All-inside anterior cruciate ligament graft-link technique: second-generation, no-incision anterior cruciate ligament reconstruction

Arthroscopy. 2011 May;27(5):717-27. doi: 10.1016/j.arthro.2011.02.008.


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.

Publication types

  • Video-Audio Media

MeSH terms

  • Anterior Cruciate Ligament / surgery*
  • Arthroscopy / methods*
  • Catheters
  • Equipment Design
  • Esthetics
  • Femur / surgery
  • Humans
  • Minimally Invasive Surgical Procedures
  • Surgical Instruments
  • Suture Techniques
  • Tendons / transplantation*
  • Tibia / surgery
  • Transplantation, Homologous