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Simplifying Anterior Cruciate Ligament Graft Bone Plug Reconstructions: The "U" Trough Technique.

ABSTRACT: This Technical Note discusses an anterior cruciate ligament graft preparation technique to simplify and ease graft visualization, insertion, and fixation. Our technique incorporates a 2-mm central trough in the bone plug of the graft to improve one's ability to efficiently identify and orient the anterior cruciate ligament graft during insertion, and ensure correct screw placement and fixation.

SUBMITTER: Perez JR

PROVIDER: S-EPMC5622206 | biostudies-literature | 2017 Aug

REPOSITORIES: biostudies-literature

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Simplifying Anterior Cruciate Ligament Graft Bone Plug Reconstructions: The "U" Trough Technique.

Perez Jose R JR Letter Michael M Klein Jason J Kaplan Lee D LD

Arthroscopy techniques 20170807 4

This Technical Note discusses an anterior cruciate ligament graft preparation technique to simplify and ease graft visualization, insertion, and fixation. Our technique incorporates a 2-mm central trough in the bone plug of the graft to improve one's ability to efficiently identify and orient the anterior cruciate ligament graft during insertion, and ensure correct screw placement and fixation. ...[more]

PMID: 29354427

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Avoiding graft-tunnel length mismatch in anterior cruciate ligament reconstruction: the single-bone plug technique.

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Anterior to Posterior Bone Plug Suture Tunnels Provide Optimal Biomechanics for Bone-Patellar Tendon-Bone Anterior Cruciate Ligament Graft.

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A Technique Utilizing GraftNet to Fill Graft Donor Sites in Bone-Patellar-Bone Anterior Cruciate Ligament Reconstruction.

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| S-EPMC6928353 | biostudies-literature

Graft Preparation Technique to Optimize Hamstring Graft Diameter for Anterior Cruciate Ligament Reconstruction.

Project description:Hamstring autografts are frequently used for anterior cruciate ligament reconstruction. The inherent variability in graft diameter has been stated as a disadvantage in its use because the presence of smaller graft diameters has been correlated with increased risk of re-rupture. Several techniques have been described to address this concern. Modifications of the basic Graftlink technique allows for increased control over final graft diameter using a standard harvest of the semitendinosus tendon with or without the gracilis tendon, and results in a graft of adequate length and diameter in all patients with rigid cortical fixation on the femur and tibia.

| S-EPMC5765566 | biostudies-literature

Revision Anterior Cruciate Ligament Reconstruction: Tibial Tunnel-First Graft-Sizing Technique.

Project description:Revision anterior cruciate ligament reconstruction (R-ACLR) has become more common as the number of failed primary ACLRs increase. Although increasingly common, R-ACLR has a greater failure rate than a primary reconstruction. Technical errors, particularly in tunnel placement, account for a large proportion of graft failure in R-ACLR as well as re-revision cases. Tunnel placement and trajectory is particularly important in R-ACLR and becomes more challenging with each additional revision attempt. This is in part because any tunnels created for revision may converge with formerly drilled tunnels or face interference hardware creating, complicating proper graft fixation. While there are many approaches to revision ACL surgery, our technique describes a simple, tibial tunnel-first graft-sizing method initially reaming tunnels with very small diameters and sequentially working your way up to more anatomic diameters.

| S-EPMC8719212 | biostudies-literature

Autogenous Hamstring-Bone Graft Preparation for Anterior Cruciate Ligament Reconstruction.

Project description:Despite the popularity of anterior cruciate ligament (ACL) reconstruction procedures, the ideal graft for reconstruction remains a matter of controversy. The ideal graft for ACL reconstruction should have histologic and biomechanical characteristics similar to those of the native ACL; should be quickly and fully incorporated within the bony tunnels; should maintain its viscoelastic properties for a long time; should have minimal donor-site morbidity; should be of sufficient length and diameter; should have minimal adverse effects on the extensor mechanism; should have no risk of rejection or disease transmission; and should be cost-effective and readily available. Synthetic grafts are not widely accepted because of their dangerous complications. The main sources of grafts for ACL reconstruction are allografts and autografts. Each type of graft has its own relative advantages and disadvantages. Allografts are not available in every country, besides being expensive, and there are many concerns regarding disease transmission. Autografts, particularly bone-patellar tendon-bone (BPTB), and hamstring tendon grafts have been the standard for ACL reconstruction. The main advantage of autogenous BPTB grafts is the direct bone-to-bone healing in the tunnel, whereas the main disadvantages of such grafts are related to donor-site morbidity, anterior knee pain, and extensor mechanism dysfunction. The popularity of autogenous hamstring tendon grafts for ACL reconstruction is increasing, but there are still concerns regarding the slow soft tissue-to-bone healing, with delayed healing and incorporation of the graft. We describe a technique for ACL reconstruction with autogenous hamstring-bone graft, aiming to produce a type of graft that combines the main advantages of BPTB and hamstring grafts, with avoidance of the main disadvantages of these 2 most commonly used graft types in ACL reconstruction.

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Internal Suture Augmentation Technique to Protect the Anterior Cruciate Ligament Reconstruction Graft.

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