title: Arthroscopic Control for Safe and Secure Seating of Suspensory Devices for Femoral Fixation in Anterior Cruciate Ligament Reconstruction Using Three Different Techniques.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the efficacy of our technique that allows direct visualization of seating of suspensory devices in anterior cruciate ligament (ACL) reconstruction.
  
  
  METHODS
  Three different suspensory devices (TightRope RT, RetroButton, and EndoButton) were used in ACL reconstruction using 3 different techniques (outside-in, anteromedial [AM] portal, and transtibial techniques). Positioning of a guiding material and seating pattern of the suspensory devices were evaluated according to the surgical technique and suspensory device used.
  
  
  RESULTS
  On the transtibial technique, 21 of total 26 cases (81%) of single bundle reconstructions and 22 of total 22 cases (100%) of double bundle reconstructions required superolateral capsulotomy where buttons were found in 21 of total 21 cases (100%) and 17 of 22 cases (77%), respectively. On the AM portal technique, all patients required capsulotomy and the button was found in only 18 of total 32 cases (56%) even after capsulotomy. On the outside-in technique, all patients required capsulotomy and the button was found in 86 of total 86 cases (100%).
  
  
  CONCLUSIONS
  Our technique for direct visualization of seating of the suspensory devices was more effective in outside-in and single bundle transtibial ACL reconstruction. However, it was less effective in double bundle transtibial and AM portal ACL reconstructions.
authors.affiliation: Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
authors.forename: Seo Goo
authors.initials: SG
authors.lastname: Kang
authors.affiliation: Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
authors.forename: Yong Seuk
authors.initials: YS
authors.lastname: Lee
keywords: Anterior cruciate ligament; Knee; Outside-in technique; Suspensory device