Trantibial anterior cruciate ligament double bundle reconstruction technique: two tibial bundle in one tibial tunnel |
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Authors: | Haeng Kee Noh Joon Ho Wang Leela P Bada Jin Hwan Ahn Jae Chul Yoo Kyung Wook Nha Yong Seuk Lee |
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Institution: | (1) Department of Orthopaedic Surgery, Ansan Hospital, Korea University School of Medicine, 516 Gojan-1 dong, Danwon-gu, Ansan-si, 425-707 Gyeonggi-do, South Korea (ROK);(2) Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea;(3) Department of Orthopedic Surgery, Ilsanpaik Hospital, Inje University, School of Medicine, Gyeonggi-do, South Korea |
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Abstract: | The anterior cruciate ligament (ACL) consists of two functional bundles that behave independently throughout the range of
knee motion. Many two-bundle reconstruction techniques have been introduced to restore the function of the two bundles of
the ACL. Generally, two femoral and two tibial tunnels are made during the surgery for a two-bundle ACL reconstruction. However,
the procedure is technically demanding and time consuming. This paper describes one-tibial-two-femoral ACL double bundle reconstruction
technique with a sextuple-stranded hamstring autograft. The anteromedial femoral tunnel is made using transtibial drilling
technique and posterolateral femoral tunnel is made using outside-in technique. The two bundles in a single tibial tunnel
are separated using biodegradable interference screw. Stable and adequate femoral fixation of the two bundles with a transtibial
fixation and bioabsorbable screw can be obtained. This technique is relatively simple, and replicates the anatomy and differential
behavior of the two native bundles of ACL more effectively. |
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Keywords: | Anterior cruciate ligament Double bundle reconstruction Hamstring tendon Tibial tunnel |
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