejo-Baena

Espejo-Reina

2014

Arthroscopy Techniques

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Cortical suspension is one of the most frequently used methods of femoral fixation in anterior cruciate ligament reconstruction. We present a simple technique for anterior cruciate ligament reconstruction using a suspension device for femoral fixation. The purposes of this technique are to ensure greater contact between the graft and the tunnel wallsda goal that is achieved by using the femoral fixation device with the shortest possible loopdto avoid the flip step and the need for hyperflexion, and in short, to minimize the risk of complications that can occur when using the anteromedial portal to drill the femoral tunnel. To this end, both the femoral and tibial tunnels are created in an outside-in manner and with the same guide. The graft is passed through in a craniocaudal direction, and the suspension device is fitted inside an expansion piece for a better adaptation to the femoral cortex.

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“…ключевой этап такой однопучковой анатоми-ческой реконструкции представляет собой лока-лизацию точки введения направляющей спицы при формировании бедренного канала для транс-плантата пкс на латеральной стенке межмыщел-ковой ямки [28,29]. основными ориентирами, представленными на рисунке, являются: линия Blumensaat, соответствующая на рентгенограм-мах в боковой проекции «крыше» межмыщелковой…”

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“…Bird c соавторами, a.d. davis с соавторами, c.K. Schillhammer с соавто-рами и H. xu с соавторами рекомендуют первона-чально ориентироваться на остатки проксималь-ной культи связки и латеральный межмыщелковый гребень [29][30][31][32]. Их анатомические исследования показали, что, несмотря на существенную инди-видуальную вариабельность коленных суставов разных пациентов, практически всегда можно определить зону приемлемого расположения точ-ки введения направляющей спицы.…”

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Modern Trends in Surgical Treatment of Patients With Acl Ruptures (Literature Review)

Rikun

Хоминец

Федотов

2017

Traumatology and Orthopedics of Russia

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The authors conducted an analysis of national and foreign scientific publications dedicated to the problems in treatment of patients with ruptures of the anterior cruciate ligament of the knee joint. The results of the analysis demonstrated that such lesions still remain the key knee pathology resulting from sports injuries that significantly affect knee function and require timely reconstructive surgical correction. Based on the study the key areas of improvement in treatment for mentioned category of patients have been identified. This is the biomechanically justified single bundle anatomical ACL reconstruction which is currently widely applied in the clinical practice by using of an isometrically located autograft. Such technique represents a radically new stage in the development of treatment methods for young and middle-aged patients with high functional demands.

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Validation of a New Technique to Determine Midbundle Femoral Tunnel Position in Anterior Cruciate Ligament Reconstruction Using 3-Dimensional Computed Tomography Analysis

Cited by 107 publications

References 42 publications

TransMedial All-Inside Posterior Cruciate Ligament Reconstruction Using a Reinforced Tibial Inlay Graft

TransMedial All-Inside Posterior Cruciate Ligament Reconstruction Using a Reinforced Tibial Inlay Graft

Anatomic Outside-In Anterior Cruciate Ligament Reconstruction Using a Suspension Device for Femoral Fixation

Modern Trends in Surgical Treatment of Patients With Acl Ruptures (Literature Review)

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