Browse
Submit Data
Databases
API
Help

Dataset Information

0 Views

0 Connections

0 Citations

0 Reanalyses

0 Downloads

Omics score: 0

"Retrograde technique" for drilling the femoral tunnel in an anterior cruciate ligament reconstruction.

ABSTRACT: Recent literature has led some surgeons to drill the femoral tunnel in an anterior cruciate ligament reconstruction through an accessory anteromedial portal. Several techniques have been reported for the safe, effective drilling of the femoral tunnel by this approach. This technical note presents a new "retrograde technique" in which all instruments are passed independently into the notch and across the medial compartment. This technique is safe and reproducible and allows for meticulous evaluation and creation of the femoral tunnel(s) while minimizing steps.

SUBMITTER: Branam BR

PROVIDER: S-EPMC3882676 | biostudies-other | 2013

REPOSITORIES: biostudies-other

ACCESS DATA

Json Xml

Publications

"Retrograde technique" for drilling the femoral tunnel in an anterior cruciate ligament reconstruction.

Branam Barton R BR Hasselfeld Kimberly A KA

Arthroscopy techniques 20131010 4

Recent literature has led some surgeons to drill the femoral tunnel in an anterior cruciate ligament reconstruction through an accessory anteromedial portal. Several techniques have been reported for the safe, effective drilling of the femoral tunnel by this approach. This technical note presents a new "retrograde technique" in which all instruments are passed independently into the notch and across the medial compartment. This technique is safe and reproducible and allows for meticulous evaluat ...[more]

PMID: 24400188

Similar Datasets

Physeal-sparing technique for femoral tunnel drilling in pediatric anterior cruciate ligament reconstruction using a posteromedial portal.

Project description:Pediatric anterior cruciate ligament (ACL) tears present a technical dilemma for orthopaedic surgeons. Multiple surgical techniques have been described to protect the distal femoral and proximal tibial physes. We present an ACL reconstruction technique performed on a 12-year-old girl with open physes who sustained an ACL tear after a noncontact twisting injury while playing soccer. A hamstring autograft reconstruction was performed by use of a posteromedial portal to drill the femoral tunnel in an all-epiphyseal fashion at the anatomic footprint of the native ACL. This case provides a new surgical technique to achieve anatomic fixation for ACL reconstruction in a skeletally immature individual using a posteromedial portal to drill a physeal-sparing lateral femoral tunnel for anatomic ACL reconstruction. This advancement may make drilling the femoral tunnel less technically challenging compared with other proposed methods while maintaining the lateral wall of the distal femur.

| S-EPMC4040012 | biostudies-literature

Ultrasonic Technique for Femoral Tunnel Creation in Anterior Cruciate Ligament Reconstruction

Project description:Bone tunnel creation in the anatomical location is essential in anterior cruciate ligament (ACL) reconstruction with an autogenous graft and is commonly performed with a drill bit matched to graft diameter. Anatomic rectangular tunnel ACL reconstruction with a bone–patellar tendon–bone autograft has been developed to anatomically create bone tunnels inside the ACL footprints and has been reported to achieve excellent outcomes. To make the rectangular tunnel, the surgeon needs to dilate 2 adjacent bone tunnels after creation of 2 round tunnels with a drill bit, while the tunnel wall occasionally cracks during dilating. An ultrasonic (US) device was developed with improvement of output power and has been implemented with a rectangular shape blade in the field of arthroscopic surgery. This US device can provide a precise and effective bone cut compared to drills. We introduced this device to clinically create a rectangular tunnel during ACL reconstruction. The US device can be useful for rectangular femoral tunnel creation and can create a precise rectangular femoral tunnel in the ACL footprint. Technique Video Video 1 Rectangular femoral tunnel creation with the ultrasonic device.

| S-EPMC10466142 | biostudies-literature

Inside-out Tibial Tunnel Drilling Technique for All-inside Anterior Cruciate Ligament Reconstruction.

Project description:All-inside anterior cruciate ligament reconstruction passed through a series of modifications over the past 2 decades, maintaining 2 common factors: half tunnels in both the femur and tibia and introduction of the graft into the knee through an arthroscopic portal. One of the disadvantages noted with this technique is the excessive cost of the instrumentation needed to perform it and its economic impact on the health care system. We describe a modification of the original technique, both maintaining the cortical bone in an intact state and avoiding the retrograde drill aiming device.

| S-EPMC5982608 | biostudies-literature

Posterior Cruciate Ligament Reconstruction with Retrograde Femoral Technique, Posterior Trans-septal Portal and Full Tibial Tunnel.

Project description:Suspensory femoral graft fixation has been a popular and reliable method in anterior cruciate ligament (ACL) reconstruction. Some authors have introduced suspensory femoral fixation in posterior cruciate ligament (PCL) reconstruction using inside-out (IO) technique. The use of IO technique for femoral tunnel preparation could significantly sharpen the critical corner, which might result in graft failure. A retrograde drilling pin that recently has been popular in ACL reconstruction allows "no incision" in the outside-in (OI) technique for the creation of a femoral socket. Here we describe the suspensory femoral fixation using a retro-socket technique in single-bundle PCL reconstruction. By using this technique, it is possible to create a retrograde femoral socket for suspensory femoral fixation in an OI manner in a desirable direction and reduce angulation of the graft in the entry area of the femoral tunnel.

| S-EPMC5621783 | biostudies-literature

Modification of Outside-In Technique In Preparing Femoral Tunnel During Anterior Cruciate Ligament Reconstruction-"PL-Portal Outside-In Technique".

Project description:We propose modifying the outside-in technique by adopting a posterolateral (PL) portal as the working portal to introduce the anterior cruciate ligament reconstruction (ACLR) aiming guide while keeping the anteromedial portal as the viewing portal, the "PL-portal outside-in technique." This modification facilitates the preparation of an anatomical femoral tunnel, even when preserving a "big" ACL remnant or in small joint scenarios, such as pediatric ACLR. There is a minimal learning curve in adopting this technique because a standard 30° arthroscope is used, and the viewing portal is anterior.

| S-EPMC10837789 | 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

Anterior cruciate ligament femoral socket drilling with a retrograde reamer: lessons from the learning curve.

Project description:Whereas "anatomic" anterior cruciate ligament reconstruction may improve clinical results, the technique has introduced new technical challenges. The purpose of this technical note and video is to explore tips and tricks that improve femoral socket drilling with a retrograde reamer, bone-patellar tendon-bone graft passage, and interference screw fixation. The techniques for retrograde femoral socket drilling in an inside-out direction, bone-patellar tendon-bone graft passage, and interference screw fixation are described and demonstrated. Pitfalls, troubleshooting tips, and possible solutions are discussed. With the retrograde reamer, the femoral socket can be placed in the footprint of the anterior cruciate ligament with a longer and more vertical tunnel. By modifying the size of the patellar bone plug, graft passage is improved. With care and technique, interference screw fixation in the femoral socket over a guidewire is possible.

| S-EPMC3882701 | biostudies-literature

Anterior cruciate ligament reconstruction with preservation of femoral anterior cruciate ligament stump.

Project description:Anterior cruciate ligament (ACL) reconstruction with preservation of either the remnant or the tibial stump is performed with the hope of improving the vascularization and proprioceptive function of the graft. Remnant preservation is technically difficult because it hinders the visualization of the intra-articular tunnel site. Taking a cue from the concept of tibial stump preservation, we have modified our ACL reconstruction technique to preserve a sleeve of the soft tissue and ACL stump attached to the femoral condyle, in addition to tibial stump preservation, while still allowing adequate visualization of the femoral ACL insertion site. We describe our modification in this article and hypothesize that this should further improve graft vascularization and ligamentization.

| S-EPMC4246405 | biostudies-literature

Direct Visualization of Existing Footprint and Outside-In Drilling of the Femoral Tunnel in Anterior Cruciate Ligament Reconstruction in the Knee.

Project description:Improper femoral tunnel placement in anterior cruciate ligament (ACL) reconstruction is a significant problem and may be a cause of ACL graft failure and abnormal kinematics, which may lead to late degenerative changes after reconstruction. Recently, there has been concern that the transtibial approach may contribute to nonanatomic placement of the femoral tunnel, resulting in abnormal knee kinematics. Tibial-independent techniques can provide more anatomic placement of the ACL graft, but these can be technically demanding. This technical note describes the senior author's technique to directly identify the femoral ACL remnant and use the center of the femoral ACL footprint and retrograde drilling to create an anatomic femoral socket for single-bundle reconstruction. This technique provides femoral tunnel placement based on identification of a patient-specific ACL footprint instead of averaged anatomic measurements from large groups. This technique has been shown to produce anatomic ACL graft position and orientation and restore more normal knee kinematics.

| S-EPMC4454815 | biostudies-literature

An Alternative Technique to Avoid Injury to the Medial Femoral Condyle When Reaming the Femoral Tunnel During Anterior Cruciate Ligament Reconstruction.

Project description:Contemporary anterior cruciate ligament reconstruction attempts to replicate the anatomical insertion sites on both the femoral and tibial sides to restore knee stability. Creation of the femoral tunnel by independently reaming through an anteromedial portal may allow surgeons to more reproducibly place the tunnel within the anatomic femoral footprint relative to a transtibial approach. However, inherent to the technique is the risk of iatrogenic injury to the articular cartilage of the medial femoral condyle as the reamers are passed adjacent to the condyle. This is particularly an issue with the use of standard nonflexible guide pins and reamers, which are placed with the knee in hyperflexion. We describe a relatively straightforward technique that can be used with standard equipment and that can be quite useful in avoiding this pitfall of the transportal approach.

| S-EPMC5368344 | biostudies-literature

OmicsDI is part of the ELIXIR infrastructure

OmicsDI is an Elixir interoperability service. Learn more ›

Tweets

OmicsDI Databases

PRIDE
PeptideAtlas
MassIVE
JPOST Repository
Physiome Model Repository

EGA
EVA
ENA
LINCS
PAXDB
Cell Collective

MetaboLights
Metabolomics Workbench
MetabolomeExpress
GNPS
BioModels
FAIRDOMHub

ArrayExpress
dbGaP
ExpressionAtlas
GEO
NODE

Information

Databases
Help
API
Contact us
Code on GitHub
Terms of use
Submit Data