Endoscopic fixation of a double-looped semitendinosus and gracilis anterior cruciate ligament graft using bone mulch screw

Comparison of Endoscopic and Two-Incision Techniques for Reconstructing a Torn Anterior Cruciate Ligament Using Hamstring Tendons

“…However, a potential disadvantage of the endoscopic technique is the inability to freely position the femoral tunnel inside the intercondylar notch because the femoral tunnel is drilled through the tibial tunnel. Because the placement of the femoral tunnel determines graft tension (1)(2)(3)(4) and positioning of the femoral tunnel is constrained by the tibial tunnel with the endoscopic technique (5,6) knee stability may be worse compared to the two-incision technique in which the femoral tunnel is positioned independently from the tibial tunnel.…”

Avaliação dos resultados da reconstrução do ligamento cruzado anterior com tendões flexores e parafuso transverso de guia rígido

“…Camanho and Olivi (20) and Krause et al (11) demonstrated fixation of the flexor tendon graft using the Endobutton ® technique; but the rigidity necessary for the fixation was not known, and the Endobutton ® graft structure generates the "elastic recoil phenomenon", which can produce longitudinal movement of the graft inside the tunnels (18) . In 1996, Howell and Gottilieb (21) demonstrated good results with fixation of the flexor tendon graft using a transverse screw in the femur and a cancellous screw and washer in the tibia (Figure 5), increasing the rigidity of the structure. In this technique, although of good mechanical quality, the graft is passed and guided by direct vision in the femoral tunnel, which can present some technical difficulty, particularly at the start of the surgeon's learning curve.…”

Can an isometer predict the tensile behavior of a double‐looped hamstring graft during anterior cruciate ligament reconstruction?

“…The knee was inspected arthroscopically, and unstable incniscal tcars were either repaired or partially excised. Thc tibial tunnel was drilled after custcxni7,ing the position and angle of the tibial tunnel to account for variability in knec extcnsion and roof angle (9)(10)(11)(12). An endoscopic femoral aimer.…”

“…An endoscopic femoral aimer. siLed spccifically for thc diameter of the graft (Arthrotek), was inserted through the tibial tunnel to place a guide wire 5-7 mm distal to the proximal edge of the intercondylar roof at approximately 11 o'clock for the right knee or 1 o'clock for the lcft knee (11). With the provisional femoral site identified, the guide wire was removed and isometric testing was conducted.…”