Economic Reliable Technique for Tunnel Grafting Using Iliac Crest Bone Graft in Two-Staged Revision Anterior Cruciate Ligament Surgery
Revision anterior cruciate ligament surgery is a technically demanding procedure. Mal-positioned tunnels together with bone loss and its management are some of the difficulties and challenges faced. Two-staged procedures have successfully been used to tackle those challenges. We present a technique...
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| Format: | Article |
| Language: | English |
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Elsevier
2020-12-01
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| Series: | Arthroscopy Techniques |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2212628720302231 |
| _version_ | 1818448453453217792 |
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| author | Ahmed Abdel-Aziz, M.Sc., M.D. Mohamed Refaat Waly, M.Sc., M.D., M.R.C.S. Mahmoud Ahmed Abdel-Aziz, M.Sc., M.D. Mohamed Mamdouh Sherif, M.Sc. Hazem Elhaddad, M.Sc. Begad Hesham Mostafa Zaky Abdelrazek, M.Sc., M.D., F.R.C.S. |
| author_facet | Ahmed Abdel-Aziz, M.Sc., M.D. Mohamed Refaat Waly, M.Sc., M.D., M.R.C.S. Mahmoud Ahmed Abdel-Aziz, M.Sc., M.D. Mohamed Mamdouh Sherif, M.Sc. Hazem Elhaddad, M.Sc. Begad Hesham Mostafa Zaky Abdelrazek, M.Sc., M.D., F.R.C.S. |
| author_sort | Ahmed Abdel-Aziz, M.Sc., M.D. |
| collection | DOAJ |
| description | Revision anterior cruciate ligament surgery is a technically demanding procedure. Mal-positioned tunnels together with bone loss and its management are some of the difficulties and challenges faced. Two-staged procedures have successfully been used to tackle those challenges. We present a technique that is safe, reliable, reproducible, and economic in the management of bone defects faced in anterior cruciate ligament revision surgery by using iliac crest bone graft. Preoperative assessment of tunnel position and size is done by computed tomography. Tri-cortical iliac crest bone graft is harvested through a trap door. It is then shaped to fit the tunnels to be filled. It is tapered at the advancing end to facilitate introduction. Mounted on a passing pin and a drill bit, the graft is arthroscopically introduced into the femoral and tibial tunnels. The second stage is performed after the graft has incorporated, as seen on postoperative computed tomography, done at approximately 3 months after the first stage. Iliac crest provides a natural abundant reservoir for bone graft and has all the advantages of being an autograft. With good meticulous technique, complications can be avoided with less donor-site morbidity. This technique is safe, reliable, and reproducible. It provides an ample amount of graft and harvest does not rely on implants; hence, it is economic. |
| first_indexed | 2024-12-14T20:19:45Z |
| format | Article |
| id | doaj.art-a83256c8a72c479d82e0f74f201f1e32 |
| institution | Directory Open Access Journal |
| issn | 2212-6287 |
| language | English |
| last_indexed | 2024-12-14T20:19:45Z |
| publishDate | 2020-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Arthroscopy Techniques |
| spelling | doaj.art-a83256c8a72c479d82e0f74f201f1e322022-12-21T22:48:46ZengElsevierArthroscopy Techniques2212-62872020-12-01912e1917e1925Economic Reliable Technique for Tunnel Grafting Using Iliac Crest Bone Graft in Two-Staged Revision Anterior Cruciate Ligament SurgeryAhmed Abdel-Aziz, M.Sc., M.D.0Mohamed Refaat Waly, M.Sc., M.D., M.R.C.S.1Mahmoud Ahmed Abdel-Aziz, M.Sc., M.D.2Mohamed Mamdouh Sherif, M.Sc.3Hazem Elhaddad, M.Sc.4Begad Hesham Mostafa Zaky Abdelrazek, M.Sc., M.D., F.R.C.S.5Trauma and Orthopaedics, Kasr-Alainy Faculty of Medicine, Cairo University, Cairo, EgyptTrauma and Orthopaedics, Kasr-Alainy Faculty of Medicine, Cairo University, Cairo, Egypt; Address correspondence to Mohamed Refaat Waly, M.Sc., M.D., Lecturer of Trauma and Orthopaedics, Kasr-Alainy Faculty of Medicine, Cairo University, Mathaf El-Manial St., Cairo, Egypt, 11553.Trauma and Orthopaedics, Kasr-Alainy Faculty of Medicine, Cairo University, Cairo, Egypt; Student Hospital, Cairo University, Cairo, EgyptTrauma and Orthopaedics, El Sahel Teaching Hospital, El Sahel, Cairo, EgyptTrauma and Orthopaedics, Kasr-Alainy Faculty of Medicine, Cairo University, Cairo, Egypt; Cairo Fatemic Hospital, Cairo, EgyptTrauma and Orthopaedics, Kasr-Alainy Faculty of Medicine, Cairo University, Cairo, EgyptRevision anterior cruciate ligament surgery is a technically demanding procedure. Mal-positioned tunnels together with bone loss and its management are some of the difficulties and challenges faced. Two-staged procedures have successfully been used to tackle those challenges. We present a technique that is safe, reliable, reproducible, and economic in the management of bone defects faced in anterior cruciate ligament revision surgery by using iliac crest bone graft. Preoperative assessment of tunnel position and size is done by computed tomography. Tri-cortical iliac crest bone graft is harvested through a trap door. It is then shaped to fit the tunnels to be filled. It is tapered at the advancing end to facilitate introduction. Mounted on a passing pin and a drill bit, the graft is arthroscopically introduced into the femoral and tibial tunnels. The second stage is performed after the graft has incorporated, as seen on postoperative computed tomography, done at approximately 3 months after the first stage. Iliac crest provides a natural abundant reservoir for bone graft and has all the advantages of being an autograft. With good meticulous technique, complications can be avoided with less donor-site morbidity. This technique is safe, reliable, and reproducible. It provides an ample amount of graft and harvest does not rely on implants; hence, it is economic.http://www.sciencedirect.com/science/article/pii/S2212628720302231 |
| spellingShingle | Ahmed Abdel-Aziz, M.Sc., M.D. Mohamed Refaat Waly, M.Sc., M.D., M.R.C.S. Mahmoud Ahmed Abdel-Aziz, M.Sc., M.D. Mohamed Mamdouh Sherif, M.Sc. Hazem Elhaddad, M.Sc. Begad Hesham Mostafa Zaky Abdelrazek, M.Sc., M.D., F.R.C.S. Economic Reliable Technique for Tunnel Grafting Using Iliac Crest Bone Graft in Two-Staged Revision Anterior Cruciate Ligament Surgery Arthroscopy Techniques |
| title | Economic Reliable Technique for Tunnel Grafting Using Iliac Crest Bone Graft in Two-Staged Revision Anterior Cruciate Ligament Surgery |
| title_full | Economic Reliable Technique for Tunnel Grafting Using Iliac Crest Bone Graft in Two-Staged Revision Anterior Cruciate Ligament Surgery |
| title_fullStr | Economic Reliable Technique for Tunnel Grafting Using Iliac Crest Bone Graft in Two-Staged Revision Anterior Cruciate Ligament Surgery |
| title_full_unstemmed | Economic Reliable Technique for Tunnel Grafting Using Iliac Crest Bone Graft in Two-Staged Revision Anterior Cruciate Ligament Surgery |
| title_short | Economic Reliable Technique for Tunnel Grafting Using Iliac Crest Bone Graft in Two-Staged Revision Anterior Cruciate Ligament Surgery |
| title_sort | economic reliable technique for tunnel grafting using iliac crest bone graft in two staged revision anterior cruciate ligament surgery |
| url | http://www.sciencedirect.com/science/article/pii/S2212628720302231 |
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