title: All-inside anterior cruciate ligament graft-link technique: second-generation, no-incision anterior cruciate ligament reconstruction.
abstract: We describe an anatomic, single-bundle, all-inside anterior cruciate ligament (ACL) graft-link technique using second-generation Flipcutter guide pins (Arthrex, Naples, FL), which become retrograde drills, and second-generation cortical suspensory fixation devices with adjustable graft loop length: femoral TightRope (Arthrex) and tibial ACL TightRope-Reverse Tension (Arthrex). The technique is minimally invasive using only four 4-mm stab incisions. Graft choice is no-incision allograft or gracilis-sparing, posteriorly harvested semitendinosus material. The graft is sutured 4 times through each strand in a loop and linked, like a chain, to femoral and tibial adjustable TightRope graft loops. With this method, graft tension can be increased even after graft fixation. The technique may be modified for double-bundle ACL reconstruction.
authors.affiliation: Taos Orthopaedic Institute Research Foundation, Taos, New Mexico 87571, USA. jlubowitz@kitcarson.net
authors.forename: James H
authors.initials: JH
authors.lastname: Lubowitz
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Ahmad
authors.forename: Christopher H
authors.initials: CH
authors.lastname: Amhad
authors.forename: Kyle
authors.initials: K
authors.lastname: Anderson
mesh_terms: D016118:Anterior Cruciate Ligament / Q000601:surgery*; D001182:Arthroscopy / Q000379:methods*; D057785:Catheters; D004867:Equipment Design; D004954:Esthetics; D005269:Femur / Q000601:surgery; D006801:Humans; D019060:Minimally Invasive Surgical Procedures; D013525:Surgical Instruments; D013536:Suture Techniques; D013710:Tendons / Q000637:transplantation*; D013977:Tibia / Q000601:surgery; D014184:Transplantation, Homologous