title: Reverse achilles tendon allograft technique for anterior cruciate ligament reconstruction.
abstract: Because of the increasing popularity of allograft anterior cruciate ligament (ACL) reconstructions, the technical difficulties with posterior bone loss in revision ACL surgery, and the limited supply of bone-patellar tendon-bone donor grafts, we have developed a technique using a reversed Achilles tendon allograft to reconstruct the ACL-deficient knee. This technique allows for bony tibial fixation with an interference screw by rotating the graft 180 degrees and optimizing soft-tissue fixation at the femur with an EndoButton CL (Smith & Nephew, Andover, MA). Short-term follow-up (average, 26.4 weeks) of 10 patients undergoing the reversed Achilles technique has shown excellent results, with Lysholm scores between 91 and 100 and 84 and 90 in 8 of 10 and 2 of 10 patients, respectively. Objective stability assessments, including the Lachman test, anterior drawer, and pivot-shift tests, were also encouraging. Reverse Achilles tendon allografts can be excellent alternatives for ACL reconstruction when bone-patellar tendon-bone grafts are not indicated.
authors.affiliation: Department of Orthopaedic Surgery, Harbor-UCLA Medical Center, Torrance, California 90509, USA.
authors.forename: David P
authors.initials: DP
authors.lastname: Zamorano
authors.forename: Stuart M
authors.initials: SM
authors.lastname: Gold
mesh_terms: D000125:Achilles Tendon / Q000601:surgery*; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D001182:Arthroscopy / Q000379:methods; D006801:Humans; D007719:Knee Joint / Q000473:pathology / Q000601:surgery; D010329:Patella / Q000601:surgery; D019651:Plastic Surgery Procedures; D014184:Transplantation, Homologous; D016896:Treatment Outcome