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Alternative Techniques for Double-Tunnel Anatomic ACL Reconstruction

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Sports Injuries

Abstract

This chapter presents a nonanatomical double-bundle ACL reconstruction technique. The reconstruction is performed using hamstring tendons that are harvested, maintaining intact the tibial insertion. The anteromedial bundle is restored placing the graft in the “over-the-top” position, while the posterolateral bundle is replaced retrieving the graft from a femoral tunnel. Graft fixation is obtained using metal staples.

Hundreds of patients have been treated with this technique during the last 10 years, including athletes with high functional requests. Furthermore, in vivo analysis of knee kinematic confirmed the effectiveness of the technique.

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References

  • Brahmabhatt V, Smolinski R, McGlowan J et al (1999) Double stranded hamstring tendons for anterior cruciate ligament reconstruction. Am J Knee Surg 12:141–145

    PubMed  CAS  Google Scholar 

  • Brower RS, Melby A III, Askew MJ et al (1992) In vitro comparison of over-the-top and through-the-condyle anterior cruciate ligament reconstruction. Am J Sports Med 20:567–574

    Article  PubMed  CAS  Google Scholar 

  • Hamada M, Shino K, Tomoki M et al (1998) Cross-sectional area measurement of the semitendinosus tendon for anterior cruciate ligament reconstruction. Arthroscopy 14:696–701

    Article  PubMed  CAS  Google Scholar 

  • Hoher J, Scheffler SU, Withrow JD et al (2000) Mechanical behavior of two hamstring graft constructs for reconstruction of the anterior cruciate ligament. J Orthop Res 18:456–461

    Article  PubMed  CAS  Google Scholar 

  • Kleipool AE, van Loon T, Marti RK (1994) Pain after use of the central third of the patellar tendon for cruciate ligament reconstruction: 33 patients followed 2–3 years. Acta Orthop Scand 65:62–66

    Article  PubMed  CAS  Google Scholar 

  • Lephart SM, Kocher MS, Arner CD et al (1993) Quadriceps strength and functional capacity after anterior cruciate ligament reconstruction: patellar tendon autograft versus allograft. Am J Sports Med 21:738–743

    Article  PubMed  CAS  Google Scholar 

  • Lipscomb AB, Johnston RK, Snyder RB et al (1982) Evaluation hamstring muscle strength following use of semitendinosus and gracilis tendon to reconstruct the anterior cruciate ligament. Am J Sports Med 10:340–342

    Article  PubMed  CAS  Google Scholar 

  • Lopomo N, Bignozzi S, Martelli S et al (2009) Reliability of a navigation system for intra-operative evaluation of antero-posterior knee joint laxity. Comput Biol Med 39:280–285

    Article  PubMed  Google Scholar 

  • Lopomo N, Zaffagnini S, Bignozzi S et al (2010) Pivot-shift test: analysis and quantification of knee laxity parameters using a navigation system. J Orthop Res 28:164–169

    PubMed  Google Scholar 

  • Marcacci M, Molgora AP, Zaffagnini S et al (2003) Anatomic double-bundle anterior cruciate ligament reconstruction with hamstrings. Arthroscopy 19:540–546

    Article  PubMed  Google Scholar 

  • Martelli S, Lopomo N, Bignozzi S et al (2007) Validation of a new protocol for navigated intraoperative assessment of knee kinematics. Comput Biol Med 37:872–878

    Article  PubMed  Google Scholar 

  • Meredick RB, Vance KJ, Appleby D et al (2008) Outcome of single-bundle versus double-bundle reconstruction of the anterior cruciate ligament: a meta-analysis. Am J Sports Med 36:1414–1421

    Article  PubMed  Google Scholar 

  • Muneta T, Sekiya I, Ogiuchi T et al (1998) Effects of aggressive early rehabilitation on the outcome of anterior cruciate ligament reconstruction with multi-strand semitendinosus tendon. Int Orthop 22:352–356

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  • Natri A, Jarvinen M, Latuala K et al (1996) Isokinetic muscle performance after anterior cruciate ligament surgery. Int J Sports Med 17:223–228

    Article  PubMed  CAS  Google Scholar 

  • Sachs RA, Daniel DM, Stone ML et al (1989) Patellofemoral problems after anterior cruciate ligament reconstruction. Am J Sports Med 17:760–765

    Article  PubMed  CAS  Google Scholar 

  • Shino K, Nakagawa S, Inoue M et al (1993) Deterioration of patellofemoral articular surface after anterior cruciate ligament reconstruction. Am J Sports Med 21:206–211

    Article  PubMed  CAS  Google Scholar 

  • Simonian PT, Harrison SD, Cooley WJ et al (1997) Assessment of morbidity of semitendinosus and gracilis tendon harvested for ACL reconstruction. Am J Knee Surg 10:54–59

    PubMed  CAS  Google Scholar 

  • Wilk KE, Keirns MA, Andrews JR et al (1991) Anterior cruciate ligament reconstruction rehabilitation: a six-month follow-up of isokinetic testing in recreational athletes. Isokinet Exerc Sci 1:36–43

    Google Scholar 

  • Zaffagnini S, Golano P, Farinas O et al (2003) Vascularity of the pes anserinus: anatomic study. Clin Anat 16:19–24

    Article  PubMed  CAS  Google Scholar 

  • Zaffagnini S, Martelli S, Acquaroli F (2004) Computer investigation of ACL orientation during passive range of motion. Comput Biol Med 34:153–163

    Article  PubMed  CAS  Google Scholar 

  • Zaffagnini S, Signorelli C, Lopomo N et al (2012) Anatomic double-bundle and over-the-top single-bundle with additional extra-articular tenodesis: an in vivo quantitative assessment of knee laxity in two different ACL reconstructions. Knee Surg Sports Traumatol Arthrosc 20:153–159

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Stefano Zaffagnini .

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Zaffagnini, S. et al. (2014). Alternative Techniques for Double-Tunnel Anatomic ACL Reconstruction . In: Doral, M., Karlsson, J. (eds) Sports Injuries. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-36801-1_93-11

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  • DOI: https://doi.org/10.1007/978-3-642-36801-1_93-11

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  • Online ISBN: 978-3-642-36801-1

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