ΣΥΝΔΕΣΜΟΠΛΑΣΤΙΚΗ ΠΡΟΣΘΙΟΥ ΧΙΑΣΤΟΥ ΣΥΝΔΕΣΜΟΥ ΜΕ ΜΟΝΗ ΔΕΣΜΗ ΣΕ ΑΝΑΤΟΜΙΚΗ ΘΕΣΗ. ΠΕΡΙΓΡΑΦΗ ΤΕΧΝΙΚΗΣ
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(Παρουσίαση σε Διεθνές Συνέδριο Εταιρείας Αρθροσκόπησης & Χειρουργικής Γόνατος της Πολωνίας, POZNAN 2011). FREE HAND NOVEL ANATOMIC SINGLE BAND TECHNIQUE FOR ACLR (X/O BUTTON,CONMED,LINVATEC,USA).PRELIMINARY RESULTS. (POZNAN 2011)
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ΣΥΝΔΕΣΜΟΠΛΑΣΤΙΚΗ ΠΡΟΣΘΙΟΥ ΧΙΑΣΤΟΥ ΣΥΝΔΕΣΜΟΥ ΜΕ ΜΟΝΗ ΔΕΣΜΗ ΣΕ ΑΝΑΤΟΜΙΚΗ ΘΕΣΗ. ΠΕΡΙΓΡΑΦΗ ΤΕΧΝΙΚΗΣ
- 1. FREE HAND NOVEL ANATOMIC SINGLE BAND TECHNIQUE FOR ACLR (X/O BUTTON,CONMED,LINVATEC,USA). PRELIMINARY RESULTS. ALEVROGIANNIS STAVROS,MD,PhD ORTHOPAEDIC SURGEON S. CONSULTANT IN SPORTS INJURIES. ATHENS/GREECE
- 9. S.B ACLR
- 13. MRI MEASUREMENT TECHNIQUES AT angle -Anterior edge of ACL -Medial tibial plateau
- 18. FEMORAL TUNNELS IN D.B TECHNIQUE
- 19. ANATOMIC D.B SURGICAL TECHNIQUE
- 25. ANATOMICAL POINTS FOR FEMORAL DRILLING
- 28. ACL GRAFT LENGTH
- 30. FEMORAL TUNNEL IN ANATOMICAL S.B TECHNIQUE The femoral tunnel is low and overlaps both the AM and PL anatomical sites
- 32. TIBIAL DRILLING IN ANATOMIC S.B ACLR
- 34. GRAFT SPIPPAGE & FIXATION
- 36. MATERIAL
- 37. PRE-OP IKDC PASSIVE MOTION DEFICIT
- 56. ACLR (JewelAcl-X/O BUTTON) + in elite 25 y. male athlete.
- 57. ACLR (JewelAcl-X/O BUTTON) + CHONDROPLASTY MFC(Chondromimetic) in a non-competitive 41 y.female athlete.
- 60. Thank you!
Editor's Notes
- Place the guide at the center of the ACL Footprint. Advance the Pin a few millimeters to notch the bone. Then check to ensure that the pin correlates to the mark made earlier. Use a twisting motion to remove the Femoral Footprint Guide.
- Insert the mono-fluted Sentinel Drill Bit over the guide pin through the accessory anteromedial portal with the cutting edge facing away from the femoral condyle and advance the Drill Bit to the femoral ACL footprint. Using a piston-like back and forth motion, drill the femoral socket to the desired depth cautiously to prevent blow out of the lateral femoral cortex. Keeping the hand off of the trigger, slide the Sentinel Drill Bit past the medial femoral condyle and out of the portal, making sure to keep the blade oriented away from the condylar surface.
- Use the XO Button Drill Bit to drill the femoral channel. Advance the drill bit through the lateral cortex. Using the XO Button Drill Bit as you would use a standard depth gauge, manually pull back on the bit to hook the head of the drill bit on the external femoral cortex to confirm the aperture to cortex length. Remove the XO Button Drill Bit leaving the graft passing guide pin in place. Place the two free ends of the #2 passing suture through the eyelet of the guide pin. Then, pull the guide pin through the femur laterally, making sure to keep a finger in the suture loop to prevent it from being pulled into the knee joint. Once the suture ends are retrieved laterally, pull the looped end of the suture all the way to the entrance of the femoral tunnel.
- Set the angle of the Pinn-ACL Guide to 55 degrees. Insert the tip into the anteromedial portal, placing the tip of the guide into the center of the tibial ACL footprint. Next, advance the external guide sleeve flush to the anterior tibial cortex. Using the ConMed Linvatec M-Power 2 handpiece and pin-driver attachment, advance the guide pin until it meets the point of the guide arm. Then, depress the Pinn-ACL drill guide lever to remove the sleeve. Remove the Pinn-ACL guide from the guide pin and joint. Place a curette over the point of the guide pin to protect against inadvertent advancement when drilling. Use the appropriate size Badger or Sentinel Drill Bit to drill the tibial tunnel.
- Using the appropriate size SE Graft Tensioner Drill/Guide, place the guide in the tibial tunnel and position two Breakaway pins and then remove the guide Retrieve the loop through the tibial tunnel using Suture Retrieval Forceps. With the suture loop exposed externally, load the suture strands of the XO Button loaded graft into the passing suture loop and pull them through the femoral tunnel, making sure to keep the graft construct outside of the tibia. Tying the appropriate bundle strands to the left and right tensioner wheels allows the bundles to be individually and accurately tensioned. Apply the desired graft tension and then cycle the knee to alleviate laxity. Hold the knee at fifteen degrees and set the desired final tension.