Background: Preservation of the Anterior Cruciate Ligament (ACL) remnant is important from the biological point\r\nof view as it enhances revascularization, and preserves the proprioceptive function of the graft construct.\r\nAdditionally, it may have a useful biomechanical function. Double bundle ACL reconstruction has been shown to\r\nbetter replicate the native ACL anatomy and results in better restoration of the rotational stability than single\r\nbundle reconstruction.\r\nMethods: We used the far anteromedial (FAM) portal for creation of the femoral tunnels, with a special technique\r\nfor its preoperative localization using three dimensional (3D) CT. The central anteromedial (AM) portal was used to\r\nmake a longitudinal slit in the ACL remnant to allow visualization of the tips of the guide pins during anatomical\r\ncreation of the tibial tunnels within the native ACL tibial foot print. The use of curved hemostat allow retrieval of\r\nthe wire loop from the apertures of the femoral tunnels through the longitudinal slit in the ACL remnant thereby,\r\nguarding against impingement of the reconstruction graft against the ACL remnant as well as the roof of the\r\nintercondylar notch.\r\nConclusion: Our technique allows for anatomical double bundle reconstruction of the ACL while maximally\r\npreserving the ACL remnant without the use of intra-operative image intensifier.
Loading....