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.
Similar content being viewed by others
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
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
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
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
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
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
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
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
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
Marcacci M, Molgora AP, Zaffagnini S et al (2003) Anatomic double-bundle anterior cruciate ligament reconstruction with hamstrings. Arthroscopy 19:540–546
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
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
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
Natri A, Jarvinen M, Latuala K et al (1996) Isokinetic muscle performance after anterior cruciate ligament surgery. Int J Sports Med 17:223–228
Sachs RA, Daniel DM, Stone ML et al (1989) Patellofemoral problems after anterior cruciate ligament reconstruction. Am J Sports Med 17:760–765
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
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
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
Zaffagnini S, Golano P, Farinas O et al (2003) Vascularity of the pes anserinus: anatomic study. Clin Anat 16:19–24
Zaffagnini S, Martelli S, Acquaroli F (2004) Computer investigation of ACL orientation during passive range of motion. Comput Biol Med 34:153–163
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
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2014 Springer-Verlag Berlin Heidelberg
About this entry
Cite this entry
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
Download citation
DOI: https://doi.org/10.1007/978-3-642-36801-1_93-11
Received:
Accepted:
Published:
Publisher Name: Springer, Berlin, Heidelberg
Online ISBN: 978-3-642-36801-1
eBook Packages: Springer Reference MedicineReference Module Medicine