Acta Scientific Orthopaedics (ISSN: 2581-8635)

Opinion Volume 3 Issue 12

“Double Bundle - Single Tunnel” Hamstring Graft Fixation in Femur

Rajkovic Stanislav1*, Vukomanovic Boris2 and Jeremic Danilo1

1Departement for Orthopaedic, Institute for Orthopaedics “Banjica”, Belgrade, Serbia
2Departement for Surgery, University of Belgrade, Serbia

*Corresponding Author: Rajkovic Stanislav, Departement for Orthopaedic, Institute for Orthopaedics “Banjica”, Belgrade, Serbia.

Received: October 31, 2020; Published: November 18, 2020

×

Abstract

Purpose: An original technique of introducing hamstring graft into the femoral tunnel and its’ fixation which forms an anatomic double bundle anterior cruciate ligament (ACL).

Materials and Methods: Hamstring tendon graft is prepared with a “head”, “body” and two “tails”. The femoral tunnel is drilled at the Resident’s and Bifurcation ridge junction through the anteromedial portal and subtunnels are prepared. The graft is introduced into the knee - “body” in the femoral tunnel, “tails” in one subtunnel and “head” in the other. Fixation is done by an absorbable interference screw. The “head” and the “tails” are twisted inside the tibial tunnel. Fixation in the tibial tunnel is done by an absorbable interference screw.

Discussion and Conclusion: This technique eliminates “bungee” and “windshield wiper” effect, anatomic position of the graft is achieved and risk of “blow out” effect and graft damage during screw insertion is significantly reduced.

Keywords: Cruciate; Ligament; Reconstruction; Arthroscopy; Sports; Injury

×

References

  1. Brown CH., et al. “The use of hamstring tendons for anterior cruciate ligament reconstruction: technique and results”. Clinics in Sports Medicine 12 (1993): 723-756.
  2. Fu FH., et al. “Current trends in anterior cruciate ligament reconstruction, part 1: biology and biomechanics of reconstruction”. American Journal of Sports Medicine 27 (1999): 821-830.
  3. Shultz WR and Carr CF. “Comparison of clinical outcomes of reconstruction of anterior cruciate ligament: autogenous patellar tendon and hamstring grafts”. The American Journal of Orthopedics 31 (2002): 613-620.
  4. Eriksson K., et al. “A comparison of quadruple semitendinosus and patellar tendon grafts in reconstruction of the anterior cruciate ligament”. The Journal of Bone and Joint Surgery British 83 (2001): 348-354.
  5. Rodeo SA., et al. “Tendon healing in a bone tunnel: a biomechanical and histological study in the dog”. The Journal of Bone and Joint Surgery American 75 (1993): 1795-180.
  6. Aune AK., et al. “Intereference screw fixation of hamstrings vs. patellar tendon grafts for anterior cruciate ligament reconstruction”. Knee Surgery, Sports Traumatology, Arthroscopy 6 (1998): 99-102.
  7. Clatworthy MG., et al. “Tunnel widening in anterior cruciate ligament reconstruction: a prospective evaluation of hamstring and patella tendon grafts”. Knee Surgery, Sports Traumatology, Arthroscopy 7 (1999): 138-145.
  8. Mologne TS and Friedman MJ. “Graft options for ACL reconstruction”. The American Journal of Orthopedics 29 (2000): 845-853.
  9. Dejour D., et al. “Double-bundle bone-patellar tendon-bone and gracilis in ACL reconstruction”. Knee Surgery, Sports Traumatology, Arthroscopy 20 (2012): 2239-2242.
  10. Beard D., et al. “Hamstrings vs. patella tendon for anterior cruciate ligament reconstruction: a randomised controlled trial”. Knee 8 (2001): 45-50.
  11. Purnell ML., et al. “Anterior cruciate ligament insertions on the tibia and femur and their relationships to critical bony landmarks using high-resolution volume rendering computed tomography”. American Journal of Sports Medicine 36 (2008): 2083-2090.
  12. Schreiber VM., et al. “Anatomic double-bundle ACL reconstruction”. Sports Medicine and Arthroscopy 18 (2010): 27-32.
  13. Morgan CD., et al. “Anatomic tibial graft fixation using a retrograde bio interference screw for endoscopic anterior cruciate ligament reconstruction”. Arthroscopy 7 (2002): e38.
  14. Uribe JW., et al. “Two-year outcome with the Aper-Fix System for ACL reconstruction”. Orthopedics 36 (2013): 159-164.
  15. Mae T., et al. “Force sharing between two grafts in the anatomical two-bundle anterior cruciate ligament reconstruction”. Knee Surgery, Sports Traumatology, Arthroscopy 14 (2006): 505-509.

 

×

Citation

Citation: Rajkovic Stanislav., et al. ““Double Bundle - Single Tunnel” Hamstring Graft Fixation in Femur".Acta Scientific Orthopaedics 3.12 (2020): 28-32.




Metrics

Acceptance rate33%
Acceptance to publication20-30 days

Indexed In



News and Events


  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is November 25, 2024.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of "Best Article of the Issue"
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.

Contact US