Trantibial anterior cruciate ligament double bundle reconstruction technique: two tibial bundle in one tibial tunnel.
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.
Noh
Haeng Kee
HK
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.
Wang
Joon Ho
JH
Bada
Leela P
LP
Ahn
Jin Hwan
JH
Yoo
Jae Chul
JC
Nha
Kyung Wook
KW
Lee
Yong Seuk
YS
D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D019637:Orthopedic Procedures / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000379:methods