Double bundle arthroscopic Anterior Cruciate Ligament reconstruction with remnant preserving technique using a hamstring autograft

<p>Abstract</p> <p>Background</p> <p>Preservation of the Anterior Cruciate Ligament (ACL) remnant is important from the biological point of view as it enhances revascularization, and preserves the proprioceptive function of the graft construct. Additionally, it may have...

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Main Authors: Ochi Mitsuo, Abouheif Mohamed M, Kongcharoensombat Wirat, Nakamae Atsuo, Adachi Nobuo, Deie Masataka
Format: Article
Language:English
Published: BMC 2011-12-01
Series:Sports Medicine, Arthroscopy, Rehabilitation, Therapy & Technology
Online Access:http://www.smarttjournal.com/content/3/1/30
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author Ochi Mitsuo
Abouheif Mohamed M
Kongcharoensombat Wirat
Nakamae Atsuo
Adachi Nobuo
Deie Masataka
author_facet Ochi Mitsuo
Abouheif Mohamed M
Kongcharoensombat Wirat
Nakamae Atsuo
Adachi Nobuo
Deie Masataka
author_sort Ochi Mitsuo
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>Preservation of the Anterior Cruciate Ligament (ACL) remnant is important from the biological point of view as it enhances revascularization, and preserves the proprioceptive function of the graft construct. Additionally, it may have a useful biomechanical function. Double bundle ACL reconstruction has been shown to better replicate the native ACL anatomy and results in better restoration of the rotational stability than single bundle reconstruction.</p> <p>Methods</p> <p>We used the far anteromedial (FAM) portal for creation of the femoral tunnels, with a special technique for its preoperative localization using three dimensional (3D) CT. The central anteromedial (AM) portal was used to make a longitudinal slit in the ACL remnant to allow visualization of the tips of the guide pins during anatomical creation of the tibial tunnels within the native ACL tibial foot print. The use of curved hemostat allow retrieval of the wire loop from the apertures of the femoral tunnels through the longitudinal slit in the ACL remnant thereby, guarding against impingement of the reconstruction graft against the ACL remnant as well as the roof of the intercondylar notch.</p> <p>Conclusion</p> <p>Our technique allows for anatomical double bundle reconstruction of the ACL while maximally preserving the ACL remnant without the use of intra-operative image intensifier.</p>
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spelling doaj.art-f01045c9b3d440d59a0e981e713f28c22022-12-21T18:35:36ZengBMCSports Medicine, Arthroscopy, Rehabilitation, Therapy & Technology1758-25552011-12-01313010.1186/1758-2555-3-30Double bundle arthroscopic Anterior Cruciate Ligament reconstruction with remnant preserving technique using a hamstring autograftOchi MitsuoAbouheif Mohamed MKongcharoensombat WiratNakamae AtsuoAdachi NobuoDeie Masataka<p>Abstract</p> <p>Background</p> <p>Preservation of the Anterior Cruciate Ligament (ACL) remnant is important from the biological point of view as it enhances revascularization, and preserves the proprioceptive function of the graft construct. Additionally, it may have a useful biomechanical function. Double bundle ACL reconstruction has been shown to better replicate the native ACL anatomy and results in better restoration of the rotational stability than single bundle reconstruction.</p> <p>Methods</p> <p>We used the far anteromedial (FAM) portal for creation of the femoral tunnels, with a special technique for its preoperative localization using three dimensional (3D) CT. The central anteromedial (AM) portal was used to make a longitudinal slit in the ACL remnant to allow visualization of the tips of the guide pins during anatomical creation of the tibial tunnels within the native ACL tibial foot print. The use of curved hemostat allow retrieval of the wire loop from the apertures of the femoral tunnels through the longitudinal slit in the ACL remnant thereby, guarding against impingement of the reconstruction graft against the ACL remnant as well as the roof of the intercondylar notch.</p> <p>Conclusion</p> <p>Our technique allows for anatomical double bundle reconstruction of the ACL while maximally preserving the ACL remnant without the use of intra-operative image intensifier.</p>http://www.smarttjournal.com/content/3/1/30
spellingShingle Ochi Mitsuo
Abouheif Mohamed M
Kongcharoensombat Wirat
Nakamae Atsuo
Adachi Nobuo
Deie Masataka
Double bundle arthroscopic Anterior Cruciate Ligament reconstruction with remnant preserving technique using a hamstring autograft
Sports Medicine, Arthroscopy, Rehabilitation, Therapy & Technology
title Double bundle arthroscopic Anterior Cruciate Ligament reconstruction with remnant preserving technique using a hamstring autograft
title_full Double bundle arthroscopic Anterior Cruciate Ligament reconstruction with remnant preserving technique using a hamstring autograft
title_fullStr Double bundle arthroscopic Anterior Cruciate Ligament reconstruction with remnant preserving technique using a hamstring autograft
title_full_unstemmed Double bundle arthroscopic Anterior Cruciate Ligament reconstruction with remnant preserving technique using a hamstring autograft
title_short Double bundle arthroscopic Anterior Cruciate Ligament reconstruction with remnant preserving technique using a hamstring autograft
title_sort double bundle arthroscopic anterior cruciate ligament reconstruction with remnant preserving technique using a hamstring autograft
url http://www.smarttjournal.com/content/3/1/30
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AT abouheifmohamedm doublebundlearthroscopicanteriorcruciateligamentreconstructionwithremnantpreservingtechniqueusingahamstringautograft
AT kongcharoensombatwirat doublebundlearthroscopicanteriorcruciateligamentreconstructionwithremnantpreservingtechniqueusingahamstringautograft
AT nakamaeatsuo doublebundlearthroscopicanteriorcruciateligamentreconstructionwithremnantpreservingtechniqueusingahamstringautograft
AT adachinobuo doublebundlearthroscopicanteriorcruciateligamentreconstructionwithremnantpreservingtechniqueusingahamstringautograft
AT deiemasataka doublebundlearthroscopicanteriorcruciateligamentreconstructionwithremnantpreservingtechniqueusingahamstringautograft