Anterior Cruciate Ligament Reconstruction Using Hamstring Tendon Autograft With Preserved Insertions
We present a technique for anterior cruciate ligament (ACL) reconstruction using hamstring tendon autograft with preserved tibial insertions. The tendons, harvested with an open-ended tendon stripper while their tibial insertions are preserved, are looped around to prepare a quadrupled graft. The fe...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2016-04-01
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| Series: | Arthroscopy Techniques |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2212628715002169 |
| _version_ | 1819063408356491264 |
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| author | Ravi Gupta, M.S., D.N.B., M.N.A.M.S., F.A.M.S., F.I.M.S.A. Raj Bahadur, M.S., F.A.M.S., F.R.C.S., F.I.M.S.A. Anubhav Malhotra, M.B.B.S. Gladson David Masih, M.Sc. Parmanand Gupta, M.S. |
| author_facet | Ravi Gupta, M.S., D.N.B., M.N.A.M.S., F.A.M.S., F.I.M.S.A. Raj Bahadur, M.S., F.A.M.S., F.R.C.S., F.I.M.S.A. Anubhav Malhotra, M.B.B.S. Gladson David Masih, M.Sc. Parmanand Gupta, M.S. |
| author_sort | Ravi Gupta, M.S., D.N.B., M.N.A.M.S., F.A.M.S., F.I.M.S.A. |
| collection | DOAJ |
| description | We present a technique for anterior cruciate ligament (ACL) reconstruction using hamstring tendon autograft with preserved tibial insertions. The tendons, harvested with an open-ended tendon stripper while their tibial insertions are preserved, are looped around to prepare a quadrupled graft. The femoral tunnel is drilled independently through a transportal technique, whereas the tibial tunnel is drilled in a standard manner. The length of the quadrupled graft and loop of the RetroButton is adjusted so that it matches the calculated length of both tunnels and the intra-articular part of the proposed ACL graft. After the RetroButton is flipped, the graft is manually tensioned with maximal stretch on the free end, which is then sutured to the other end with preserved insertions. We propose that preserving the insertions is more biological and may provide better proprioception. The technique eliminates the need for a tibial-side fixation device, thus reducing the cost of surgery. Furthermore, tibial-side fixation of the free graft is the weakest link in the overall stiffness of the reconstructed ACL, and this technique circumvents this problem. Postoperative mechanical stability and functional outcome with this technique need to be explored and compared with those of ACL reconstruction using free hamstring autograft. |
| first_indexed | 2024-12-21T15:14:12Z |
| format | Article |
| id | doaj.art-4618c7c3c19941d38d4eaf1112394aad |
| institution | Directory Open Access Journal |
| issn | 2212-6287 |
| language | English |
| last_indexed | 2024-12-21T15:14:12Z |
| publishDate | 2016-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Arthroscopy Techniques |
| spelling | doaj.art-4618c7c3c19941d38d4eaf1112394aad2022-12-21T18:59:13ZengElsevierArthroscopy Techniques2212-62872016-04-0152e269e274Anterior Cruciate Ligament Reconstruction Using Hamstring Tendon Autograft With Preserved InsertionsRavi Gupta, M.S., D.N.B., M.N.A.M.S., F.A.M.S., F.I.M.S.A.0Raj Bahadur, M.S., F.A.M.S., F.R.C.S., F.I.M.S.A.1Anubhav Malhotra, M.B.B.S.2Gladson David Masih, M.Sc.3Parmanand Gupta, M.S.4Department of Orthopaedics, Government Medical College and Hospital, Chandigarh, India; Address correspondence to Ravi Gupta, M.S., D.N.B., M.N.A.M.S., F.A.M.S., F.I.M.S.A., Department of Orthopaedics, Government Medical College and Hospital, Chandigarh, India.Baba Farid University of Health Sciences, Punjab, IndiaDepartment of Orthopaedics, Government Medical College and Hospital, Chandigarh, IndiaDepartment of Orthopaedics, Government Medical College and Hospital, Chandigarh, IndiaDepartment of Orthopaedics, Government Medical College and Hospital, Chandigarh, IndiaWe present a technique for anterior cruciate ligament (ACL) reconstruction using hamstring tendon autograft with preserved tibial insertions. The tendons, harvested with an open-ended tendon stripper while their tibial insertions are preserved, are looped around to prepare a quadrupled graft. The femoral tunnel is drilled independently through a transportal technique, whereas the tibial tunnel is drilled in a standard manner. The length of the quadrupled graft and loop of the RetroButton is adjusted so that it matches the calculated length of both tunnels and the intra-articular part of the proposed ACL graft. After the RetroButton is flipped, the graft is manually tensioned with maximal stretch on the free end, which is then sutured to the other end with preserved insertions. We propose that preserving the insertions is more biological and may provide better proprioception. The technique eliminates the need for a tibial-side fixation device, thus reducing the cost of surgery. Furthermore, tibial-side fixation of the free graft is the weakest link in the overall stiffness of the reconstructed ACL, and this technique circumvents this problem. Postoperative mechanical stability and functional outcome with this technique need to be explored and compared with those of ACL reconstruction using free hamstring autograft.http://www.sciencedirect.com/science/article/pii/S2212628715002169 |
| spellingShingle | Ravi Gupta, M.S., D.N.B., M.N.A.M.S., F.A.M.S., F.I.M.S.A. Raj Bahadur, M.S., F.A.M.S., F.R.C.S., F.I.M.S.A. Anubhav Malhotra, M.B.B.S. Gladson David Masih, M.Sc. Parmanand Gupta, M.S. Anterior Cruciate Ligament Reconstruction Using Hamstring Tendon Autograft With Preserved Insertions Arthroscopy Techniques |
| title | Anterior Cruciate Ligament Reconstruction Using Hamstring Tendon Autograft With Preserved Insertions |
| title_full | Anterior Cruciate Ligament Reconstruction Using Hamstring Tendon Autograft With Preserved Insertions |
| title_fullStr | Anterior Cruciate Ligament Reconstruction Using Hamstring Tendon Autograft With Preserved Insertions |
| title_full_unstemmed | Anterior Cruciate Ligament Reconstruction Using Hamstring Tendon Autograft With Preserved Insertions |
| title_short | Anterior Cruciate Ligament Reconstruction Using Hamstring Tendon Autograft With Preserved Insertions |
| title_sort | anterior cruciate ligament reconstruction using hamstring tendon autograft with preserved insertions |
| url | http://www.sciencedirect.com/science/article/pii/S2212628715002169 |
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