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KMID : 0828620090130010082
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Journal of Korean Arthroscopy Society
2009 Volume.13 No. 1 p.82 ~ p.85
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ACL Reconstruction with Remnant Preserving Technique - Technical Note -
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Cho Sung-Do
Youm Yoon-Seok
Jeong Ji-Young
Jeon Hyung-Min
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Abstract
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Purpose: In anterior cruciate ligament (ACL) reconstruction, preservation of the remnant original tissue might promote graft healing and be helpful in proprioception. But this procedure is difficult and causes the notch impingement. So we introduce a surgical technique that makes a transtibial femoral tunnel at 10 or 2 o’clock position with preservation of remnant tissue.
Surgical approach: We tried to preserve the remnant tissue and synovium as much as possible, especially those of tibial attachment and extending to the posterior cruciate ligament (PCL), so as to have some tension and to prevent notch impingement. We set the tibial drill guide at 40~45 degrees and the intra-articular guide tip was 1 mm anterior and medial to the conventional site. The starting point of tibial guide pin was proximal to the pes anserinus and anterior to the medial collateral ligament. When the reamer approached the cortical bone of the tibial articular surface, the reamer must be advanced very carefully to minimize injury to the remnant tissue. The tibial and femoral tunnel at 10 or 2 o’clock position were made with the reamer, the diameter of which was same with that of the graft.
Conclusion: We report a remnant preserving technique in ACL reconstruction that makes a transtibial femoral tunnel at 10 or 2 o’clock position
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KEYWORD
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ACL, Reconstruction, Remnant tissue pres
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