Arthroscopic anterior cruciate ligament reconstruction using autogenous hamstring tendon graft without detachment of the tibial insertion |
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| Affiliation: | 1. Department of Orthopaedic Surgery, Arthroscopic Surgery Unit, Yonsei University College of Medicine, Seoul, Korea;2. Department of Orthopaedic Surgery, Ahnyang Medical Center Ahnyang, Korea;1. Hospital Antônio Prudente, Fortaleza, Brazil;2. Clínica Boghos Boyadjian, Fortaleza, Brazil;3. Centro Universitário Christus, Fortaleza, Brazil;4. Hospital Israelita Albert Einstein, São Paulo, Brazil;5. Hospital do Coração (HCor) and Teleimagem, São Paulo, Brazil;6. Hospital Universitário Walter Cantídio, Universidade Federal do Ceará, Fortaleza, Brazil;7. Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil;1. Department of Orthopedic Surgery, Osaka Medical and Pharmaceutical University, Japan;2. QOL Research Laboratory, Gunze Limited, Kyoto, Japan;1. Warren Alpert Medical School of Brown University, Providence, RI, USA;2. Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Providence, RI, USA;1. Service de chirurgie orthopédique et traumatologique, Hôpital d’Instruction des Armées Laveran, 34, BD Laveran, 13013 Marseille, France;2. Service de médecine physique et réadaptation, Hôpital d’Instruction des Armées Laveran, 34, BD Laveran, 13013 Marseille, France;3. Department of Orthopaedic surgery and traumatology, Hôpital Privé Toulon Hyères-St Roch, 99, Av St Roch, 83000 Toulon, France |
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| Abstract: | This article describes a modified arthroscopic technique of anterior cruciate ligament reconstruction using quadrupled hamstring tendon graft. The autogenous semitendinosus and gracilis grafts are harvested without detachment of the tibial insertion. To obtain longer grafts, the accessory tibial insertions of the hamstring tendons are dissected. The EndoButton (Acufex Microsurgical, Andover, MA) is used for femoral fixation and two spiked staples are used for tibial fixation in a belt buckle fashion. Then the residual anterior laxity is restored by additional absorbable interference screw fixations. In this technique, more viable graft is obtained and more firm distal fixation is achieved by preservation of the tibial insertion of hamstring tendons. |
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