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A new technique in double-bundle anterior cruciate ligament reconstruction using implant-free femoral fixation

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Abstract

Purpose

The study is a prospective case-series analysis to demonstrate a new double bundle technique for anterior cruciate ligament (ACL) reconstruction with the use of hamstring tendons through a single tibial tunnel, a double femoral socket with implant-free femoral fixation and interference screw for tibial fixation.

Materials and methods

Twenty-one patients were treated with the same technique. Hamstring tendons were not removed from the tibial side, and using a single tibial and a double femoral tunnel of 8 and 6 mm, respectively, anatomic ACL reconstruction was performed. Graft passage was performed from the tibial side to the posterolateral femoral tunnel and was looped back to the anteromedial femoral tunnel to be fixed on the tibial tunnel with an interference screw and additional extracortical fixation. Follow-up of the study group was performed for a two-year period, documenting standard clinical and radiographic parameters.

Results

Post-operative follow-up (mean 24 months) revealed radiological widening of tibial tunnel (mean 133.6%) in all patients and minor femoral tunnels widening (119.4% and 117.5%). Clinical evaluation showed no signs of instability, and knee evaluation using the IKDC score was performed.

Conclusion

The manuscript describes a novel technique in ACL reconstruction, and reports the radiographic results of tunnel widening and clinical scores. Implant-free femoral fixation led to minor tunnel widening similar to previously published data. Further studies need to be performed to compare the long-term results with different published techniques of cost-effective implant-free ACL reconstruction.

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Acknowledgement

The authors are thankful to the Santa Casa de São Paulo Support Center for Scientific Publications, Faculty of Medical Sciences, São Paulo, Brazil, and Catriona Holmes, Paris, France, for their editorial assistance.

Conflict of interest

The senior surgeon (DD) had a conflict of interest with SBM company (royalties), manufacturer of the used bioabsorbable screw. The rest of the authors declare that they have no conflicts of interest.

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Authors and Affiliations

  1. Santa Casa de São Paulo, Faculty of Medical Sciences, São Paulo, Brazil

    Rodrigo Kancelskis Prado, Patrícia M. B. Fucs & Nilson Roberto Severino

  2. Lyon-Ortho-Clinic, Clinique Emilie de Vialar, 116, Rue Antoine Charial, 69003, Lyon, France

    Panagiotis G. Ntagiopoulos & David Dejour

Authors
  1. Rodrigo Kancelskis Prado
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  2. Panagiotis G. Ntagiopoulos
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  3. Patrícia M. B. Fucs
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  4. Nilson Roberto Severino
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  5. David Dejour
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Corresponding author

Correspondence to David Dejour.

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Prado, R.K., Ntagiopoulos, P.G., Fucs, P.M.B. et al. A new technique in double-bundle anterior cruciate ligament reconstruction using implant-free femoral fixation. International Orthopaedics (SICOT) 36, 1479–1485 (2012). https://doi.org/10.1007/s00264-012-1488-7

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  • DOI: https://doi.org/10.1007/s00264-012-1488-7

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