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KMID : 0828620050090020222
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Journal of Korean Arthroscopy Society
2005 Volume.9 No. 2 p.222 ~ p.231
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Anterior Cruciate Ligament Double Bundle Reconstruction with Hamstring Tendon Autografts - Technical Notes
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Ahn Jin-Hwan
Kang Hong-Je
Lee Sang-Hak
Ahn Hyung-Kwon
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Abstract
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Purpose:This article describes a double-bundle ACL reconstruction technique using a five-strand hamstring tendon autograft with conventional anteromedial bundle reconstruction and additional posterolateral bundle reconstruction.
Operative technique: For the tibial tunnel, the conventional single tunnel technique is performed and for the femoral tunnel, the double tunnel technique is performed with the anteromedial and posterolateral bundle. After minimal notchplasty, the anteromedial femoral tunnel is prepared with leaving one milimeter of posterior femoral cortex within the over-the-top, which is positioned at the 11-o’clock orientation for the right knee or at the 1-o clock position for the left knee. The posterolateral femoral tunnel that is located 5 to 7 mm superior to the inner margin of the lateral meniscus anterior horn at 90°of flexion is prepared with the outside-in technique using a 4.5 cannulated reamer. The graft material for the double bundle reconstruction is made of the conventional four-strand hamstring autograft in the anteromedial bundle and of a single-strand semitendinosus tendon in the posterolateral bundle. The anteromedial bundle is fixed with using a rigid fix system on the femoral side and the posterolateral bundle is fixed to tie with the miniplate from the outside femur. Then, with the knee in 10°to 20°of flexion, a bioabsorbable screw is simultaneously applied to achieve tibial fixation with tensioning of both bundles.
Conclusions:A double bundle reconstruction with five-strand hamstring autograft, which is designed with a favorable conventional anteromedial bundle and an additional posterolateral bundle to restore rotation stability, seems to be a very effective method for the treatment for ACL instabilities.
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KEYWORD
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Anterior cruciate ligament, Double bundle reconstruction, Five-strand hamstring autograft
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