Bone-Tendon-Autograft Anterior Cruciate Ligament Reconstruction: A New Anterior Cruciate Ligament Graft Option
The bone-tendon-bone (BTB) autograft is widely used for anterior cruciate ligament (ACL) reconstruction. However, the primary disadvantages of this technique include postoperative kneeling pain, the risk of perioperative patellar fracture, and graft-tunnel mismatch. Therefore, a single bone plug tec...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2020-10-01
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| Series: | Arthroscopy Techniques |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2212628720301675 |
| _version_ | 1819105393534566400 |
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| author | CPT. Steven R. Wilding, M.D. CPT. Christian A. Cruz, M.D. LCDR. Brian J. Mannino, M.D. CPT. James B. Deal, M.D. CPT Jeffrey Wake, D.O., A.T.C. Craig R. Bottoni, M.D. |
| author_facet | CPT. Steven R. Wilding, M.D. CPT. Christian A. Cruz, M.D. LCDR. Brian J. Mannino, M.D. CPT. James B. Deal, M.D. CPT Jeffrey Wake, D.O., A.T.C. Craig R. Bottoni, M.D. |
| author_sort | CPT. Steven R. Wilding, M.D. |
| collection | DOAJ |
| description | The bone-tendon-bone (BTB) autograft is widely used for anterior cruciate ligament (ACL) reconstruction. However, the primary disadvantages of this technique include postoperative kneeling pain, the risk of perioperative patellar fracture, and graft-tunnel mismatch. Therefore, a single bone plug technique for ACL reconstructions was developed to mitigate the disadvantages of the BTB technique. To differentiate this graft, we have coined the term BTA, for bone-tendon-autograft. The middle third of the patellar tendon is used with a typical width of 10 to 11 mm. A standard tibial tubercle bone plug is harvested. The length of the patellar tendon and graft construct is then measured. If the tendon is >45 mm and the construct at least 70 mm, then we proceed with the BTA technique. At the inferior pole of the patella, electrocautery is used to harvest the tendon from the patella. The advantages of this technique include faster graft harvest and preparation. Obviating the patellar bone plug harvest should eliminate the risk of perioperative patellar fracture and theoretically will mitigate donor site morbidity and kneeling pain, 2 of the most commonly cited complications of the use of BTB autografts for ACL reconstruction. In conclusion, the BTA technique is a reliable technique for ACL reconstruction. |
| first_indexed | 2024-12-22T02:21:32Z |
| format | Article |
| id | doaj.art-fb9b98d1141b40b08a8a97991078b7e5 |
| institution | Directory Open Access Journal |
| issn | 2212-6287 |
| language | English |
| last_indexed | 2024-12-22T02:21:32Z |
| publishDate | 2020-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Arthroscopy Techniques |
| spelling | doaj.art-fb9b98d1141b40b08a8a97991078b7e52022-12-21T18:42:07ZengElsevierArthroscopy Techniques2212-62872020-10-01910e1525e1530Bone-Tendon-Autograft Anterior Cruciate Ligament Reconstruction: A New Anterior Cruciate Ligament Graft OptionCPT. Steven R. Wilding, M.D.0CPT. Christian A. Cruz, M.D.1LCDR. Brian J. Mannino, M.D.2CPT. James B. Deal, M.D.3CPT Jeffrey Wake, D.O., A.T.C.4Craig R. Bottoni, M.D.5Tripler Army Medical Center, Department of Orthopaedic Surgery, Honolulu Hawaii, U.S.A.Address correspondence to Christian Cruz, M.D., 1 Jarrett White Rd., Honolulu, HI 96859, U.S.A.; Tripler Army Medical Center, Department of Orthopaedic Surgery, Honolulu Hawaii, U.S.A.Tripler Army Medical Center, Department of Orthopaedic Surgery, Honolulu Hawaii, U.S.A.Tripler Army Medical Center, Department of Orthopaedic Surgery, Honolulu Hawaii, U.S.A.Tripler Army Medical Center, Department of Orthopaedic Surgery, Honolulu Hawaii, U.S.A.Tripler Army Medical Center, Department of Orthopaedic Surgery, Honolulu Hawaii, U.S.A.The bone-tendon-bone (BTB) autograft is widely used for anterior cruciate ligament (ACL) reconstruction. However, the primary disadvantages of this technique include postoperative kneeling pain, the risk of perioperative patellar fracture, and graft-tunnel mismatch. Therefore, a single bone plug technique for ACL reconstructions was developed to mitigate the disadvantages of the BTB technique. To differentiate this graft, we have coined the term BTA, for bone-tendon-autograft. The middle third of the patellar tendon is used with a typical width of 10 to 11 mm. A standard tibial tubercle bone plug is harvested. The length of the patellar tendon and graft construct is then measured. If the tendon is >45 mm and the construct at least 70 mm, then we proceed with the BTA technique. At the inferior pole of the patella, electrocautery is used to harvest the tendon from the patella. The advantages of this technique include faster graft harvest and preparation. Obviating the patellar bone plug harvest should eliminate the risk of perioperative patellar fracture and theoretically will mitigate donor site morbidity and kneeling pain, 2 of the most commonly cited complications of the use of BTB autografts for ACL reconstruction. In conclusion, the BTA technique is a reliable technique for ACL reconstruction.http://www.sciencedirect.com/science/article/pii/S2212628720301675 |
| spellingShingle | CPT. Steven R. Wilding, M.D. CPT. Christian A. Cruz, M.D. LCDR. Brian J. Mannino, M.D. CPT. James B. Deal, M.D. CPT Jeffrey Wake, D.O., A.T.C. Craig R. Bottoni, M.D. Bone-Tendon-Autograft Anterior Cruciate Ligament Reconstruction: A New Anterior Cruciate Ligament Graft Option Arthroscopy Techniques |
| title | Bone-Tendon-Autograft Anterior Cruciate Ligament Reconstruction: A New Anterior Cruciate Ligament Graft Option |
| title_full | Bone-Tendon-Autograft Anterior Cruciate Ligament Reconstruction: A New Anterior Cruciate Ligament Graft Option |
| title_fullStr | Bone-Tendon-Autograft Anterior Cruciate Ligament Reconstruction: A New Anterior Cruciate Ligament Graft Option |
| title_full_unstemmed | Bone-Tendon-Autograft Anterior Cruciate Ligament Reconstruction: A New Anterior Cruciate Ligament Graft Option |
| title_short | Bone-Tendon-Autograft Anterior Cruciate Ligament Reconstruction: A New Anterior Cruciate Ligament Graft Option |
| title_sort | bone tendon autograft anterior cruciate ligament reconstruction a new anterior cruciate ligament graft option |
| url | http://www.sciencedirect.com/science/article/pii/S2212628720301675 |
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