Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
, 8 (8), e861-e865
eCollection

An Alternative Femoral Fixation in All-Inside Anterior Cruciate Ligament Reconstruction: A Solution for Preventing Possible Graft Loosening

Affiliations

An Alternative Femoral Fixation in All-Inside Anterior Cruciate Ligament Reconstruction: A Solution for Preventing Possible Graft Loosening

Yavuz Kocabey et al. Arthrosc Tech.

Abstract

The aim of this surgical Technical Note is to search for a way to prevent possible graft loosening in all-inside anterior cruciate ligament (ACL) reconstruction. We used a fixed-loop cortical suspensory device on the femoral end and a suspensory cortical fixation technique and sutures on the tibial end. Then we flexed the knee for 150 cycles, reexamined the tightness of the ACL graft, and compared it with the initial tightness. Loosening of the ACL graft, which is suggested to be related to suspensory cortical fixation, could be prevented using the button system on the femoral end and tightening the suspensory cortical fixation on the tibial end.

Figures

Fig 1
Fig 1
Arthroscopy portals for the right knee in a supine patient. (AL, anterolateral FAL, far anterolateral; AM, anteromedial.)
Fig 2
Fig 2
(Left) Femoral footprint of ruptured ACL through anterolateral portal. (Right) Remnants of ACL through the anterolateral portal.
Fig 3
Fig 3
The elevation of the sartorius fascia.
Fig 4
Fig 4
(Left) Graft harvesting. (Right) The quadrupled semitendinosus graft for all-inside ACL reconstruction.
Fig 5
Fig 5
(Left) Femoral tunnel view through the far anterolateral portal. (Right) Femoral tunnel through the anterolateral portal.
Fig 6
Fig 6
(Left) The introduction of Flip-Cutter into the joint through the tibial insertion of the ACL. (Middle) Opening of the Flip-Cutter and retrograde drilling of tibial tunnel. (Right) The view of the tibial tunnel through the anterolateral portal.
Fig 7
Fig 7
(Upper left) ACL graft after initial tightening. (Upper right) ACL graft after 150 cycles of flexion and extension. (Bottom left) Examination after after initial tightening. (Bottom right) Examination after 150 cycles of flexion and extension.

Similar articles

See all similar articles

References

    1. Butler D., Noyes F., Grood E. Ligamentous restraints to anterior-posterior drawer in the human knee. J Bone Joint Surg Am. 1980;62:259–270. - PubMed
    1. Boguszewski D.V. University of Cincinnati; 2012. Characterizing the porcine knee as a biomechanical surrogate model of the human knee to study the anterior cruciate ligament. Ph.D. Diss.
    1. Arendt E.A., Agel J., Dick R. Anterior cruciate ligament injury patterns among collegiate men and women. J Athl Training. 1999;34:86. - PMC - PubMed
    1. Boden B.P., Dean G.S., Feagin J.A., Garrett W.E. Mechanisms of anterior cruciate ligament injury. Orthopedics. 2000;23:573–578. - PubMed
    1. Toth A., Cordasco F. Anterior cruciate ligament injuries in the female athlete. J Gender Spec Med. 2001;4:25–34. - PubMed
Feedback