NDLI: Medial portal technique for single-bundle anatomical Anterior Cruciate Ligament (ACL) reconstruction

Content Provider	PubMed Central
Author	Brown, Charles H. Spalding, Tim Robb, Curtis
Abstract	The aim of the paper is to describe the medial portal technique for anatomical single-bundle anterior cruciate ligament (ACL) reconstruction. Placement of an ACL graft within the anatomical femoral and tibial attachment sites is critical to the success and clinical outcome of ACL reconstruction. Non-anatomical ACL graft placement is the most common technical error leading to recurrent instability following ACL reconstruction. ACL reconstruction has commonly been performed using a transtibial tunnel technique in which the ACL femoral tunnel is drilled through a tibial tunnel positioned in the posterior half of the native ACL tibial attachment site. ACL reconstruction performed using a transtibial tunnel technique often results in a vertical ACL graft, which may fail to control the combined motions of anterior tibial translation and internal tibial rotation which occur during the pivot-shift phenomenon. The inability of a vertically oriented ACL graft to control these combined motions may result in the patient experiencing continued symptoms of instability due to the pivot-shift phenomenon. The medial portal technique in which the ACL femoral tunnel is drilled through an anteromedial or accessory anteromedial portal allows consistent anatomical ACL tunnel placement. This paper describes the advantages of the medial portal technique, indications for the technique, patient positioning, proper portal placement, anatomical femoral and tibial tunnel placement, graft tensioning and fixation.
Related Links	http://dx.doi.org/10.1007/s00264-012-1772-6
Ending Page	269
Page Count	17
Starting Page	253
File Format	PDF
ISSN	03412695
e-ISSN	14325195
Journal	International Orthopaedics
Issue Number	2
Volume Number	37
Language	English
Publisher	Springer-Verlag
Publisher Date	2013-02-01
Access Restriction	Open
Rights Holder	Springer-Verlag
Subject Keyword	Orthopedics and Sports Medicine Research in Higher Education
Content Type	Text
Resource Type	Article
Subject	Orthopedics and Sports Medicine Surgery

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