A Simplified Double-Bundle Anterior Cruciate Ligament Reconstruction by the Three-Inside Technique With Two Suspension Buttons and One Interference Screw
In comparison with the single-bundle technique, double-bundle anterior cruciate ligament (ACL) reconstruction has proven its superiority regarding biomechanical studies and clinical outcomes in both rotational knee stability and anterior translation function. However, the complexity and risk of comp...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2022-01-01
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| Series: | Arthroscopy Techniques |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2212628721002711 |
| _version_ | 1818975580696084480 |
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| author | Cong Dung Truong, M.D. To Dong Kha, M.D. Thanh Huan Vuong, M.D. Abdelrahman Zakzouk, M.B.B.C.H. Nguyen Minh Dung, M.D. Tung Dang Xuan Tran, M.D., Ph.D. Abdelrahman M Makram, M.B.B.C.H. Nguyen Tien Huy, M.D., Ph.D. |
| author_facet | Cong Dung Truong, M.D. To Dong Kha, M.D. Thanh Huan Vuong, M.D. Abdelrahman Zakzouk, M.B.B.C.H. Nguyen Minh Dung, M.D. Tung Dang Xuan Tran, M.D., Ph.D. Abdelrahman M Makram, M.B.B.C.H. Nguyen Tien Huy, M.D., Ph.D. |
| author_sort | Cong Dung Truong, M.D. |
| collection | DOAJ |
| description | In comparison with the single-bundle technique, double-bundle anterior cruciate ligament (ACL) reconstruction has proven its superiority regarding biomechanical studies and clinical outcomes in both rotational knee stability and anterior translation function. However, the complexity and risk of complications remain a great concern for the orthopaedic surgeon performing double-bundle ACL reconstruction. We present a simplified double-bundle ACL reconstruction by the 3-inside technique with 2 suspension buttons and 1 interference screw. The semitendinosus tendon is tripled to be the anteromedial (AM) bundle, whereas the gracilis is doubled for the posterolateral (PL) bundle. We perform a 3-socket approach with an inside-out femoral tunnel for the AM bundle, an outside-in femoral tunnel for the PL bundle, and a retrograde tibial socket for the tibial bundle. Thus, this technique is, simply, a combination of 2 procedures: one single all-inside method (for the AM bundle) and one outside-in method (for the PL bundle), with which most arthroscopic surgeons are familiar. The AM and PL bundles are fixed at 30° and 45°, respectively, using 2 suspension buttons and 1 interference screw. Our simplified technique could reduce surgical costs and minimize complications while maintaining isometric position and appropriate graft size for each patient. |
| first_indexed | 2024-12-20T15:58:13Z |
| format | Article |
| id | doaj.art-ae373d3d1bcc417b8571515fcc950f25 |
| institution | Directory Open Access Journal |
| issn | 2212-6287 |
| language | English |
| last_indexed | 2024-12-20T15:58:13Z |
| publishDate | 2022-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Arthroscopy Techniques |
| spelling | doaj.art-ae373d3d1bcc417b8571515fcc950f252022-12-21T19:34:22ZengElsevierArthroscopy Techniques2212-62872022-01-01111e43e52A Simplified Double-Bundle Anterior Cruciate Ligament Reconstruction by the Three-Inside Technique With Two Suspension Buttons and One Interference ScrewCong Dung Truong, M.D.0To Dong Kha, M.D.1Thanh Huan Vuong, M.D.2Abdelrahman Zakzouk, M.B.B.C.H.3Nguyen Minh Dung, M.D.4Tung Dang Xuan Tran, M.D., Ph.D.5Abdelrahman M Makram, M.B.B.C.H.6Nguyen Tien Huy, M.D., Ph.D.7Van Hanh Private Hospital, Ho Chi Minh City, VietnamSchool of Medicine, Vietnam National University Ho Chi Minh City, Ho Chi Minh City, Vietnam; Vietnam National University Ho Chi Minh City, Ho Chi Minh City, VietnamFaculty of Medicine, Pham Ngoc Thach University of Medicine, Ho Chi Minh city, VietnamFaculty of Medicine, Tanta University, Tanta, EgyptSport Medicine Association HCMC, Ho Chi Minh City, VietnamVan Hanh Private Hospital, Ho Chi Minh City, Vietnam; School of Dentistry, Taipei Medical University, Taipei City, TaiwanFaculty of Medicine, October 6 University, Giza, EgyptSchool of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan; Address correspondence to Cong Dung Truong, M.D., Van Hanh Private Hospital, Ho Chi Minh City, Vietnam. E-mail: bsdung0944@gmail.com; or Nguyen Tien Huy, M.D., Ph.D., School of Tropical Medicine and Global Health (TMGH), Nagasaki University, Nagasaki 852-8523, Japan.In comparison with the single-bundle technique, double-bundle anterior cruciate ligament (ACL) reconstruction has proven its superiority regarding biomechanical studies and clinical outcomes in both rotational knee stability and anterior translation function. However, the complexity and risk of complications remain a great concern for the orthopaedic surgeon performing double-bundle ACL reconstruction. We present a simplified double-bundle ACL reconstruction by the 3-inside technique with 2 suspension buttons and 1 interference screw. The semitendinosus tendon is tripled to be the anteromedial (AM) bundle, whereas the gracilis is doubled for the posterolateral (PL) bundle. We perform a 3-socket approach with an inside-out femoral tunnel for the AM bundle, an outside-in femoral tunnel for the PL bundle, and a retrograde tibial socket for the tibial bundle. Thus, this technique is, simply, a combination of 2 procedures: one single all-inside method (for the AM bundle) and one outside-in method (for the PL bundle), with which most arthroscopic surgeons are familiar. The AM and PL bundles are fixed at 30° and 45°, respectively, using 2 suspension buttons and 1 interference screw. Our simplified technique could reduce surgical costs and minimize complications while maintaining isometric position and appropriate graft size for each patient.http://www.sciencedirect.com/science/article/pii/S2212628721002711 |
| spellingShingle | Cong Dung Truong, M.D. To Dong Kha, M.D. Thanh Huan Vuong, M.D. Abdelrahman Zakzouk, M.B.B.C.H. Nguyen Minh Dung, M.D. Tung Dang Xuan Tran, M.D., Ph.D. Abdelrahman M Makram, M.B.B.C.H. Nguyen Tien Huy, M.D., Ph.D. A Simplified Double-Bundle Anterior Cruciate Ligament Reconstruction by the Three-Inside Technique With Two Suspension Buttons and One Interference Screw Arthroscopy Techniques |
| title | A Simplified Double-Bundle Anterior Cruciate Ligament Reconstruction by the Three-Inside Technique With Two Suspension Buttons and One Interference Screw |
| title_full | A Simplified Double-Bundle Anterior Cruciate Ligament Reconstruction by the Three-Inside Technique With Two Suspension Buttons and One Interference Screw |
| title_fullStr | A Simplified Double-Bundle Anterior Cruciate Ligament Reconstruction by the Three-Inside Technique With Two Suspension Buttons and One Interference Screw |
| title_full_unstemmed | A Simplified Double-Bundle Anterior Cruciate Ligament Reconstruction by the Three-Inside Technique With Two Suspension Buttons and One Interference Screw |
| title_short | A Simplified Double-Bundle Anterior Cruciate Ligament Reconstruction by the Three-Inside Technique With Two Suspension Buttons and One Interference Screw |
| title_sort | simplified double bundle anterior cruciate ligament reconstruction by the three inside technique with two suspension buttons and one interference screw |
| url | http://www.sciencedirect.com/science/article/pii/S2212628721002711 |
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