• Title/Summary/Keyword: Double bundle technique

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Anatomic Double-Bundle Posterior Cruciate Ligament Reconstruction Using Achilles Allograft - Preliminary Report - (이중고리 동종 아킬레스건을 이용한 후방십자인대 재건 - 예비 보고 -)

  • Lim, Hong-Chul;Yoo, Jae-Chul;Han, Sang-Hwan
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.1
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    • pp.7-13
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    • 2002
  • Purpose : Preliminary report of the technique and trial of double bundle PCL reconstruction using Achilles allograft. Materials and Methods : From May 1999 to July 2000, 8 cases of PCL insufficient patients were treated with Achilles allograft reconstruction using the double bundle and double femoral tunnel technique. The tibial tunnel was prepared anteromedially. All other combined injuries within the knees were treated accordingly. Minimal follow-up period was 1 year. The results was assessed from the point of function and stability using Lysholm knee score and KT-2000 arthrometer. Results : Up to present follow up. 8 patients showed good sign of recovery with no instability (translation less than 2 mm) except olio that has been grafted-ligament rupture. In addition, none showed any sign of infection nor ROM limitation. Two complications were seen, which one had grafted-bone fracture and the other grafted-ligament rupture. The former occurred during operation and the latter occurred due to improper protection. Conclusion : Presently the follow up period is too short to draw any conclusive opinion but it is essential to select healthy and well sterilized allografts fur successful outcome. Double femoral tunnel technique seems to be more physiologic in PCL reconstruction. With these prerequisites, it seems to be a good alternative to use Achilles allografts fur the reconstruction of PCL. However, a longer follow-up is needed.

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What Has Been Learned in Anterior Cruciate Ligament Reconstruction during the Past 20 Years? (전방십자인대 재건수술은 지난 20년간 어떻게 발전하였나?)

  • Ro, Du Hyun;Han, Hyuk-Soo;Lee, Myung Chul
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.1
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    • pp.1-13
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    • 2021
  • Considerable progress on anterior cruciate ligament reconstruction surgery has been made over the past 20 years, and the results have improved significantly. An anatomical understanding of the anterior cruciate ligament has also changed, and the surgical technique has also changed accordingly. The double-bundle concept is still valid, but the ribbon-shaped anterior cruciate ligament concept, including direct fiber and indirect fiber, is gradually replacing it. The isometry point theory no longer exists, and various surgical methods, such as single-bundle anatomical reconstruction, double-bundle reconstruction, remnant preservation, and rectangular tunnel technique, are being performed. Regarding the graft, interest in the bone-patellar tendon-bone, patellar tendon, quadriceps tendon, and allogeneic tendon change over time, and this change is ongoing.

Overview of the PCL Reconstruction (후방 십자 인대 손상 치료의 개관(over view))

  • Jung, Young Bok
    • Journal of the Korean Arthroscopy Society
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    • v.2 no.1
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    • pp.1-3
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    • 1998
  • The PCL reconstruction in chronic isolate PCL reconstruction was still controversy. 1) In isolate PCL deficient knee, functionally not so bad as like ACL deficient knee. 2) The result of the PCL reconstruction was not as good as ACL reconstruction. Therefore, isolate PCL injuries has been treated as nonoperatively. Hey Grovere, who was the first to attempt an intra-articular reconstruction of the PCL, utilized the semi-tendinous tendon other static procedures have been described in only a few cases with very limited follow-up. Dynamic procedures utilizing the medial head of the gastrocnemius has been reported by Hugston and Degenhardt, Kennedy and Grainger, and Insall and Hood. These procedures did not improve static stability. Dr Clancy, who was introduce the use of BPTB for the PCL reconstruction transtibial and femoral tunnel. From 1995, untill early 1990 PCL reconstruction was done as tend as placement of the isometric point. Physiometic placement of Anatomical placement of the femoral tunnel in PCL reconstruction were introduced in 1995. Tibial Inlay Technique was reported by Dr Berg in 1995. The main advantage of the tibial Inlay Technique was to avoid fraying of the graft at the posterior tibial tunnel orifice. In complete PCL ruptured and severely posterior unstable knee, dual femoral tunnel technique will be to get better result than one bundle technique. To achieve restoration of normal posterior laxity, it is critical to address the posterior as well as the posterolateral structures. Futher research is necessary to evaluate new surgical approches such as double-bundle reconstructions and tibial inlay techniques as well as improved techniques for capsular and collateral ligament injuries.

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Minimal Ablation of the Tibial Stump Using Bony Landmarks Improved Stability and Synovial Coverage Following Double-Bundle Anterior Cruciate Ligament Reconstruction

  • Kodama, Yuya;Furumatsu, Takayuki;Hino, Tomohito;Kamatsuki, Yusuke;Ozaki, Toshifumi
    • Knee surgery & related research
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    • v.30 no.4
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    • pp.348-355
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    • 2018
  • Purpose: To evaluate the clinical effects of using anatomical bony landmarks (Parsons' knob and the medial intercondylar ridge) and minimal ablation of the tibial footprint to improve knee anterior instability and synovial graft coverage after double-bundle anterior cruciate ligament reconstruction. Materials and Methods: We performed a retrospective comparison of outcomes between patients who underwent reconstruction with minimal ablation of the tibial footprint, using an anatomical tibial bony landmark technique, and those who underwent reconstruction with wide ablation of the tibial footprint. Differences between the two groups were evaluated using second-look arthroscopy, radiological assessment of the tunnel position, postoperative anterior knee joint laxity, and clinical outcomes. Results: Use of the anatomical reference and minimal ablation of the tibial footprint resulted in a more anterior positioning of the tibial tunnel, with greater synovial coverage of the graft postoperatively (p=0.01), and improved anterior stability of the knee on second-look arthroscopy. Both groups had comparable clinical outcomes. Conclusions: Use of anatomical tibial bony landmarks that resulted in a more anteromedial tibial tunnel position improved anterior knee laxity, and minimal ablation improved synovial coverage of the graft; however, it did not significantly improve subjective and functional short-term outcomes.

Current Concepts in Reconstruction of Anterior Cruciate Ligament (전방십자인대 재건술의 경향)

  • Yoon, Kyoung Ho
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.12 no.1
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    • pp.1-7
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    • 2013
  • This article provides an overview of the current concepts regarding anterior cruciate ligament reconstruction, including anatomy, biomechanics, operative techniques and clinical results. Many techniques have been introduced for ACL reconstruction: single bundle reconstruction, remnant preserving augmentation, and double bundle reconstruction. Each technique has its strong and weak points, and it is not sure which technique is superior than others. It is considered to suggest that rather than to select the same method of surgery in all patients, select the method of reconstruction depending on the characteristics of the individual patient, the state of the residual ligaments and extent of the damage.

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