Arthroscopic double bundle ACL reconstruction using a bone patellar tendon bone-gracilis tendon composite autograft:...

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomechanical Engineering

Background:

• Anterior cruciate ligament (ACL) injuries are common, often requiring surgical reconstruction.
• Traditional ACL reconstruction techniques may have limitations in restoring full knee function and rotational stability.
• Double-bundle reconstruction aims to more accurately replicate the native ACL's anatomy and function.

Purpose of the Study:

• To describe and evaluate an alternative arthroscopic double-bundle ACL reconstruction technique.
• To utilize a composite autograft comprising bone-patellar tendon-bone (BPTB) and gracilis tendon.
• To assess the potential benefits of this technique regarding tunnel widening, revision ease, and rotational stability.

Main Methods:

• Arthroscopic technique employing one tibial and two femoral tunnels for double-bundle ACL reconstruction.
• Utilizing a composite autograft: BPTB for one bundle and gracilis tendon for the other.
• Fixation of the BPTB graft in isometric tibial and femoral tunnels using conventional methods.
• Fixation of the gracilis tendon in a postero-lateral (PL) tunnel via an outside-in technique.

Main Results:

• The described technique allows for the reconstruction of both anteromedial (AM) and PL bundles of the ACL.
• The composite graft offers a novel approach to ACL reconstruction.
• Potential benefits include minimized post-operative tunnel widening and facilitated revision surgery.

Conclusions:

• The devised arthroscopic double-bundle ACL reconstruction technique using a BPTB-gracilis composite autograft is a viable alternative.
• This method may offer advantages in reducing tunnel widening and simplifying future revisions.
• The technique shows promise in restoring rotational stability of the knee following ACL injury.