Technique of anatomical footprint reconstruction of the ACL with oval tunnels and medial portal aimers
详细信息 查看全文
- 作者：Wolf Petersen (1)
Philipp Forkel (1)
Andrea Achtnich (1)
Sebastian Metzlaff (1)
Thore Zantop (2) - 关键词：Anatomic ACL reconstruction ; Oval tunnels ; Insertion site anatomy ; ACL aimer ; Medial portal technique
- 刊名：Archives of Orthopaedic and Trauma Surgery
- 出版年：2013
- 出版时间：June 2013
- 年：2013
- 卷：133
- 期：6
- 页码：827-833
- 全文大小：463KB
- 参考文献：1. Aglietti P, Giron F, Losco M, Cuomo P, Ciardullo A, Mondanelli N (2010) Comparison between single-and double-bundle anterior cruciate ligament reconstruction: a prospective, randomized, single-blinded clinical trial. Am J Sports Med 38(1):25鈥?4 CrossRef
2. Anderson AF, Snyder RB, Lipscomb AB Jr (2001) Anterior cruciate ligament reconstruction. A prospective randomized study of three surgical methods. Am J Sports Med 29:272鈥?79
3. Aune AK, Holm I, Risberg MA, Jensen HK, Steen H (2001) Fourstrand hamstring tendon autograft compared with patellar tendon-bone autograft for anterior cruciate ligament reconstruction. A randomized study with two-year follow-up. Am J Sports Med 29:722鈥?28
4. Barrett GR, Noojin FK, Hartzog CW, Nash CR (2002) Reconstructionof the anterior cruciate ligament in females: a comparison of hamstring versus patellar tendon autograft. Arthroscopy 18:46鈥?4
5. Battaglia TC, Miller MD (2005) Management of bony deficiency in revision anterior cruciate ligament reconstruction using allograft bone dowels: surgical technique. Arthroscopy 21(6):767
6. Bedi A, Altchek DW (2009) The 鈥渇ootprint鈥?anterior cruciate ligament technique: an anatomic approach to anterior cruciate ligament reconstruction. Arthroscopy 25(10):1128鈥?138 CrossRef
7. Bedi A, Musahl V, Steuber V, Kendoff D, Choi D, Allen AA, Pearle AD, Altchek DW (2011) Transtibial versus anteromedial portal reaming in anterior cruciate ligament reconstruction: an anatomic and biomechanical evaluation of surgical technique. Arthroscopy 27(3):380鈥?90 CrossRef
8. Behrendt S, Richter J (2010) Anterior cruciate ligament reconstruction: drilling a femoral posterolateral tunnel cannot be accomplished using an over-the-top step-off drill guide. Knee Surg Sports Traumatol Arthrosc 18(9):1252鈥?256 CrossRef
9. Bowers AL, Bedi A, Lipman JD, Potter HG, Rodeo SA, Pearle AD, Warren RF, Altchek DW (2011) Comparison of anterior cruciate ligament tunnel position and graft obliquity with transtibial and anteromedial portal femoral tunnel reaming techniques using high-resolution magnetic resonance imaging. Arthroscopy 27(11):1511鈥?522 CrossRef
10. Harner CD, Poehling GG (2004) Double bundle or double trouble? Arthroscopy 20(10):1013鈥?014 CrossRef
11. Herbort M, Lenschow S, Fu FH, Petersen W, Zantop T (2010) ACL mismatch reconstructions: influence of different tunnel placement strategies in single-bundle ACL reconstructions on the knee kinematics. Knee Surg Sports Traumatol Arthrosc 18(11):1551鈥?558 CrossRef
12. Ho JY, Gardiner A, Shah V, Steiner ME (2009) Equal kinematics between central anatomic single-bundle and double-bundle anterior cruciate ligament reconstructions. Arthroscopy 25(5):464鈥?72 CrossRef
13. Kato Y, Maeyama A, Lertwanich P, Wang JH, Ingham SJ, Kramer S, Martins CQ, Smolinski P, Fu FH (2013) Biomechanical comparison of different graft positions for single-bundle anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 21(4):816-823
14. Loh JC, Fukuda Y, Tsuda E, Steadman RJ, Fu FH, Woo SL (2003) Knee stability and graft function following anterior cruciate ligament reconstruction: comparison between 11 o鈥檆lock and 10 o鈥檆lock femoral tunnel placement. 2002 Richard O鈥機onnor Award paper. Arthroscopy19:297鈥?04
15. Lubowitz JH (2009) Anteromedial portal technique for the anterior cruciate ligament femoral socket: pitfalls and solutions. Arthroscopy 25:95鈥?01 CrossRef
16. Muneta T, Koga H, Mochizuki T, Ju YJ, Hara K, Nimura A, Yagishita K, Sekiya I (2007) A prospective randomized study of 4-strand semitendinosus tendon anterior cruciate ligament reconstruction comparing single-bundle and double-bundle techniques. Arthroscopy 23(6):618鈥?28 CrossRef
17. Pascual-Garrido C, Swanson BL, Swanson KE (2012) Transtibial versus low anteromedial portal drilling for anterior cruciate ligament reconstruction: a radiographic study of femoral tunnel position. Knee Surg Sports Traumatol Arthrosc 21(4):846-850
18. Petersen W, Zantop T (2007) Anatomy of the anterior cruciate ligament with regard to its two bundles. Clin Orthop Relat Res 454:35鈥?7 CrossRef
19. Sastre S, Popescu D, N煤帽ez M, Pomes J, Tomas X, Peidro L (2010) Double-bundle versus single-bundle ACL reconstruction using the horizontal femoral position: a prospective, randomized study. Knee Surg Sports Traumatol Arthrosc 18(1):32鈥?6 CrossRef
20. Streich NA, Friedrich K, Gotterbarm T, Schmitt H (2008) Reconstruction of the ACL with a semitendinosus tendon graft: a prospective randomized single blinded comparison of double-bundle versus single-bundle technique in male athletes. Knee Surg Sports Traumatol Arthrosc 16(3):232鈥?38 CrossRef
21. Siebold R (2007) Observations on bone tunnel enlargement after double-bundle anterior cruciate ligament reconstruction. Arthroscopy 23(3):291鈥?98 CrossRef
22. Siebold R, Zantop T (2009) Anatomic double-bundle ACL reconstruction: a call for indications. Knee Surg Sports Traumatol Arthrosc 17(3):211鈥?12 CrossRef
23. Trojani C, Sbihi A, Djian P, Potel JF, Hulet C, Jouve F, Bussi猫re C, Ehkirch FP, Burdin G, Dubrana F, Beaufils P, Franceschi JP, Chassaing V, Colombet P, Neyret P (2011) Causes for failure of ACL reconstruction and influence of meniscectomies after revision. Knee Surg Sports Traumatol Arthrosc 19(2):196鈥?01 CrossRef
24. Yagi M, Kuroda R, Nagamune K, Yoshiya S, Kurosaka M (2007) Double-bundle ACL reconstruction can improve rotational stability. Clin Orthop Relat Res 454:100鈥?12 CrossRef
25. Yasuda K, Kondo E, Ichiyama H, Tanabe Y, Tohyama H (2006) Clinical evaluation of anatomic double-bundle anterior cruciate ligament reconstruction procedure using hamstring tendon grafts: comparisons among 3 different procedures. Arthroscopy 22(3):240鈥?51 CrossRef
26. Zantop T, Petersen W (2011) Arthroscopic filling of misplaced and wide bone tunnels after reconstruction of the anterior cruciate ligament with bone graft in patients with recurrent instability. Oper Orthop Traumatol 23(4):337-350
27. Zantop T, Herbort M, Raschke MJ, Fu FH, Petersen W (2007) The role of the anteromedial and posterolateral bundles of the anterior cruciate ligament in anterior tibial translation and internal rotation. Am J Sports Med 35(2):223鈥?27 CrossRef
28. Zantop T, Petersen W, Sekiya JK, Musahl V, Fu FH (2006) Anterior cruciate ligament anatomy and function relating to anatomical reconstruction. Knee Surg Sports Traumatol Arthrosc 14(10):982鈥?92 CrossRef - 作者单位：Wolf Petersen (1)
Philipp Forkel (1)
Andrea Achtnich (1)
Sebastian Metzlaff (1)
Thore Zantop (2)
1. Department of Orthopaedic and Trauma Surgery, Martin Luther Hospital, Caspar Theyss Strasse 27-34, Grunewald, 14193, Berlin, Germany
2. Sporthopaedicum Straubing, Bahnhofsplatz 27, 94315, Straubing, Germany - ISSN：1434-3916
文摘
Purpose The purpose of this article was to demonstrate an anterior cruciate ligament (ACL) reconstruction technique using oval tunnels. Aim of this single bundle technique is to fit the footprint anatomy of the ACL as closely as possible. Technique and patients The presented technique is a single bundle technique using a semitendinosus graft. For femoral tunnel placement, a specific medial portal aimer (Karl Storz, Tuttlingen, Germany) is used. Aiming and drilling of the femoral tunnel are performed via the medial portal. Oval tunnels are created by stepwise dilatation with ovally shaped dilatators. The position of the femoral tunnel is visualized and controlled with the arthroscope via the medial portal. For the tibial tunnel placement, a specific aimer was used as well. With this technique, 24 patients were operated and all intra- and postoperative complications were analyzed prospectively. The tunnel position was documented postoperatively by CT scan. Results There were no significant intra- and postoperative complications associated with the oval tunnel technique. The postoperative 3D CT scan revealed that all femoral and tibial tunnels were located within the area of the anatomical ACL insertions. Conclusions This article presents an ACL reconstruction technique using oval dilatators and medial portal aimers to create oval tunnels. These oval tunnels match the insertion site anatomy much closer than round tunnels do. Level of Evidence Level IV, case series.