Zaffagnini Stefano, Marcheggiani Muccioli Giulio Maria, Bonanzinga Tommaso, Nitri Marco, Grassi Alberto, Marcacci Maurilio
Laboratorio di Biomeccanica, Istituto Ortopedico Rizzoli, via di Barbiano, 1/10, 40100 Bologna, Italy.
Musculoskelet Surg. 2013 Apr;97(1):39-43. doi: 10.1007/s12306-012-0230-3. Epub 2012 Dec 12.
This article describes an anatomic, double-bundle, arthroscopic anterior cruciate ligament reconstruction technique with hamstrings using second-generation out-in retrograde femoral drills, second-generation cortical femoral suspensory fixation devices with adjustable graft loop length, standard out-in tibial drills, and titanium low-profile tibial staples. Grafts choice is autologous gracilis and semitendinosus tendons. They are harvested through the single minimally invasive tibial incision maintaining their tibial insertion. Sutures are tightened at the free proximal tendon ends to obtain a sufficient strength to traction. The grafts are reflected in two separate loops and linked to femoral adjustable TightRope graft loops. With this method, grafts length can be customized to the anatomy of every knee and their tension can be increased even after graft fixation. The preservation of tendons tibial insertion could improve the neoligamentization process, acting as a tenodesis.
本文介绍了一种采用第二代逆行股骨钻、移植物环长度可调节的第二代皮质股骨悬吊固定装置、标准的经胫骨由外向内钻孔技术以及钛质低轮廓胫骨钉的解剖学双束关节镜下腘绳肌前交叉韧带重建技术。移植物选择自体股薄肌腱和半腱肌腱。通过单一微创胫骨切口获取移植物，保留其胫骨附着点。在游离的近端肌腱末端收紧缝线，以获得足够的牵引强度。将移植物折成两个独立的环，并与股骨可调节TightRope移植物环相连。采用这种方法，移植物长度可根据每个膝关节的解剖结构进行定制，并且即使在移植物固定后也可增加其张力。保留肌腱的胫骨附着点可改善新韧带形成过程，起到韧带固定作用。
