Anatomical reconstruction of the anterior cruciate ligament. Surgical technique and case reports

Authors

  • Germán Alejandro Jaramillo Quiceno Clínica del Norte. Medellín, Colombia
  • Pilar Duque Orozco Universidad Pontificia Bolivariana. Medellín, Colombia
  • Iván Darío Agudelo Zuluaga Clínica Saludcoop. Medellín, Colombia
  • Antonio Paz Venencia Clínica Saludcoop. Medellín, Colombia
  • Julián Alberto Castro Padilla Clínica Saludcoop. Medellín, Colombia

DOI:

https://doi.org/10.1016/j.rccot.2017.03.003

Keywords:

anterior cruciate ligament, femoral tunnel, medial portal, arthroscopic reconstruction

Abstract

Background: The main objective in the reconstruction of the anterior cruciate ligament is to restore knee biomechanics, provide adequate stability, and a function free of pain in order to return to the activity level prior to injury. The objective of the study is to present the surgical technique used, as well as the outcomes of our case series.
Materials & methods: A retrospective study was designed, to subjectively and clinically evaluate a sample of patients who underwent reconstruction of the anterior cruciate ligament with the medial portal technique. The Lysholm scale was used for the subjective evaluation of the patient, after completing rehabilitation and returning to work activities.
Results: The mean pre-surgical score on the Lysholm scale was 50.3 (16-90), with a mean postsurgical score 85.5 (20-95). Low post-surgical scores were associated with patients who had lateral pain when TransFix® was used as the fixation technique.
Discussion: The femoral tunnel by anteromedial portal in the reconstruction of the anterior cruciate ligament is a variation of the traditional arthroscopic technique that can be performed safely when taking clear anatomical parameters into account.
Evidence level: IV.

Downloads

Download data is not yet available.

Author Biographies

Germán Alejandro Jaramillo Quiceno, Clínica del Norte. Medellín, Colombia

Ortopedista, Universidad Pontificia Bolivariana, Medellín; Fellow de Cirugía Artroscópica y Trauma Deportivo, Universidad El Bosque; Servicio de Ortopedia, Clínica Saludcoop y Clínica del Norte, Medellín, Colombia.

Pilar Duque Orozco, Universidad Pontificia Bolivariana. Medellín, Colombia

Residente de segundo año de Ortopedia, Universidad Pontificia Bolivariana, Medellín, Colombia.

Iván Darío Agudelo Zuluaga, Clínica Saludcoop. Medellín, Colombia

Médico general, Servicio de Cirugía, Clínica Saludcoop, Medellín, Colombia.

Antonio Paz Venencia, Clínica Saludcoop. Medellín, Colombia

Médico general, Servicio de Cirugía, Clínica Saludcoop, Medellín, Colombia.

Julián Alberto Castro Padilla, Clínica Saludcoop. Medellín, Colombia

Médico general, Servicio de Cirugía, Clínica Saludcoop, Medellín, Colombia.

References

Steiner ME, Battaglia TC, Heming JF, Rand JD, Festa A, Baria M. Independent drilling outperforms conventional transtibial drilling in ACL reconstruction. Am J Sports Med. 2009;37:1912-9. https://doi.org/10.1177/0363546509340407

Howell SM, Gittins ME, Gottlieb JE, Traina SM, Zoellner TM. The relationship between the angle of the tibial tunnel in the coronal plane and loss of flexion and anterior laxity after anterior cruciate ligament reconstruction. Am J Sports Med. 2001;29:567-74. https://doi.org/10.1177/03635465010290050801

Ho JY1, Gardiner A, Shah V, Steiner ME. Equal kinematics between central anatomic single bundle and double bundle ACL reconstructions. J Arthroscopy. 2009;25:464-72. https://doi.org/10.1016/j.arthro.2009.02.013

Meredick KJ, Vance D. Appleby. Outcome of single-bundle versus double-bundle reconstruction of the anterior cruciate ligament. Am J Sports Med. 2008;36:1414. https://doi.org/10.1177/0363546508317964

Noyes FR. The function of the human anterior cruciate ligament and analysis of single- and double-bundle graft reconstructions sports health: A multidisciplinary approach. Sports Health. 2009;1:66-75. https://doi.org/10.1177/1941738108326980

Shen W, Forsythe B, Ingham SM, Honkamp NJ, Fu FH. Application of the anatomic double-bundle reconstruction concept to revision and augmentation anterior cruciate ligament surgeries. J Bone Joint Surg Am. 2008;90:20-34. https://doi.org/10.2106/JBJS.H.00919

Chhabra A, Kline AJ, Nilles KM, Harner CD. Tunnel expansion after anterior cruciate ligament reconstruction with autogenous hamstrings: a comparison of the medial portal and transtibial techniques. Arthroscopy. 2006;22:1107-12. https://doi.org/10.1016/j.arthro.2006.05.019

Heming JF, Rand J, Steiner ME. Anatomical limitations of transtibial drilling in anterior cruciate ligament reconstruction. Am J Sports Med. 2007;35:1708-15. https://doi.org/10.1177/0363546507304137

Nakamura M, Deie M, Shibuya H, Nakamae A, Adachi N, Aoyama H, Ochi M. Potential risks of femoral tunnel drilling through the far anteromedial portal: a cadaveric study. Arthroscopy. 2009;25:481-7. https://doi.org/10.1016/j.arthro.2008.11.010

Smith HJ, Richardson JB, Tennant A. Modification and validation of the Lysholm Knee Scale to assess articular cartilage damage. Osteoarthritis Cartilage. 2009;17:53-8. https://doi.org/10.1016/j.joca.2008.05.002

Duthon VB, Barea C, Abrassart S, Fasel JH, Fritschy D, Ménétrey J. Anatomy of the anterior cruciate ligament. Knee Surg Sports Traumatol Arthrosc. 2006;14:204-13. https://doi.org/10.1007/s00167-005-0679-9

Fu FH, Bennett CH, Lattermann C, Ma CB. Current trends in anterior cruciate ligament reconstruction. Am J Sports Med. 1999;27:821-30. https://doi.org/10.1177/03635465990270062501

Bedi A, Altchek DW. The "footprint" anterior cruciate ligament technique: an anatomic approach to anterior cruciate ligament reconstruction. Arthroscopy. 2009;25:1128-38. https://doi.org/10.1016/j.arthro.2009.03.008

Published

2017-04-25

How to Cite

1.
Jaramillo Quiceno GA, Duque Orozco P, Agudelo Zuluaga ID, Paz Venencia A, Castro Padilla JA. Anatomical reconstruction of the anterior cruciate ligament. Surgical technique and case reports. Rev. Colomb. Ortop. Traumatol. [Internet]. 2017 Apr. 25 [cited 2025 May 10];31(2):63-7. Available from: https://revistasccotorg.biteca.online/index.php/rccot/article/view/360

Issue

Section

Original research