title: Navigated intra-articular ACL reconstruction with additional extra-articular tenodesis using the same hamstring graft.
abstract: OBJECTIVE
  In some complex cases, standard anterior cruciate ligament reconstruction is not enough and could lead to a new failure. Lateral extra-articular reconstruction should be added. We describe a new mini-invasive technique using the same hamstring graft for intra-articular reconstruction and lateral tenodesis, optimized with navigation.
  
  
  METHODS
  This arthroscopic technique is precisely described, different graft setting are possible, four strands graft inside the joint and two strands for the tenodesis or two strands graft for all the whole graft. As the lateral tenodesis is not anatomic, tunnel placement could be tricky. The use of navigation system is a real advantage for this technique with optimal tunnels placement.
  
  
  RESULTS
  No results are given.
  
  
  CONCLUSIONS
  This technique is comparable to others reported previously, showing a clinical advantage and no increasing of osteoarthritis. The use of the same graft avoids collateral damages, and navigation improves the graft placement.
authors.affiliation: Sports Medicine Center, 9 rue Jean Moulin, 33700, Mérignac, France. philippe.colombet5@wanadoo.fr
authors.forename: Philippe D
authors.initials: PD
authors.lastname: Colombet
mesh_terms: D016118:Anterior Cruciate Ligament / Q000601:surgery*; D001178:Arthroplasty / Q000379:methods; D001182:Arthroscopy / Q000379:methods*; D001696:Biomechanical Phenomena; D003131:Combined Modality Therapy; D006085:Graft Survival; D006801:Humans; D007593:Joint Instability / Q000517:prevention & control*; D007718:Knee Injuries / Q000000981:diagnostic imaging / Q000601:surgery; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D019651:Plastic Surgery Procedures / Q000379:methods*; D012680:Sensitivity and Specificity; D013710:Tendons / Q000637:transplantation*; D053656:Tenodesis / Q000379:methods*; D013718:Tensile Strength
references.citation: Am J Sports Med. 1988 Sep-Oct;16(5):434-43
references.pmid: 3189674
references.citation: Am J Sports Med. 1993 Mar-Apr;21(2):257-62; discussion 263
references.pmid: 8465922
references.citation: Am J Sports Med. 1991 Jul-Aug;19(4):384-8
references.pmid: 1897654
references.citation: Am J Sports Med. 1990 May-Jun;18(3):262-6
references.pmid: 2372075
references.citation: Clin Sports Med. 1988 Oct;7(4):751-72
references.pmid: 3052881
references.citation: Am J Sports Med. 1983 Sep-Oct;11(5):293-302
references.pmid: 6638243
references.citation: Knee Surg Sports Traumatol Arthrosc. 2006 Nov;14(11):1060-9
references.pmid: 16909301
references.citation: Knee Surg Sports Traumatol Arthrosc. 2007 Oct;15(10):1168-74
references.pmid: 17589826
references.citation: J Bone Joint Surg Am. 2007 Sep;89 Suppl 2 Pt.2:196-213
references.pmid: 17768215
references.citation: J Bone Joint Surg Br. 1993 Sep;75(5):812-7
references.pmid: 8376447
references.citation: Arthroscopy. 2008 Oct;24(10):1152-60
references.pmid: 19028168
references.citation: Instr Course Lect. 2001;50:463-74
references.pmid: 11372347
references.citation: Am J Sports Med. 2008 Jul;36(7):1275-82
references.pmid: 18354147
references.citation: J Bone Joint Surg Am. 2006 Nov;88(11):2373-9
references.pmid: 17079393
references.citation: Am J Sports Med. 1990 Mar-Apr;18(2):169-76
references.pmid: 2343985
references.citation: Am J Sports Med. 2009 Apr;37(4):707-14
references.pmid: 19193599
references.citation: Knee Surg Sports Traumatol Arthrosc. 2009 Jan;17(1):65-70
references.pmid: 18982310
references.citation: Am J Sports Med. 2008 Oct;36(10):1896-902
references.pmid: 18567717
references.citation: Am J Sports Med. 1998 Jan-Feb;26(1):20-9
references.pmid: 9474397